Much of our collective anxiety around the movement of people is grounded in our fears about how ‘The Great Acceleration’ (that immense increase in human activity that has occurred since the 18th century) is getting ever faster. In our globally connected world, everything is in movement…. Sometimes we enjoy it, especially the goods, experiences and information that this connectivity brings us, but often we are worried by how this new world is eroding old certainties.
This new level of uncertainty is not going away; and Brexit add to the uncertainty – at least in the short term. So finding the social structures to handle uncertainty will be a key challenge of this century – whatever the formal relationship between London and Brussels.
Of course uncertainty in human affairs is not new, but now the scale of the effects is so large, and those effects often seem as if they are arriving too fast to manage. At one time, a clan, a tribe or even a nation, might have faced an existential challenge and failed, dying out and leaving just some ruins in the forest for posterity. But, until the current ‘Anthropocene Age’ truly got under way, the effects were local, often slow, and plenty of us survived even the worst crisis.
The new hyper-connectivity that the human race has created is also effecting the other living beings with whom we share our world. Bacteria and other microbes, for example, can also take advantage of the free movement of people, goods and services to piggy-back around the world ever faster and more widely.
The increasing ineffectiveness of antibiotics
Bacteria alone number about five million trillion trillion (according to the careful counters at the University of Georgia); that’s a ‘5’ with 30 zeroes added. Almost all of them are very friendly, helpful, well integrated beings, and quite a few trillion contribute to human well-being directly by working in our guts. But a few, enough, can be very harmful and our ability to harness anti-microbial drugs (e.g. antibiotics) to fight them has, since the late 1920s, marked a great leap forward in the role played by science in reducing human suffering.
Now, in 2016, we are facing a new collective challenge that is being multiplied in size by the power of globalisation; namely the impending end of the effectiveness of major antibiotics that we have relied on for 60 years. Simply put, we’ve worn out their efficacy and there appear to be very few new ones coming on stream.
As last month’s O’Neill Report for the British Government makes clear, anti-microbial drug resistance (AMR) is spreading across the world and by 2050 more people will be dying from it annually than from cancer – some 10 million globally, per annum.
It’s our own fault, of course, we have been spraying antibiotics around like ‘wonder drugs’, using them in animal care and so on, without paying heed to the consequences.
Large populations of microbes are developing AMR and global travel will bring them to our doorstep. It’s salutary to remember that penicillin itself was found by Fleming while researching influenza, the virus that killed up to 100 million in 1918-20 after infecting half a billion people.
The market has not stepped in to solve the issue because developing new antimicrobial drugs is not currently profitable, given the current long lead times; and many of the causes of AMR lie in prescribing practices and overuse.
This is a classic issue for combined government action, for example at the European or UN level.
One key recommendation of the O’Neill report is to encourage the development of new antimicrobial drugs with ‘market entry rewards’ funded (O’Neill hopes) by the G20. But, as well as this and other actions, I believe health providers need to learn more about managing innovation from entities like Google, Apple and others in the Tech world.
Giant businesses like Big Pharma and giant institutions like Britain’s NHS don’t find it easy to innovate at speed (although the NHS has recently launched the NHS Innovation Accelerator) but the AMR issue would be a good test case.
As with other areas of innovation, it’s important to observe necessary safety parameters, but we must not allow this to prevent innovation or we may end up with even greater safety risks in the long term.
There are trillions of global migrants, none of whom respect any borders, just about to cause us a great deal of grief. They may be individually microscopic, but together they amount to a big challenge for us all to beat together… and that will certainly need innovation!