The End of the World as we Know it, A Post-Antibiotic Era?

Amoxicillin - Flickr/Wil C. Fry

By Jeffrey Havenner

I watched the sun come up on December 22, 2012 with a certain satisfaction. It was the day after the predicted "end of the world" due to the expiration of the Mayan calendar. Little did I know, until I read it in an article on hospital-acquired infections, that we may be facing at the very least the end of another era of the usefulness of antibiotics in medicine. Has bacterial resistance really come to that? Some medical experts are suggesting so.

A favorite saying of Pasteur was that "chance favors the prepared mind." In the 1920s English physician Alexander Fleming was looking at some cultures of Staphylococcus aureus that were contaminated with the same blue green mold that is common on old bread. He could have destroyed the cultures and started over but instead he examined them and noticed that something about the mold seemed to be restricting the growth of the bacteria. Fleming is credited with discovering Penicillin, the first antibiotic.

Since that discovery, antibiotics have become a staple of medicine, as they are actual curative drugs. That is, antibiotics do not prevent one from getting a disease, as do vaccines. Instead they clear from the patient's system the actual causative agent of a disease after infection.  Unfortunately, just as Sir Isaac Newton described the law of action and opposite reaction in physics the opposite reaction to antibiotics was antibiotic resistance in bacteria.

As time has gone on, microbiologists have described antibiotic resistance genes on plasmids and so called "pathogenicity islands" that can be transferred horizontally between bacteria occupying the same environments. Some pathogens have achieved multiple antibiotic resistance to the point that there are few treatment options left. Potential allergic reactions and toxic side effects complicate the picture even more.

The problem of antibiotic resistance is twofold. The most resistant forms of pathogens can lurk in hospital environments ready to infect patients with already compromised immune systems. Along with that the rate that new antibiotics are coming into clinical use has been declining steadily since the 1980s.

Commercially, antibiotics seem to be following the law of diminishing return. As bacteria become more proficient in acquiring resistance, a certain pessimism settles in that new antibiotics could even recoup the cost of R&D and the lengthy approval process by the FDA.

So what will happen? In one scenario the Government could take over antibiotic development and production largely by contracting with commercial entities similar to defense contracting. Antibiotic research and development could become the province of Non-Governmental Organizations. Ralph Winter envisioned groups of scientifically oriented Christians fighting disease in the name of God and not for personal fame or profit. Finally, new classes of drugs could be developed that target bacterial virulence mechanisms without necessarily killing them. These might become forms of maintenance and disease-management drugs that are more profitable in the long run. We will examine these in greater detail later.

Endnote:

This is the article referred to above: http://www.bethesdamagazine.com/Bethesda-Magazine/January-February-2013/The-KPC-Killer/. The incident caused quite a stir in the Washington DC area because it was a local event that occurred at the NIH in 2012. 

Jeffrey Havenner is a retired microbiologist who serves the RWI as a scientific consultant.

Image of Man, Image of God

By Jeffrey Havennner

Editorial Note: This material, written by Jeff Havenner, was actually written for Advent. However, we considered it too good to wait most of a year to share. Hope you enjoy.

In the season of Advent, followers of Jesus look back on the coming of God’s Son in human image, as a human child, born of an earthly mother in the humble setting of a stable long ago. His birth itself looked back on another event much longer ago, which was God’s creation of man in his own image. The account in Genesis depicts God speaking from heaven saying, “Let us make man in our image and let him have dominion over the fish of the sea and over the birds of the sky and over the cattle and over all the earth and over every creeping thing that creeps on earth” (Genesis 1:26).  We are told in passages that follow that both male and female human beings together carry the imprint of God’s image and bear his stamp of authority on the earth. Why is this of importance?

Elamite Head of an Ruler, Iran - 2300-2000 BCE Flickr/Mary Harrsch

Dr. Richard Pratt, Professor of Old Testament studies at Reformed Theological Seminary in Orlando, FL made the analogy to the practice of kings in the ancient world. When kings wanted to demonstrate their control over territory they would erect statues of themselves to emphasize their control to any forces that might contest their power. Normally these would be tall impressive statues of stone that projected the intimidating power of the king. Dr. Pratt said the creation of man was similar, only instead of creating stone statures of imposing size, God made more modest images of clay. God thus intended to declare his rule over the territory of earth that was in rebellion against him at the time of his creation of man.

Dr. Gregory Boyd, in his book God at War, argues that the rebellion on earth was manifest in the Serpent's presence in the garden. Eden was established as a beachhead from which to liberate the earth from Satan who was already present. By creating and filling the earth with his image, God was announcing his claim to the earth and putting Satan on notice that he did not even need to use his own power directly. Rather God would use just little clay images of himself.

The serpent broke those images by inducing man to disobey God's command about forbidden fruit and probably thought, "That was easy."  God however said, “I shall put enmity between you and the woman and between your seed and her seed. He shall crush your head and you shall bruise him on the heel” (Genesis 3:15).  In effect God told Satan that a struggle would continue between him and the broken clay images of God. God would gain the ultimate victory and Satan's powers would be held up to ridicule. So Advent prepares us for the coming of the seed of the woman in the likeness of broken clay images.  He will be bruised on His heel but deal the serpent a mortal blow to the head and restore the universe completely under the rule of God.

Jeff Havenner is a retired microbiologist who worked at the Frederick Cancer Research Center and the Walter Reed Army Institute of Research.

Countering Evil by Eradicating Disease

By Jeff Havenner

Flickr/U.S. Department of Agriculture

Ralph Winter once asked whether pathogenic microorganisms represented "evil intelligent design." My initial thought considering that question was that a "yes" answer gave the devil too much credit. That was my off the cuff response, having never thought much in terms of evil regarding microbial pathogens. My response was like that given in a word association game. Someone says a word and the respondent answers with the first word or phrase that comes to mind. The patterns of immediate answers give clues to the way a person's mind works.

Before we can understand evil with respect to pathogens, we must ask more basically whether science recognizes evil at all. Most practitioners in the sciences have been taught to believe that everything exists as a result of a natural or material cause. Such causes are assumed morally neutral. The understanding of facts or conditions in terms of evil or good is outside of the realm of science. For the microbiologist, the presence of pathogenic microorganisms simply is fact. The fact of pathogens existence and the diseases they manifest represents, at most, some form of species coevolution. Neither God nor the devil are viewed as being behind them.

This view works in an academic sense. Ironically, when pathogenic microorganisms begin interacting badly with human populations and causing epidemic diseases, our attitude changes. Humanity begins to respond to those pathogens as if they are an evil to be combatted and subdued. Just as with word association, our immediate response to disease, our desire to cure it with an antibiotic or other drug or to prevent it by vaccination or even to eradicate it entirely gives us a clue as to how our collective mind seems to work. Whether we admit it or not, we act as if evil does exist as a force that must be fought with intellectual and physical effort. 

Thomas Malthus

Eradication programs are global responses to diseases that are perceived to be evil on a multinational level. The impulse to eradicate disease seems to come from the desire to eliminate a seemingly purposeful enemy of our human existence. This runs counter to what one might expect from a purely Malthusian and Darwinian frame of reference.

Thomas Malthus, an English cleric and 18th Century social theorist, believed that natural disaster, including famine and diseases were acts of God, beneficial in the overall sense to prevent the overpopulation of the planet. The naturalistic view of Darwinian thought was drawn from Malthus and asserted that whatever purely environmental forces do not kill off a species, end up leaving that species stronger over time and can give rise to a whole new species.

The human response to diseases, however, inclines toward preventing and curing them so as to free humanity from their ravages and the deaths they cause. Rather than the reference frames of either Malthus or Darwin, our response to disease thus bears more resemblance to that of Jesus, who, as the Gospels tell us, came into the human world to heal and to cast out evil.   

Reference: A review of Malthus' theories in relation to those of Charles Darwin. 

Jeff Havenner graduated from the University of Maryland, College Park with Bachelor and Master of Science degrees in microbiology. He worked at the Frederick Cancer Research Center in oncogenic virology. Following that he was directly commissioned in the US Army and worked at the Walter Reed Army Institute of Research, Department of Rickettsial Diseases.  After leaving the Army he continued his career working in the field of radiation safety and safety management.