Antibiotics and the tragedy of the commons

I've been turfing through the pile of research materials I've gathered over the past two years and finding gems I had forgotten about. Here's one, from a post at Pioneering Ideas, a blog dealing with projects funded by the Robert Wood Johnson Foundation. One of RWJF's projects is "Extending the Cure," which seeks to reframe thinking about antibiotic use and stewardship by viewing them as economic and social-science problems rather than as medical problems.

In a guest post last year, Ramanan Laxminarayan, PhD, a senior fellow at Resources for the Future, explains the central problem in beautifully clear language:

[A]ntibiotic resistance is not always going to show up as a ‘crisis’ type of problem. ...

Sure - a set of circumstances such as a new strain of influenza that facilitates secondary infections such as Staphylococcus aureus that cannot be treated easily would result in a crisis. But the more likely scenario is one where, ten years from now, we are all using antibiotics that cost $1,000 or more a treatment course and none of the cheaper antibiotics work. This has a ripple effect on productivity of other medical technologies such as transplants and surgeries and on overall health care costs and insurance premiums. Since no one insurer is affected differently than others, there is no incentive for anyone to act.

Just as there is not going to be a single ‘day that the oil runs out’ and we have to think of solutions to our energy needs twenty-to- fifty years from now, we also have to start thinking of our antibiotics portfolio twenty-to-fifty years from now.

The full post is here.