It is Time to Consider Regulating Antibiotic Prescription
On Friday 10th of October a report was issued which showed that, despite pressure to do otherwise, doctors have been prescribing antibiotics at an ever increasing rate. As the Ebola outbreak continues to dominate the news the long term existential threat from global pandemics is surprisingly ignored. Scientists have long warned that our high use of antibiotics threatens to produce resistant diseases and it is this that threatens the existence of humanity itself.
If claims of existential threats to humanity itself seem a little hyperbolic, then my next claim – that unrestrained capitalism is an existential threat – will seem absurdly extreme. However, in her recent book This Changes Everything: Capitalism vs. The Climate, Naomi Klein argues that unrestrained capitalism threatens humanity because it produces and is unable to control climate change. The argument is made in favour of regulation of markets in order to see off the existential threat of climate change. Similar arguments must now be made regarding the use of antibiotics across capitalist societies, because at present they threaten to produce a global pandemic that would put all of humanity at risk.
The widespread use of antibiotics, not only on people, but enmass in factory farms, has lead many scientists to fear the development of diseases which would be resistant to antibiotics. If one of these were deadly the fear is that humanity would find the disease very difficult to combat. Though the chances of this result are low the existence of even a slight possibility of a resistant pandemic is intolerable because what we stand to lose is essentially everything.
Unrestrained capitalism does nothing to avoid the growth of resistant diseases. Whilst capitalism has provided huge advances in medicine – even if they are unevenly distributed globally – its drive towards progress also threatens to undermine that progress because the drive is primarily derived from capital and profit.
Of course 800 words is not the place to set out an entire argument as to how profit and capital are putting the globe at risk of pandemics, but the recent report on antibiotics provides a starting point to put forward a few considerations. There are lots of explanations for the increase in the prescription of antibiotics. I am going to focus on those related to over prescription to human, but won’t even cover all of those . Chief amongst those not considered here is the very existence of ‘Big Pharma’ and the disproportionate amount of pharmaceutical research funding it commands. Instead of big issues like Big Pharma, I want to focus on two apparently smaller explanations for the over prescription of antibiotics. First lazy doctors, and second intransigent patients. Both these supposed explanations when read in relation to each other can show how the manicantations of capitalism are perpetuating the increase on antibiotic prescription.
As market forces take a firmer and firmer grip on society the relationship between doctors and patients is changing to become increasingly economic. Increasingly doctors are no longer there help sick patients recover as such – rather they are there to put the cogs back in the machine when they fall out. The NHS was brought into being as part of a grand scheme affecting all areas of life. It did not stand on its own. Disease was a giant to fell in its own right – that someone might not be able to work while sick was not central. However, as market forces have steadily eroded workers rights the perception of sickness and work has changed. Now being sick is a defect of you as a worker. It carries a penalty – sick pay is harder to get, for part-time and zero-hours workers in particular. Doctors provide a service – they are expected to get you back to work. The perception that doctors are lazy, providing antibiotics as a quick fix, is one way to do this. Patients are intransigent – as well they might be – for many a medical service is needed in order to work.
The increasing marketisation of society is spreading into the medical world itself. The more it does so the more medicine becomes a service like any other – whether it is private individuals or the state which pays for it. Rather than being a part of a holistic reform of society, as the NHS initially was – it is now a service tacked onto the side of the rest of the market place. It designed to service sick workers and return them to their stations in the main economic system. When marketisation takes complete control of the health service it simply becomes part of the market. Under such conditions the drive to return workers to work will come from both workers and employers, both of whom suffer direct financial penalty for illness. Quick fix cures like antibiotics will only continue to be prescribed on the back of drives to productivity and profit, despite the longer term risks.
Market considerations will not allow for a restriction of antibiotic prescription. Left to its own devices, capitalism threatens to end humanity in a terrible pandemic. Regulation is the very minimum that is required. The need to harness the good markets can produce must be tempered by the need to restrict their power, and antibiotic prescription is as good a place to start as any.