Solutions Needed for Antibiotic Resistance
resistant infectious diseases have created a public health crisis worldwide.
The conventional reductionist approach is failing to cope. Sam Burcher
and Mae-Wan Ho argue for the revival of traditional healthcare systems,
and for the many safe and effective anti-microbials now documented among
indigenous plants that have been tried and tested for millennia.
Infectious diseases are responsible for one-quarter of all the deaths
in the world, second only to cardiovascular diseases . They are associated
with the new strains of bacteria and viruses emerging within the past
twenty-five years, which are also highly resistant to drugs and antibiotics.
become more difficult to treat, the severity of illness increases, as
does the duration of infectiousness, adverse reactions, the length of
convalescence and costs.
Drug and antibiotic resistant infectious diseases have created a public
health crisis worldwide, and this was the subject of a series of high
level international conferences in 1998, such as the World Health Assembly
and the European conference “The Microbial Threat”.
In Britain, the House of Lords Select Committee on Science and Technologies
and the Standing Medical Advisory Committee (SMAC) each produced a special
report on antimicrobial resistance . These resulted in an Antimicrobial
Resistance Strategy and Action Plan in June 2000 , which will cover
work for the next two years and will be advised by the new Expert Advisory
Committee on Antimicrobial Resistance.
The proposed strategies include, Surveillance - to monitor and provide
data on resistant organisms, illnesses associated with them and antimicrobial
Prudent antimicrobial use - to slow down evolution of resistance by reducing
unnecessary and inappropriate exposure of microorganisms to antimicrobial
agents in clinical practice, vet practice, animal husbandry, agriculture
Infection control - to reduce the spread of infection in general, thereby
reducing the use of anti-microbial agents and the spread of anti-microbial
Infection controls within hospitals and the community – promoting collaboration
between the European Union and the World Health Organization.
Research into the basic mechanisms of resistance - to find out how resistance
spreads, and how to prevent, treat and overcome resistance with novel
These strategies seem sensible, but there are already signs that they
may not be enough to combat antibiotic resistance. For example, although
the overuse and abuse of antibiotic have contributed to the evolution
of high levels of resistance among bacteria associated with disease, a
growing body of evidence now indicates that phasing out antibiotics or
reducing use will not necessarily reverse the situation . Essentially,
the functional complexity of genes frustrates any attempt to make predictions
based on the simplistic assumption that one gene is responsible for one
function. An antibiotic resistance gene often has multiple functions,
while many different genes may contribute to resistance against a single
is now overwhelming evidence that antibiotic resistance genes spread by
horizontal transfer among different strains of bacteria, which is almost
impossible to control.
It is also becoming widely recognised that designing ever more deadly
drugs to kill bacteria is no longer a viable option, both financially
and clinically. Resistance to new drugs is appearing with increasing rapidity,
often within a year of introduction. That means little or no return to
drug companies that develop the antibiotics. Furthermore, drugs that are
toxic to bacteria are often toxic for human beings as well, and the ‘side-effects’
may become much worse than the cure.
Some scientists are now rethinking the failed conventional model of killing
pathogens with new, ever more deadly antibiotics as bacteria become resistant
to the old ones . They are designing drugs that aim to physiologically
‘tame’ the bacteria, rather than kill them. This is an important approach,
which acknowledges the accumulating literature on the flexibility of micro-organisms.
Bacteria can change drastically according to ecological conditions. They
not only look different but behave differently as well. In particular,
bacteria can stop proliferating and become non-virulent but remain metabolically
active under appropriate ecological conditions. A logical extension to
designing drugs that physiologically tame the bacteria is to find how
ecological balance could be restored, so bacteria need never become virulent
. It is time to stop waging war on nature.
Another strategy that has not yet been considered in Britain is to integrate
traditional or alternative medicines more broadly into the National Health
Service, especially in the search for more effective, low risk, less costly
antimicrobial agents. Other countries have made serious efforts at incorporating
holistic medical practices into national health, with notable success
especially in China where traditional and western medicine are practiced
and taught together .
China began integrating traditional medicine in the National Healthcare
system in the 1950’s. Health officials trained in modern medicine sought
compatability between traditional and modern medicine by a western science-based
approach that emphasized empirical research. Although some feel that this
has compromised traditional medicine and that there is room for improvement,
the overall result has been beneficial. Hospitals practicing traditional
medicine treat 2000 million outpatients and almost 3 million inpatients
annually. Over 95% of general hospitals have traditional medicine departments
that treat 20% of outpatients daily. This adds up to 40 million people
per day! 
In other countries such as South Korea and India, where traditional and
western medicine operated in parallel but separately, there has been conflict
and rivalry and lack of quality control. Increasingly, countries are feeling
the need for proper integration of traditional and modern medical practices,
and not just the predominance of one over the other.
The Central Council of Indian Systems of Medicines oversees research institutes
where treatment is evaluated. The Indian government is adding ten traditional
medicines into its family welfare program, partly funded by the World
Bank. They cover a range of medical problems such as anemia, nutritional
deficiencies and childhood diarrhea. New regulations were introduced
in July 2000 to improve Indian herbal medicines by establishing standard
manufacturing practices, quality control, authenticity of raw materials
and absence of contamination. The government has set up ten new drug-
testing laboratories for Indian systems of medicine and is upgrading existing
labs to provide rigorous evidence to licensing authorities on the safety
and quality of herbal medicines. Randomized controlled clinical trials
of selected prescriptions have been initiated. This will help document
the safety and efficacy of the prescriptions and provide the basis for
their international licensing as medicines rather than simply food supplements
There are many tried and tested antimicrobials and agents that improve
the body’s resistance to infections within traditional medical systems
[11, 12], which have been the subject of hundreds, if not thousands of
western scientific studies. These include ginseng, Astralgulus, milk thistle,
licorice, Echinacea, and garlic.
Anti-microbials continue to be documented among plants that are used in
traditional medical systems. Researchers at Lucknow, India, noticed that
seedlings of plants used for a variety of infectious diseases predominate
on fresh or decomposing cattle dung. Plants don’t normally grow on cattle
dung as it contains a lot of bacteria, among other things. The researchers
reckoned that plant which grow on cattle dung may well have anti-microbial
properties protecting them from microbial attack. This was confirmed when
the seeds were directly tested against eight bacterial and three fungal
strains. The dung seeds turn out to have high levels of anti-microbial
In another investigation, 82 traditionally used Indian plants were screened
for antibacterial activity. As many as 56 of the plants exhibited antibacterial
activity against one or more test pathogens. Five showed strong, broad-spectrum
activity against test bacteria. The five alcohol-soaked extracts with
the highest anti-microbial activities were then tested for toxicity in
red blood cells of sheep, and found to have none .
In a study on the tribal use of twenty-seven important Indian medicinal
plants in the Bastar district of Madhya Pradesh, people were observed
using plants to treat illnesses such as diabetes, debility, migraine and
skin infections .
So-called complementary or alternative medicines (CAM) in the west are
derived from traditional health practices of many cultures. In the United
States, around 42% of the population now use CAM. In recognition of the
important role played by CAM in healthcare, the US Congress established
the National Centre for Complementary and Alternative Medicines (NCCAM)
within the National Institutes of Health (NIH) in 1999, with a budget
of nearly $20 million. (Its current budget has increased to $68 million.)
NCCAM’s purpose is to conduct and support basic and applied research and
research training, and to disseminate health information. Other programs
have been set up to identify, investigate and validate CAM, the diagnostic
and prevention modalities, disciplines and systems over the next five
years. In 1999, the University of Pittsburgh School of Medicine was awarded
$15million to co-ordinate a six-year study on the efficacy of Gingko biloba
in preventing senile dementia. The study involves a group of 3 000 compared
with a control group taking placebos .
Following the UK House of Lords report on antibiotic resistance, Lord
Walton, chairman for the foundation for integrated medicine said there
was “a good case to suggest that the NHS should play a very strong role
in developing integrated medicine”. Many now believe using more complementary
medicine in the National Health Service could lead to lower costs, as
well as encouraging more patient-centred approaches . It could also
result in more effective and safer treatments. Iatrogenic illnesses associated
with conventional medicine  are the third leading cause of death in
the United States and other industrialized countries sharing the same
reductionist model of disease.
We need a comprehensive paradigm change, not just in addressing antibiotic
resistant infectious diseases, but in delivering basic healthcare .
1. World Health Statistics, 1999.
2. Department of Health The Path of Least Resistance 1999, See www.doh.gov.uk/smac1.htm
3. Department of Health UK Antimicrobial Resistance Stratagy and Action
Plan June 2000 Published by the NHS Executive. See www.doh.gov.uk/arbstrat.htm
4. “Phasing out antibiotics will not reduce antibiotic resistance – the
irrelevance of natural selection” by Mae-Wan Ho, ISIS News 6, September
2000, ISSN: 1474-1547 (print) ISSN: 1474-1814 (online) http://www.i-sis.org/i-sisnews6.htm#phas
5. Heinemann, J.A., Ankerbaner, R.G. and Amabile-Cuevas, C.F. (2000).
Do antibiotics maintain antibiotic resistance? Drug Discovery Today 5,
6. See Ho, M.W. (1998,1999). Genetic Engineering Dream or Nightmare? Turning
the Tide on the Brave New World
7. Science and
Big Business, Gateway, Gill & Macmillan, Dublin, Continuum Books,
New York, final chapter.
8. Gerard Bodeker, Lessons on integration from the developing worlds experience.
BMJ 2001; 322:164-167 Jan.
9. The State Administration of Traditional Chinese medicine of the People’s
Republic of China. Anthology of policies, laws and regulations of the
people’s republic of China on traditional Chinese medicine. Shangdong
10. Bagchi GD. Singh AA. Khanuja SP. Bansal RP. Singh SC. Kumar S. Wide
spectrum antibacterial and antifungal activities in the seeds of some
coprophilous plants of north Indian plains. Journal of Ethnopharmacology
1999 Jan; 64 (1): 69-77.
11. Ahmad I. Mehmood Z. Mohammad F. Screening of some Indian medicinal
plants for their antimicrobial properties. Journal of Ethnopharmacology
1998 Sep; 62 (2): 183-93.
12. Sharma DC. Chandra U. Prophylactic uses of some medicinal plants in
Bastar District of Madhya Pradesh. Ancient Science of Life 1998 Apr:17
13. Cho HJ. Traditional medicine, professional monopoly and structural
interests: A Korean case. Soc Sci Med 2000:50: 123-135 (medline)
14. Department of Indian Systems of Medicines and Homeopathy. Annual Report
199-2000. Department of Indian Systems of Medicines and Homeopathy 2000,
15. Steven Taormina, December 1999, Top Ten Best Researched Herbs. See
Royyn Landis and Karta Purkh (1997) Singh Khalsa, Herbal Defence against
illness and aging - A practical guide to healing, ISBN 07225 36550
16. Linsa W Engel and Stephen E Straus (2001). Rigorous Research, Sound
Policy-Key to integration of CAM and Conventional Medicine. Global Health
& Environment Monitor, Vol 9, Issue 1, p 8
17. Lords back integrated medicine, Positive News, Spring 2001, No 27
18. Starfield, B. (2000). Is US health really the best in the world? Journal
American Medical Association 284, 483-5.
19. See “The human genome - A big white elephant” by Mae-Wan Ho, ISIS
Report June 9, 2001 http://www.i-sis.org/elephant.shtml
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