Drug Company CEO Blames Drug Industry For Increased Drug Resistance 136
BarbaraHudson writes Times Live is reporting that while doctors have usually been blamed for bacterial resistance because of over-prescribing, Karl Rotthier, chief executive of the Dutch DSM Sinochem Pharmaceuticals, claims lax procedures at drugs companies are the real cause. "Most antibiotics are now produced in China and India and I do not think it is unjust to say that the environmental conditions have been quite different in these regions. Poor controls mean that antibiotics are leaking out and getting into drinking water. They are in the fish and cattle that we eat, and global travel and exports mean bacteria are traveling. That is making a greater contribution to the growth of antibiotic resistance than over-prescribing", Rothier said. "We cannot have companies discharging untreated waste water into our environment, contributing to illness and, worse, antibacterial resistance. We cannot accept that rivers in India show higher concentrations of active antibiotic than the blood of someone undergoing treatment."
Holy Carp! (Score:4, Insightful)
We cannot accept that rivers in India show higher concentrations of active antibiotic than the blood of someone undergoing treatment.
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Isn't that needed to kill the germs from all the dead bodies they float down the river? India is a pit. :(
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Newsflash: dead animals and fish float down the rivers around here as well.
What, you thought fish gets out of the river to die? Or for that matter to piss and shit?
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We cannot accept that rivers in India show higher concentrations of active antibiotic than the blood of someone undergoing treatment.
I'd have to see a source before I'd credit that as true, but damn, it's a frightening concept.
Re:Holy Carp! (Score:5, Informative)
More on this: http://www.nature.com/news/201... [nature.com]
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the treatment plant released drugs in its effluent water at levels sometimes equivalent to the high doses that are given therapeutically
So it's the water coming out of the plant that (sometimes) reaches that level. The actual river has orders of magnitude more flow than that. Compare that to:
We cannot accept that rivers in India show higher concentrations of active antibiotic than the blood of someone undergoing treatment.
So he may have a valid point, but this is obvious FUD.
Re:Holy Carp! (Score:5, Interesting)
So it's the water coming out of the plant that (sometimes) reaches that level. The actual river has orders of magnitude more flow than that.
So he may have a valid point, but this is obvious FUD.
So in other words, the river itself might have a few tenths or hundredths of a percent of a concentration below the therapeutic MIC (potentially of multiple different antibiotics, depending on what factories happen to be located on that river).
Your interpretation of this is doesn't-matter, therefore FUD. My interpretation of this is enough to exert influence on relative competitiveness within a microbial community, and exert selection for antibiotic resistance.
Long before you reach lethal anti-microbial concentrations, you get subtle changes in growth rate and microbial gene expression. In agriculture, farms routinely use antibiotics at just a few percent of therapeutic dosing, and that is already enough to cause massive changes in the microbial community (with the side-effect of improving the growth rate of the host animal). You don't need to directly kill the microbes themselves, you just need enough to skew the balance of power between the various micro-organisms that are busy competing with each other.
The concentrations in the river may be a fraction below even that, but even slight pressures are enough to alter the course of evolution, when administered over a long enough time period. And "long enough" in this situation is in the context of an organism with 20-minute generation times.
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The is a logical conclusion for the the information given. However you are still creating a localised, open air, bacterial laboratory, not a small one but relatively large consider the length of the water way until it reaches a river and discharges the antibiotics to be diluted along with the rest of the bacteriological experiment. So still an extraordinarily bad idea. So a waning that all pharmaceutical corporations should recycle all manufacturing use water and not discharge any at all to the environment
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People believe the Ganges has healing properties. It would be pretty ironic if that became true due to antibiotic pollution.
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I don't follow.
Factory outflow may have therapeutic levels of antibiotics, but rivers tend to be fairly big, so it would be diluted a lot. You seem to be assuming that drug factories are so thick on the ground in India that they will provide almost all of the flow of the river.
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Agreed. I'd like to know more about the truth of that statement, but if its literally generally true - just how widespread is it etc. That's shocking and unacceptable.
If its just one river that's not much more than creek being tested right next to the waste pipe of a pharma factory its still entirely unacceptable, but not quite as alarming as the statement would have us think.
(Much like the 'great garbage patch' which although a real and genuine problem is not quite the floating garbage island the media he
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The issue is not drug factories illegally dumping; the issue is that sewage treatment plants don't actually remove all contaminants from the water (just solids and bacteria, really) and that India has a whole lot of people. The drugs that are in the water got there by being prescribed to and passed
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I am not a medical doctor or any kind of doctor for that matter, but my understanding is many antibiotics are readily passed into urine even in patients with mostly normal kidney and liver function.
Re:Holy Carp! (Score:5, Insightful)
Remember that in the early days of penicillin, when manufacturing meant making a couple of grams of the stuff, it was 'recycled' from patient's urine, purified and used again. Many drugs are passed unchanged through the kidney. Many more have only modest changes that might still be biologically active. Standard sewage treatment plants have a relatively haphazard approach to breaking down complex organic molecules of all sorts. If the primary bacteria and flocculation (precipitation) don't get the compound it goes into the drink (so to speak).
UV radiation is pretty good at breaking down things, and even atmospheric radiation (without adding additional UV lights) works to some extent but it is slow and the UV does not penetrate any great deal into the water column. So you either need active UV filtering (something the EPA is pushing) or some other active means of removing organochemicals. Add industrial level effluents and you've got a problem. All of this requires money, time, rule of law and civil commitment. Which means it doesn't always happen - either in China or India or anywhere.
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Actually, it's even worse than that. India JUST banned the sale of antibiotics off the shelf this March. Until recently, you could just walk in and grab them. http://bsac.org.uk/news/major-... [bsac.org.uk]
There are way too many things wrong with that, but among them is that a lot of unused antibiotics probably wound up in the trash.
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Why read some boring headlines, when you can read the comic book [comixology.com] instead?
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Antibiotic-resistant bacteria are not better adapted in general than non-antibiotic-resistant bacteria. In fact, they may be slightly less survivable in an antibiotic-free environment, since there can be a slight metabolic price to being resistant. I'd expect it to take numerous exposures to get antibiotic resistance established in the species.
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Maybe we could bottle the river water and sell it as a cure all?
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May be, he's right. He criticizes pharmaceutical companies both in China and in India, and his own company manufactures antibiotics in China. If his own company is having this problem of not being able to enforce proper procedures in China, I would tend to trust the guy, after all he's the CEO of that company.
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I can only infer that he knows he's evil, but he can't do the right thing because he's too weak willed to explain it to the shareholders. In any case, he seems to be implying that he's evil.
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It's a prisoner's dilemma. Every player in the market has the choice to either improve waste disposal (cooperate) or not (defect). If everyone cooperates, then society as a whole wins, but the price of antibiotics go up across the board. However, if anyone defects, then they drive all those cooperating out of the market with lower prices. This is a perfect example of how government regulation (forced cooperation) can solve this type of dilemma.
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That and it's more a tragedy of the commons. It's cheaper to outsource our pollution, but it's still our planet.
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This is heavily dependent on how much the market values whatever may make the cost go up. If the market values proper antibiotic production highly, then those companies that produce it properly and advertise the heck out of it will be able to get paid more, perhaps making more money that way. In practice, this is unreliable, but sometimes socially responsible production is a competitive advantage in some ways.
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When someone is sick and needs to buy antibiotics, they do not research the environmental practices of the companies they can buy it from. People buy blind. Doing nice things that they'd approve of if they knew doesn't help sell anything.
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Tragedy of the commons: no one wants antibiotic-resistant bacteria, since they're a threat to everyone, but no one can stop cheating, since that means they'll go bankrupt and still get antibiotic-resistant bacteria caused by all the other cheaters. The only known solution is a Leviathan that force
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There's also the question of what causes antibiotic-resistant bacteria. Putting lots of antibiotics in the factory outflow can't help the situation, but how much does it hurt it? There's lots of other ways to get antibiotics to the bacteria improperly.
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Until then, he would just put the company out of business - which is why he can't go to the shareholders with this.
So capitalism demands he pollutes as much as possible. Anything else will be hurting the shareholder value.
It's not cheating until the rules change and he is pushing for a rule change.
It's cheating to make something in China designed in the US, sold in the US, and produced abroad to keep prices down in a manner that would be illegal in the US. So, do you want to argue about cheating, or whether he could have taken some action himself, without appealing to the people to force him to change?
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He could try to unilaterally _not_ use those Chinese manufacturers. But then his product prices will go up, and he has no way to persuade customers that they should pay more.
In China drugs manufactured outside of China sell for more than domestic drugs, since people know about the counterfeit and QC issues.
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Actually, this is a long term business conspiracy cooperation between China and India:
1. Render antibiotics useless because of resistance
2. The world will have no other choice but to rely on traditional Chinese and Indian medicines
3. Profit!
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1. Patent new antibiotic
2. Make fortune
3. Bacteria become resistant ... just about the time the antibiotic goes generic!
4. Invent new antibiotic, watch your generic competitors go bankrupt
5. Repeat
Of course, the industry is having problems with steps 1,2,4, and 5. And the timing on #3 isn't very tight either.
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once again, science and technology triumph where religion has shown mixed results at best!
the previously legendary properties of the River Ganges [npr.org] are now firmly established! at least until the resistance evolves.
Drug company CEO (Score:1)
Is apparently on the good drugs that doctors don't over-precsribe to us.
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Slightly off topic... (Score:4, Informative)
Poor controls mean that antibiotics are leaking out and getting into drinking water. They are in the fish and cattle that we eat, and global travel and exports mean bacteria are traveling.
And those fish, cattle and even people are getting those antibiotics for *free* - seriously impacting our bottom line and tight-fisted control over drugs that, in reality, don't really cost as much as we say they do to research and manufacture, but we sell for a metric fuck-ton of cash.
According to this NY Times article, $2.6 Billion to Develop a Drug? New Estimate Makes Questionable Assumptions [nytimes.com] are an "estimate that drug companies could have made more money if they used their research investment for things other than drug development."
In both of these announcements, a significant amount of the costs to develop the drugs were opportunity, or time, costs. They are the returns that might be expected, but that investors went without, while a drug was in development. When a drug company invests in research and development, it is tying up money that could otherwise be invested elsewhere. In this announcement, the Tufts Center says that $1.2 billion of the $2.6 billion is time costs.
The end of the article notes:
In 2010, a systematic review of studies that looked at the cost of drug development was published in Health Policy. The review found 13 articles, with estimates ranging from $161 million to $1.8 billion (in 2009 dollars). Obviously, methodology matters.
That's a far cry from $2.6 Billion.
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Technically, so is yours (and this) ... :-)
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...with estimates ranging from $161 million to $1.8 billion...
That's a far cry from $2.6 Billion.
I understand this sort of costing depends on the difficulty of the research, whether you're accounting for failure rate, and whether you choose to include time value (of money and other things). Sounds like if you're research new drugs with novel chemistry, it's going to be around that $2.6 billion number after accounting for time value. If you're researching a slight variation of a drug you already have, especially if you're just changing it minimally in order to preserve a patent, then that's going to be
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...with estimates ranging from $161 million to $1.8 billion...
That's a far cry from $2.6 Billion.
I understand this sort of costing depends on the difficulty of the research, whether you're accounting for failure rate, and whether you choose to include time value (of money and other things). Sounds like if you're research new drugs with novel chemistry, it's going to be around that $2.6 billion number after accounting for time value. If you're researching a slight variation of a drug you already have, especially if you're just changing it minimally in order to preserve a patent, then that's going to be vastly cheaper.
You need to read the article. It *might* be $2.6 billion, but only for completely new drugs that are not modifications of other drugs AND it did not involve any public research (such as using prior public university research) AND it was not tax deductable. Might as well be developing a vaccine for unicorn farts if that is how you determine an "average" cost.
The $161 million number is far more accurate, discounting only drugs that failed to obtain FDA approval.
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You need to read the article. It *might* be $2.6 billion, but only for completely new drugs that are not modifications of other drugs AND it did not involve any public research (such as using prior public university research) AND it was not tax deductable. Might as well be developing a vaccine for unicorn farts if that is how you determine an "average" cost.
I notice a couple of things. First, I don't see any actual disagreement with my post. Second, public research is not free research. Instead, it's another form of cost inflation since public research is notoriously more expensive than focused private research.
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For purposes of running a drug company, you can't disregard drugs that failed to obtain FDA approval. If half your R&D dollars go into dead ends, then the cost of researching a successful drug is double what was actually spent on it. You also need to take into account the time value of money. Suppose it will take five years to get the drug to profitability. In that case, you need to balance the current R&D costs against what else you could do with that money. If you could invest it at 10%, for
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Any R&D calculation is going to, and should, include opportunity costs. Businesses don't leave millions or billions of dollars in a chequing account.
Those wacky subcontractors (Score:5, Insightful)
So, lemme get this straight.
A drug company CEO is blaming manufacturing companies in third world countries (which the big drug companies use to cut costs) for having shoddy practices. This hand wringing goes so far as "I wish they'd clean up their act." But then stops, of course, because it's not OUR fault - it's those people over in India and China that are to blame.
It's not like we hire them (or, in some cases, employ them as wholly owned subsidiaries), so we're in an excellent position to dictate policy (and ENFORCE policy) for them. Nope. It's all their fault. Nothing to do with us at all.
This is Apple putting the blame on Foxconn for unconscionable conditions in their manufacturing plants. Or western garment companies who contract their manufacturing to Bangladesh shaking their heads at Tazreen. [nytimes.com]
Shame on those other people in countries we choose to do work in because of lax regulation and cheap unskilled labor for having poor regulation and lacking skilled quality control people! It's all their fault.
A drug company CEO taking this position, but not accepting any blame, disgusts me.
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A drug company CEO taking this position, but not accepting any blame, disgusts me.
Not just any drug company, a drug company that manufactures antibiotics.
DSM Sinochem Pharmaceuticals, formed together with the Sinochem Group in August 2011, is the global market leader in beta-lactam APIs such as semi-synthetic penicillins (SSPs) and semi-synthetic cephalosporins (SSCs), which represent the biggest class of APIs in anti-infectives. It is also a leader in other active ingredients such as nystatin [anti-fungals] and next generation statins.
Not surprisingly, a company with "Sino" in its name has manufacturing facilities in Asia (India and China specifically). [dsm-sinochem.com]
Hang on (Score:1)
Exactly WHO decided to manufacture in China, that would be the big Drug companies as a guess.
Exactly WHO should be monitoring their manufacture, that would be the big Drug companies as a guess.
Exactly WHO encourages over subscription, a pill for everything, that would be the big Drug companies as a guess.
My guess is something went wrong somewhere and they are starting the smokescreen already to divert attention.
Re:Hang on (Score:4, Informative)
Exactly WHO decided to manufacture in China, that would be the big Drug companies as a guess. Exactly WHO should be monitoring their manufacture, that would be the big Drug companies as a guess. Exactly WHO encourages over subscription, a pill for everything, that would be the big Drug companies as a guess.
My guess is something went wrong somewhere and they are starting the smokescreen already to divert attention.
Exactly WHO here is the FDA, since they are the authority that allows those "big Drug companies" to even be in the business of making or selling drugs.
And yes, something went wrong. It's called the Military Prescription Complex, also known as Big Pharma. You want to point to something or someone? How about you point the finger back to the very organization in charge of regulating Big Pharma.
Course it might help if you didn't fill the fucking regulatory board overseeing that with a bunch of ex Big Pharma cronies hell-bent on ensuring profits are prioritized to the point of questioning their dedication to the Hippocratic oath.
Without checking his claims (Score:2, Insightful)
Hypocrisy (Score:2, Insightful)
Blaming the same countries they're outsourcing to because it's less expensive? (and killing local economy since the staff is part of the outsourcing)
Besides, how many people just throw old pills in the *garbage* ? I'm pretty sure that's the main reason for drug resistance.
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Demanding? I couldn't get the doctor to stop prescribing antibiotics for my kid for every minor throat infection. I just wanted to know whether it was serious or not (usually because we were going on vacation or visiting other families with very young babies and some anti-vaxxers.)
I think I threw away four or five prescriptions immediately when we got home. Didn't even check what they were for, the remark 'Take this and come back in two weeks if it persists. Oh, you must use the prescription in its entirety
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The main point of my post was questioning the logic that major drug manufacturers are outsourcing significant portions of their manufacturing leading to this issue. Rather than it being caused by smaller genetic manufacturers. Especially since the bulk of antibiotics are generic at this point.
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You've combined possible sensible behavior with completely ignorant behavior.
Yes, your MD is an asshole (and a lazy shit) for prescribing antibiotics without doing a culture. -- unless you just happened to leave out the part where he had a positive finding.
No, he was exactly right for requiring that the entire scrip be taken. It's morons who "feel better after 3 days" and stop the scrip who thus allow partially resistant bacteria to survive and go on to breed (so to speak) more fully resistant bacteria.
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It sounds more like he's setting up an argument against the "generics" industry.
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Besides, how many people just throw old pills in the *garbage* ? I'm pretty sure that's the main reason for drug resistance.
Huh, never thought of using a rhetorical question as evidence to unequivocally settle one of the most important health issues we face today. All those doctors must feel silly having wasted all that time researching.
Re:Hypocrisy (Score:5, Interesting)
Besides, how many people just throw old pills in the *garbage* ? I'm pretty sure that's the main reason for drug resistance.
It's funny, because this illustrates the bigger problem of people not being aware that when they stop taking antibiotics early, they potentially breed resistant bacteria if their illness relapses. *Noone* should have any antibiotics left to throw the garbage, with the rare exception of someone having an allergic reaction to them.
My one coworker ceased her antibiotics when she felt better, relapsed, and had to get stronger antibiotics. In the meantime, she infected two of her family members with the more resilient bacteria, one of whom had to be hospitalized.
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Also, when the testing involves allowing a disease to become more advanced while waiting for confirmation, that's a Bad Thing. When the test involves biopsying your testicles, that's also a Bad Thing.
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I'm pretty sure that's the main reason for drug resistance.
I dunno. I saw a television report wherein some doctors have spent years recording the DNA of various bacteria found on meat bought in the supermarket, and comparing it to antibiotic-resistant yeast infections that show up in the local hospital. They're pretty sure that drug resistance comes from antibiotic-laden manure-covered fields on farms. I think I like their theory better.
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Besides, how many people just throw old pills in the *garbage* ? I'm pretty sure that's the main reason for drug resistance.
I really hope the correct answer to this question is zero. Antibiotics need to be taken in a full course. Not doing so breeds the highly resistant strains you are now blaming the third world for. Anyone who is throwing out antibiotics are not taking them according to doctors instructions and as a result are a danger to themselves and those around them.
But I thought... (Score:5, Insightful)
Corporations said they would always act in the best interest because they're held accountable by stockholders and consumers? Is he saying that unregulated corporations are doing things which may be harming the population in general because of a short-term profit motive? Say it isn't so!
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In the best way to maximize profit. If fines are less than profits, then action will be taken. If fines can be routed around by corrupting monitors or government that makes the laws, than those actions will be taken.
Many tend to forget that free market sees any kind of governance, especially good governance as inefficiency blocking maximum profiteering and routes around it, often in a way that is extremely damaging to society.
We cannot accept (Score:2, Insightful)
I also find it hard to accept a wide array of wacky statements. Whenever I see a statistic or comparison that would be interesting if true, I assume it's not true. Usually such statements are, at best, highly exaggerated.
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If you mean the river thing, it's actually true
http://www.nature.com/news/2011/110216/full/news.2011.46.html
Pot, meet kettle. (He's in denial today.) (Score:3, Insightful)
News flash! Drug company CEO blames the other manufacturers of drugs for problems adversely affecting their supply and demand ratios; stock holders and the media swallow it, hook, line and sinker. CEO is quoted as saying, "But don't worry... that's totally not us. You need to regulate our competitors -- err... ummmm... I mean, those other drug companies, over there... we're totally fine here. These aren't the drugs you're looking for. Move along."
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Show me the quote were he says "not us", or are you making shit up?
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Show me the quote were he says "not us", or are you making shit up?
Seriously? Of course I'm making that all up, dude; it's called satirical commentary, and it's meant to be empirically obvious. You didn't really think that the CEO of a Dutch drug company had used American slang, and paraphrased Star Wars in his statements to the media, did you?
The whole point is that this guy is waving his hands about and making all kinds of accusations against companies in other countries which are undeniably his competitors, and then pointing to all of the region-specific problems being
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Obviously I'm expecting a quote from him giving that message not the exact words you used.
So again do you have any evidence?
"we do not always live up to the responsibility we have towards society. Irresponsible behaviour is tainting the image of our industry and puts society at risk." - we includes himself obviously, that's the meaning of the damn word after all. So there's some evidence of the exact opposite of you made up shit (no evidence so far, so I'll take that side of the or for now).
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No, the GP is almost certainly correct. As the CEO of a drug company, if Rotthier were arguing for onerous regulation of his own company out of concern for the environment...he would be the ex-CEO of a drug company. However, since his company manufactures drugs in Europe and that kind of dumping ("irresponsible behaviour") is already illegal, he is not-that-unjustly arguing--and probably lobbying--for protectionism against Asian drug manufacturers that are not held to the same environmental standards, and
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Sure, other than the fact that his company does in fact manufacturer drugs in asia, with manufacturing sites in both China and India.
There's a rather large hint in the name of the company.
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Re:Pot, meet kettle. (He's in denial today.) (Score:4, Informative)
Antibiotic resistance is estimated to contribute to more than 25000 deaths every year in Europe alone.
Penicillin, the first antibiotic, was discovered in 1928 and more than 100 compounds have been found since but, until a reported discovery earlier this month, no new class has been found since 1987.
Dame Sally Davies, the UK government's chief medical officer, has said that antibiotic resistance is "as big a risk as terrorism" and warned that Britain could return to a 19th-century world in which the smallest infection or operation could kill.
Rotthier said the responsibility was on everyone, from patients and doctors to governments and pharmaceutical companies, to take immediate steps to ensure the "legacy of antibiotics as a life-saving medicine is not squandered".
We're running out of "magic bullets" to kill off bacteria. If you're a cynic, you could ask "What good is it to run a drug company if the drugs you make aren't in demand because they no longer work?" If you take it at face value, it's "This is some scary stuff that can affect everyone."
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Comparison is silly. Terrorism is a joke in comparison to bacterial drug resistance, and sheer lethality of latter today is already at least an order of magnitude more lethal. And most of our antibiotics still work today, as initial versions of bacteria that adapted are merely resistant and adaptations often reduce bacteria's ability to infect and damage us.
But that is just the initial adaptation. It's going to get much worse.
The problem isnt the manufacturers (Score:5, Insightful)
Two thirds of all antibiotics go to perfectly healthy farm animals. Not to cure them of anything, but to make them fatter for market, and make more money for Agrobusiness.
Get rid of that, and you will reduce the evolution and spread of antibiotic resistant bacteria by 2/3.
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That is the official line. I've seen several pieces of research that disagree, showing that feeding antibiotics to animals significantly helps fattening them up. Factory farms overusing antibiotics appear to agree with those conclusions - otherwise they'd be saving a ton of money on reducing dosage.
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Antibiotics fatten animals themselves? No.
Antibiotics reduce infections, hence the animals gain more weight.
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Not the way it works. Several studies have been done that appear to indicate that the impact is actually on gut microbiome which changes the way metabolism works resulting in fattening.
It could be worse (Score:5, Interesting)
"We cannot have companies discharging untreated waste water into our environment, contributing to illness and, worse, antibacterial resistance. We cannot accept that rivers in India show higher concentrations of active antibiotic than the blood of someone undergoing treatment."
I'm just happy that Monsanto is not one of these drug companies. They'd probably sue everyone on the planet for drinking water that may contain their product and not paying for the privilege of consuming their pollutants.
Sidenote (Score:5, Interesting)
Graphics in linked articles show the effluent of Indian wastewater treatment plants. Few public wastewater facilities can, or were designed to, remove antibiotics from our waste. They are designed for household waste, not industrial waste. Most antibiotics and other drugs pass straight through a typical wastewater plant unharmed. In the USA, Industrial PreTreatment is required for businesses that would otherwise discharge toxic or damaging substances to a public treatment plant. Usually the offending business builds, runs, and pays for pretreatment. Unless, of course, the "good ol' boy" system can unload the cost onto local residents.
America and India have the same problem; India just has more metric tons of it and far less regulation.
FYI: licensed wastewater operator (retired).
Crunch all you want... We'll make more! (Score:3, Interesting)
So is he saying that doctors should keep prescribing antibiotics for illness where they are unnecessary, and that prophylactic application of antibiotics in agriculture should continue? That is, the only thing that needs to be fixed is the manufacturing leakage?
Of course that's the only problem. Because, in India and China, those problems aren't likely to be fixed any time soon (perhaps if ever). If over-prescription isn't the problem, doctors and agricultural users can continue purchasing unnecessarily large quantities of the drugs, guilt free. That's a convenient stance for a drug company CEO to have.
I'm not saying that mishandled wastage at a drug plant isn't an issue. It appears that it is. The CEO said so. But I'd me more interested in seeing facts that back up his claim that overuse is not the issue causing antibacterial resistant bacteria. The overuse is probably more widespread than the factories, and probably more likely to be the cause of the superbugs in your area (unless, of course, your area is near these factories).
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In India, until March of this year, antibiotics were an off-the-shelf drug.
http://bsac.org.uk/news/major-... [bsac.org.uk]
You can't blame the doctors there for this one.
But as usual, things are probably a mixture of things. In India, antibiotics were easy to get, and waste at the plants was an issue. In North America, over-prescription and people not taking the full course of drugs when they ARE required is an issue. In all places, prophylactic use in animals is definitely an issue.
Put all those things together, and here
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So is he saying that doctors should keep prescribing antibiotics for illness where they are unnecessary, and that prophylactic application of antibiotics in agriculture should continue? That is, the only thing that needs to be fixed is the manufacturing leakage?
The biggest joke is that if we were to reduce prescription, we would reduce leakage by the same factor if not more.
Don't forget the animal feed... (Score:2)
This sounds like a big problem but beyond the manufacturing plants, about 80% of all antibiotics are fed to animals to make them grow faster (more profits) and these also end up in rivers all over the world. Also, animal farms are incubators for drug resistant bacteria.
It is self correcting don't worry about it. (Score:2)
ICU doctor here.... (Score:2)
This really intrigues me because it never struck me that this could be a mechanism for antibiotic resistance. It is even more interesting to me knowing the first CRE (Carbapenem-resistant Enterobacteriaceae [cdc.gov])
clearly arose in India [source] [asm.org]
but the reasons weren't clear to me and I just naively assumed it was a random mutation. India, also according to to that same paper has quite a problem with antibiotic resistance which one wouldn't expect as there isn't so much of a problem with antibiotic overuse as there seems to be in the West. So, m
Noob Intern Replying (Score:2)
It is even more interesting to me knowing the first CRE (Carbapenem-resistant Enterobacteriaceae [cdc.gov]) clearly arose in India.
Funny thing was the response of Indian politicians was that naming of the NDM-1 resistance factor was "malicious slander". The acronym of course standing for New Delhi Metallo-beta-lactamase. I happen to agree that geographic and ethnic names should no longer be used for disease entities, but nationalistic outrage is not a useful response to a problem.
but the reasons weren't clear to me and I just naively assumed it was a random mutation. India, also according to to that same paper has quite a problem with antibiotic resistance which one wouldn't expect as there isn't so much of a problem with antibiotic overuse as there seems to be in the West.
Don't be so sure of that, when antibiotics are (or maybe were until recently) common non-prescription OTC products in India and other parts of south and sou
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This really intrigues me because it never struck me that this could be a mechanism for antibiotic resistance. It is even more interesting to me knowing the first CRE (Carbapenem-resistant Enterobacteriaceae [cdc.gov])
clearly arose in India [source] [asm.org]
but the reasons weren't clear to me and I just naively assumed it was a random mutation. India, also according to to that same paper has quite a problem with antibiotic resistance which one wouldn't expect as there isn't so much of a problem with antibiotic overuse as there seems to be in the West. So, maybe not so random and maybe we have honed in on a legit reason for growing resistance.
The other problem in India and similar places is that the dosage wasn't what the label said. The doctor may have prescribed 500 mg of amoxicillin, and the patient bought capsules in a bottle labeled 500mg amoxicillin, but what was in those capsules was a fraction of the prescribed dosage.
Case in point is Ranbaxy who sold millions of doses of what they knew was non-performing anti-retroviral drugs.
http://www.bloomberg.com/apps/... [bloomberg.com]
And more like this:
http://fortune.com/2013/05/15/... [fortune.com]
http://fortune.com/2013/01/ [fortune.com]
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It's worth noting that this particular issue is getting worse. Drugs with reduced effective compound content or even without any are surprisingly common in today's pharmaceutical market and even trusted chains tend to have problems with fake labels and such.
That's why pharma as industry is a pioneer of various ways of marking and labelling packages to ensure that they're the real deal.
Sure, blame the source that isn't paying... (Score:2)
Those animals piss and shit those drugs where it eventually ends up in the water supply.
The difference between industrial agriculture and pharma factories in India/China is that agriculture pays for the drugs.
A whiff of hypocrisy? (Score:2)
It is interesting to hear an executive of a pharmaceutical company admit that the industry is rotten, but not all that surprising. But of course, he's not really saying that; he is trying to blame the developing world, again not all that surprising.
Adding antibiotics to live-stock feeds has been a well known practise in the West for decades - I first heard about it in the 70es, and it must have been going on for a while before it got into the news. There was a public outcry back then, so the industry starte
WTF? (Score:2)
Re:More people should be serious about this (Score:5, Insightful)
It's not like drug-resistant bacteria are going to rise up and kill us all at once some day in a weird, snotty epidemic...
Actually, it may be like that... tuberculosis and pneumonia are quite capable in ravaging through our population if unchecked.
In the years right before the wide availability of antibiotics in the US (1930's), just these two bacterial infections were responsible about 20% of all deaths in the US (not including other bacterial infections). If you've seen someone suffering TB, perhaps it might be considered your weird snotty epidemic...
Also, those mushroom-based antibiotics aren't the ones of last resort. The nasty antibiotics with all the nasty side-effects are the modern ones (that are basically injectable pesticides that doctors often hold back as last resort). If we don't clean up our act we might be going back to something more akin to a pre-anti-biotic Victorian era with people dying of consumption (not some quaint 60's ampicillin pill-poping rehash).
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It's not like drug-resistant bacteria are going to rise up and kill us all at once some day in a weird, snotty epidemic...
Actually, it may be like that...
I find it ironic that in spite of our ridiculous survival advantage over nearly every other species, it's the most biologically simple ones that have a real chance of taking us out.
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That is exactly the point. TB is becoming more and more nasty again. Pneumonia is quite a solid killer even in the age of antibiotics still working.
And there's always a danger of something like bubonic plague showing up with no antibiotics that can fight it. While modern sanitation will ensure that we likely won't have a 1/3 of the population dead, you'll still be looking at death toll in double digits in terms of percentage. Bacterial diseases are very lethal, we just tend to forget that well over half the
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There's no need for regulation...
Just keep that in mind as you bury your 3-headed child.
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As they literally pollute the communal stream.