Deregulation: why the drugs don’t work

The development of penicillin, the world’s first antibiotic, in the 1920s is perhaps one of the most important developments in the history of medical science. Along with the development of public health and medical research, it meant that diseases such as tuberculosis, typhoid, blood poisoning and pneumonia, which had terrified communities, could be easily treated. Surgical procedures that had carried risks of amputation or even death suddenly became simple, routine treatments. The video above (released by our colleagues at Friends of the Earth Europe this summer) shows we are on the verge of a regressing back to a time without these protections.

The threat of anti-microbial resistance (AMR) is rising. Horror stories about medical interventions leading to drug-resistant bugs from America to Egypt are becoming more commonplace.

AMR is a technical term for a process through which micro-organisms (such as bacteria and viruses) develop resistance to the antibiotics and antivirals used to treat them. While AMR is a natural process, the process of bacterial and viral resistance is being hugely accelerated by the misuse of antibiotics. As a result, resistant microbes (including ​‘superbugs’ like the infamous MRSA) are proliferating at an alarming rate, creating one of the biggest threats to global health.

This is a medical and biological problem, but it also has deeply political and economic causes. First, the increasing privatisation of medical research has led to profit-driven research agendas. This has reduced incentives for research into one-off treatments, like new antibiotics to treat drug-resistant bacteria. Treatments for chronic conditions generate longer-term revenue streams once copyrighted, so receive the bulk of funding. Without more investment in finding new antibiotics medical scientists are falling behind in the arms race against superbugs.

Second, anti-microbial resistance (AMR) is being accelerated by the overuse of antibiotics and antivirals in agriculture. Antibiotics and antivirals are widely used by industrial farmers to prevent infections among livestock; in the USA it is estimated 90% of antibiotics are used in agriculture. AMR therefore develops in animals and is spread to soil and groundwater through the livestock excrement, and directly to humans when they eat meat and dairy from industrial farms. 

Third, antibiotics are often misused by patients. One recent study estimated that 7% of antibiotics taken in the EU are taken without a prescription, with the highest rates in Romania (20%) and Greece (16%). It is common for people to be prescribed antibiotics for illnesses which are not bacterial, and which antibiotics will therefore have no effect on, like the common cold, flu and even headaches.

The EU’s action plan makes paltry use of the powers at its disposal.

The EU has taken notice of the problem with its most recent action plan published in 2017. However, as Friends of the Earth point out, the problem is that the EU’s action plan makes paltry use of the powers at its disposal. Crucially, it develops guidelines and a voluntary approach on behalf of private industry, rather than mandatory regulations and clear targets, as called for by the European Public Health Alliance.

Pharmaceutical companies are businesses with profit motives. There is no financial incentive for them to voluntarily implement actions that stop industrial agriculture from plying animals with their products; encourage doctors to exercise caution in prescribing drugs; and prevent people from using antibiotics to treat colds and headaches. In fact, big pharma has been influential in lobbying the EU to stop it from implementing measures that might harm their profits.

The EU’s unwillingness to take any stronger measures to tackle AMR is part of a broader mindset. This reluctance (veering on outright hostility) to establishing new regulation, alongside eagerness to ignore or unravel existing regulation, is part of the deregulatory agenda sweeping across Europe. Its purpose is to boost private profits by removing barriers to business; it is delivered through policies such as the deceptively named ​‘Better Regulation’ programme; and its social and environmental costs are potentially huge.

Deregulation is putting our health at risk by accelerating the spread of AMR. And under-regulation and deregulation also affect economic, social and environmental policy. This agenda was the brainchild of the corporate lobbying industry (an alliance originally led by British American Tobacco hand – in-hand with big pharma), and is part of a push to capture the EU to boost profits for big business.

The EU’s transnational reach gives it the ideal vantage point to tackle AMR. Indeed, the EU touts itself as an area of global best practice in fighting anti-microbial resistance. But this is based on the increased regulations and resistance management developed by specific EU member states like Sweden, the Netherlands, Denmark and the UK. These veil the bad practices of other member states that undercut these efforts, leading to under-regulation. 

Anti-microbial resistance is a challenge that requires an ambitious, global regulatory approach.

AMR is a challenge that requires an ambitious, global regulatory approach. The causes of the problem point to clear solutions: more public funding for antibiotic and antiviral research; coordinated international action to inform the public and regulate the misuse and overuse of antibiotics and antivirals; and public support for small-scale, sustainable agriculture that use antibiotics only to cure diseases — not as prevention. The European Union could lead the way through a suite of measures, including: stronger regulations for agriculture and public health; setting clear targets for the reduction of use of antibiotics based on robust indicators; awareness raising campaigns; and investing in research, data collection, and monitoring.

The European Commission is oddly shy when it comes to muscular action on antibiotics and antivirals. There is a suite of areas where regulation is lacking or is being watered down at the behest of corporate lobbyists, from finance to the car industry. The EU faces a growing wave of popular discontent which threatens its existence. Using its transnational reach to act more decisively in defense of the public interest in halting AMR would be a good way to demonstrate its worthiness.

Working with partners at the European Environmental Bureau, and alongside others such as Friends of the Earth Europe, and the Corporate Europe Observatory, at NEF we are campaigning for genuinely better regulation, that puts people and the environment above profit, and ensures that the EU continues to protect the public interest.

The rules designed protect us and the places and habitats we hold dear have been painted as ​‘burdens’ on business – but a successful economy is one that puts people and planet first. Find out more about NEF’s work to end the deregulation agenda here.