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When We Lose Antibiotics, Here's Everything Else We'll Lose Too (wired.com)
273 points by jcklnruns on Nov 20, 2013 | hide | past | favorite | 175 comments



> Without the drugs that keep livestock healthy in concentrated agriculture, we’d lose the ability to raise them that way.

Antibiotics for industrial animal farms are one of the reasons bacteria develop multiple resistances. One should ban antibiotics for animals world wide. Unfortunate this wont happen, till its to late.

"The sheep look up" holds still true.


While I tend to agree with you, the problem is we'll then have a lot less livestock to eat, and there will be a global food shortage.

The house of cards is stacked very, very high.


> we'll then have a lot less livestock to eat

Even if that's true, while meat is tasty, it's a luxury, and arguably a step in the food chain that's a waste.

If the entire industrial meat sector evaporated today, my guess is the biggest impact would be an economic disruption from large number of suddenly unemployed and businesses no longer buying services/products, rather than any kind of food shortage per se.

But if we're talking about an antibiotic ban, the impacts wouldn't even reach that far. ABX don't enable production, they enable cheaper production. The most likely outcome isn't a serious collapse in supply, it's some combination of an increase in costs and modest reduction in supply.


Currently, meat serves the important function of regulating the supply of cereals. When there is overproduction, the grain producers can still sell for meat producers, not going out of business. Where the production reduces, meat producers sell thiner (and sometimes younger) animals, freeing more grains for human consumption.

Left alone, grain consumption is extremely inelastic, and production is extremely variable - not a good combination. But yes, it's not that hard to create other mechanisms for regulating that market, even world wide.


> Currently, meat serves the important function of regulating the supply of cereals.

  She swallowed the cow to catch the goat.
  She swallowed the goat to catch the dog.
  She swallowed the dog to catch the cat.
  She swallowed the cat to catch the bird.
  She swallowed the bird to catch the spider
  That wiggled and wiggled and tickled inside her.
  She swallowed the spider to catch the fly.
  But I dunno why she swallowed that fly.
  Perhaps she'll use a combination of market forces and
    warehouses to accomplish the same thing much more 
    simply next time around.


You don't think biofuels could take up an appreciable portion of that slack? I'd expect that buying up grain in bulk at surplus prices, and converting it into ethanol to be pretty profitable.


This is so relatively unimportant compared to the issue of antibiotics becoming useless that it made me laugh. It needs a healthy dose of perspective.


> Even if that's true, while meat is tasty, it's a luxury

No more a luxury than, say, cancer treatments.


If you don't get your cancer treated, you die.

If you don't eat meat, you don't eat meat.


If you live in Tibet or any other 4000+ meter environment where growing things is quite a bit more difficult, and you don't eat meat, you die. Say whatever you want about the Chinese, but the Tibetans do very much welcome the fresh vegetables that they can now get via better transport links and internal trade.

I visited north Xinjiang once, and was quite over-exposed to meat so much that I was happy to get back to lower elevation lands where I could actually get some vegetables again.


That's completely off-topic in a conversation that is obviously about large-scale ranches. Do those Tibetans use antibiotics to promote growth?


In my defense, parent was an off-topic false dichotomy. Do two wrongs make a right?


In this context, Tibet is a rounding error on pretty much any metric you can imagine.


So what about medical treatments that save lives but have yet to be invented? How is humanity possibly surviving now when there are still medical conditions that lead to death?


If you don't eat your meat, how can you have any pudding?


How can you have any pudding if you don't eat your meat?


Stand still laddie!


How can you have any pudding if you don't eat your meat!


The main difference being that cancer treatment saves your life while eating meat shortens it.


> eating meat shortens it

What a massive load of shit. Even if we're going to get on the train that eating meat vicariously results in antibiotics being rendered useless, the two are not any more directly related than watching Netflix destroys the environment (Netflix runs on computers, producing computers causes pollution, pollution destroys the environment).


Hold on, tiger. There appears to be some interesting research that supports this indirectly. It's not the meat, it's the methionine. It's highest in animal products (eggs are #1).

Methionine is an essential amino acid that is one of 2 that is used for the start codon for DNA transcription. It follows that if cancer is uncontrolled cell growth, that restricting the resource it needs would limit it's growth.

Appeal to authority: my wife, the molecular biologist pointed out the codon angle. It seems reasonable enough to me to have become a pseudo vegan (without the self-righteousness (at least in regards to that)).

http://en.wikipedia.org/wiki/Methionine#Methionine_restricti...

http://www.ncbi.nlm.nih.gov/pubmed/11603655


Whoa whoa whoa, this is a huge huge huge stretch in terms of causing cancer, and is not consistent with any current beliefs and thoughts on oncogenesis. Methionine availability is much more like the Warburg Effect [1], an effect where cells mostly perform anaerobic instead of aerobic metabolism.

Changing one's diet based on this speculation would be absolute quackery.

A cell's addiction to methionine is an effect of cancer, and restricting methionine can be potentially be used to treat cells that are already cancerous, but there's no thought on how this could possible cause cancer. Dump a bunch of methionine in cells and they're not going to develop cancer, as far as anything I've ever seen. Interestingly enough, diabetes patients that use metformin to treat their diabetes seem to have slightly lower cancer rates than diabetes patients that don't use metformin, which has triggered interest in insulin receptors as possible treatment targets or causes, which are vaguely related to metabolism, but such work is extremely early and no conclusions should be drawn. And that's on far far more solid ground than methionine as a cancer risk.

We understand caloric restriction far better than methionine restriction in terms of extending lifespans of lab animals, so if one wants to speculate on dietary changes, this seems like a far better speculative, pre-knowledge, gamble than methionine restriction.

[1] http://en.wikipedia.org/wiki/Warburg_effect#Oncology


I don't think I said (and know that I didn't mean to imply) that excess methionine causes cancer.

Methionine restriction by avoiding methionine rich foods doesn't strike me as harmful at all, since there's still plenty in even a vegan diet. And in my case, I said pseudo-vegan -- it's more a mindset than dogma.


Can you explain a bit more? I'm interested, but I'm interpreting your post as "helps with DNA copying so its good for cell reproduction means it causes cancer". I'm sure I have it wrong. I mean.... loads of things we eat are good for cell reproduction. It's almost like saying "living makes you more likely to die"


I'd probably make it more confusing :-)

http://en.wikipedia.org/wiki/Start_codon

Note the reference to methionine. My understanding is that the body recycles methionine as well. So give your body just enough to let it do it's thing but don't pour gasoline on the cancer fire by supply a surplus of a critical component.

I'm still slowly doing the research on this. It was spurred by my daughter telling me about "the Blue Zone healing cancer". Googled that, and checked out the dietary element, and that led to the topic we're discussing now.

It seems reasonable enough. And simple enough. And you don't have to be vegan, but mindful of intake.

Just trying to share a recent discovery that seems like a possible life changer.


Hmm interesting. I eat a few dozen eggs per month, mostly because they're the cheapest source of protein.

I may have to consider chicken or something else.


I eat at least a dozen per week, and plan to continue. This is non-sense. The "seems to make sense" part especially. You can take any thread from human biology and spin to extremes using inductive reasoning. Fortunately the body has myriad checks and balances.

I submit to you "free radicals". Oh-my-god-theyre-awful-help. Enter anti-oxidants, oh-my-god-theyre-great-yay. Let's supplement them right? Ouch, turns out, those dietary anti-oxidants were the bees knees, but supplementation to extremes might be a bad idea, and we might need some free radicals to prevent cancerous cell growth.

My moral here is, natural whole foods, mostly, will keep you pretty near balance. Eat your berries, whole grains, eggs, and proteins because the one thing we know is bad for us is a lack of balance.


Umm, I think he was referring to the (purported) health benefits of a meat-free diet. The ideal amount of meat in one's diet is perhaps debatable, but I wouldn't call the claim "a massive load of shit" (both because it overstates and because I would come up with something more civil).


Arguable. According most low-carb diets, eating meat is good for you and it's carbs that screw you over.


Low-carb diets advocate replacing carbs with fat in addition to protein, and there are many non-meat sources of fat and protein.

And the premise of the diet is supported by sound scientific research rather than simply hearsay (as your comment implies).


> According most low-carb diets, eating meat is good for you

Those diets may be good for losing weight, but are they good for a healthy person?


After figuring low-carb on my own (I never had heard of it before), and making my nutrition person (forgot the name in english for that profession) cringe, it worked wonder.

First, I started to lose 1kg a week, until I was in a healthy weight (when the weight stabilized instead, without much adjustments to diet), and my choleterol that I was fighting for years, dropped to healthy levels in 4 months, also several other broken blood levels got fixed.

Also my sleep got better, and for the first time in my life going to the gym made a difference (before that, I could go to the gym all I wanted, and I would never get stronger, and I was very weak, sedentary 14 year old girls could lift more weight than me in the upper body).

But that is just a anecdote, it happened to me, I did no research to see WHY it happened, it just did, and now I stick with that diet.


nutrition person (forgot the name in english for that profession)

Either "nutritionist" or "dietitian".


There is a very wide range of low-carb sources of food that are well-rounded and excellent -- avocados, tomatoes, almonds/almond milk, spinach, cheeses, high-fat yoghurt, tofu, blueberries, raspberries.

And obviously many meats.

This is a thorough list: https://docs.google.com/spreadsheet/lv?key=0Ah8MbmZepQxWdGo4...

Initially, it's definitely challenging, and switching to a wholly low-carb diet is not without an unpleasant transition period.


That wasn't my point. What if there was a cancer treatment that costs literally billions of dollars, so that only a few people in the world could afford it? Would that cancer treatment be a "luxury," or would you consider it a basic need for all humans?


I'd say it (the expensive treatment) was a basic need. A need that was not being met. You could tell it was a need because those who needed it but didn't get it would die.


So, which would you rather have, a lot less livestock to eat, or no way to treat bacterial infections?

Oh, but guess what, you don't get to choose that trade-off -- you'll have a lot less livestock to eat either way. You can do it with or without entering the post-antibiotic era. (Or at any rate, a lot more expensive meat, which will likely result in a lot less of it, sure.)

Fortunately, a lot less livestock to eat does not mean a global food shortage. People are quite capable of living with a lot less meat. It may be a global deliciousness shortage, because meat is delicious; but most people on the planet don't eat much meat already (cause they can't afford it).

The OP is odd in suggesting "We have a few chances left to turn back the tide of resistance — but only a few, and not much room for mistakes. I hope we take them." -- without any hints as to what these chances are -- and then suggesting that if we don't take them, what we'll 'lose' is cheap meat from routine antibiotic use in livestock! But in fact, ceasing the use of routine antibiotics in livestock production -- before they become useless, because it'll be stopped when they become useless anyhow -- seems like the #1. What else you got?


If even some of the land that was freed up by a fall-off in livestock production was instead used to grow plants, we'd actually have a food surplus, and a significant one.

EDIT: "even some of"


Many places which are unsuitable to crop production can be used for livestock production with very wide grazing.

Most livestock production is done in hyper-concentrated confinement operations which take up negligible land space. For the wellbeing of the animals, the quality of the environment surrounding these sites, and the quality of the meat -- these confinement operations should be done away with. The space, though, is irrelevant.

Eliminating livestock production increases food availability because the feed-conversion-ratio is between 4 and 40 (how many pounds of feed turn into 1 pound of cow,pig,chicken, etc).

It is certainly not about space.


What about the space required to grow food for livestock?


Livestock can utilize food sources that we can't (pigs are the greatest food recyclers ever created), and they can graze in wastelands that we otherwise find difficult to make productive.

India is primarily vegetarian ONLY because they have lots of land in which to grow things. Most other regions do not have so much grow-worthy land, and require a mix of farming and livestock to sustain their populations.


The U.S. devotes 80 million acres to corn production, corn that is mostly used as animal feed:

http://www.ers.usda.gov/topics/crops/corn/background.aspx

(ethanol has shifted that mostly some, yay!)


That doesn't mean those 80 million acres are able to grow food humans can eat though. Not every year.

For instance, on my farm, while our soil and climate is quite good for growing beans of many varieties, which are great for human consumption, you still need to maintain a rotation to maintain a viable farm. We've had to push cereals out of some of our land because it simply won't grow on their soils. That basically leaves corn as our only real rotation option.

To add to that, corn is essentially worthless right now. Its market price is below what it costs to grow. I'd rather grow something I can make money from, but I don't know what that is. You just have to roll the dice and hope the price improves before you have to sell it.

As an interesting aside, a neighbour of mine actually did try growing beans year after year, but he soon found himself out of business completely when disease started running rampant and his yields dropped to nothing. It was kind of sad to watch, and frightening to think what could be if we lose the animal markets.


We can eat corn! I certainly don't want to shift my diet over to consume so much of it (I do realize that the quality of the harvest varies and different varieties, etc., but we can eat it).

Mostly, this thread seems a bit wishy-washy on how we feed livestock in the U.S...


True, but not 80 million acres worth, and only after heavy processing like turning it into HFCS. The corn we grow is not the stuff you eat on the cob.


Well, I like corn bread. And corn tortillas. I don't mind corn flakes. I don't like corn dogs. There's lots of ways to utilize field corn for human consumption.

But sure, it's unlikely humans would keep growing that much corn if it wasn't going to ethanol or livestock.


Fair enough, but still a drop in the bucket compared to what is being grown. You said yourself that the vast majority was consumed by other animals.

> But sure, it's unlikely humans would keep growing that much corn if it wasn't going to ethanol or livestock.

Which is likely, and in line with what I was suggesting earlier. However, unless some unforeseen markets open up, that means leaving the land fallow every few years rather than growing corn, not growing more food for humans.

That is where I was going with my original post. If we stopped growing corn completely, that doesn't necessarily mean we gain 80 million acres to grow something else, you just lose the meat out of the nation's diet, putting more pressure on the land that is already growing other foods.

I'm not saying it is impossible to see such a transition through, but our agriculture system grew up with animals being a large part of it. To stop that over a short period of time would be a huge transition, and I could see it being an incredibly painful time for farmers and consumers alike. It won't simply be a matter of stopping the consumption of animals and starting to eat a vegetarian diet like small groups of people are able to do today.


> Eliminating livestock production increases food availability because the feed-conversion-ratio is between 4 and 40 (how many pounds of feed turn into 1 pound of cow,pig,chicken, etc).


To add to that, the grazing animals don't need the antibiotics just to survive their conditions, only the ones in concentrated confinement need them.


The confined animals don't need them to survive either, it is just cheaper and easier to treat every animal than it is to only treat the sick ones.


Not to mention we'd reduce water usage dramatically in a lot of places where water use is one of the most pressing issues people face.


And don't forget air quality! Cow farts are a leading cause of greenhouse gases.

Seriously.


We already have a food surplus.


Less cheap industrial meat in the overfed west (particularly the US) is not equal to global food shortage.


pumping them full of antibiotics under factory farm conditions seems like an awful hack anyway.

it's like running eighty concurrent webserver processes and killing them 100 times per second round-robin because if you don't kill them constantly they will bring down the whole system.

I mean maybe this setup "works" but aren't we really stretching the definition of that word?


> it's like running eighty concurrent webserver processes and killing them 100 times per second round-robin because if you don't kill them constantly they will bring down the whole system

Ruby on Rails?


A significant portion of the drugs used in feed are used to tip the digestive chemistry so that the feed is processed more efficiently. It isn't that big an effect, but it isn't really wildly crazy. There's a bunch of studies on feeding ionophores to graze animals (which I take as a demonstration of intent).


It's pretty doubtful that a reduction in livestock would lead to a food shortage. The amount of resources it takes to produce a calorie of meat is vastly larger than to produce a calorie of plant-based food.


Erm. People have been eating meat on a regular, frequent basis only very recently in History. 60 years ago it was meat just one a month or something. And people didn't just die off because they couldn't eat meat anymore.


That's simply not true. Inuit have almost exclusively eaten meat for centuries. And there are parts of the world where agriculture and irrigation don't work and animals which can feed on scrub are the staple.


Well, I was talking about Europe, mainly, and I assume in most countries of the developed word this was very much the same. I don't think Inuits have very much to do with the industrial production of meat we have nowadays, do they ?


Actually, I believe the Inuit don't practice animal husbandry either; they mainly get their food from the ocean (mostly as meat).


It is, at least in Europe. Ask your grandparents and they will tell you that they maybe ate meat once a week


Here's one of the big the reason.

Meat requires a lot of space to grow!

Europe is small, and there isn't a lot of extra space. Less meat.

Enter the United States. WOAH! Lots of land! More space to raise meat! More meat!

NPR mentioned another factor a while back in their program, "The making of meat eating America," American innovation.

http://www.npr.org/blogs/thesalt/2012/06/26/155720538/the-ma...

Almost two centuries ago, he says, meat was one reason why immigrants found America so amazing. "When the Irish come in the 1840s, they write letters back saying 'I eat meat every day,'" Horowitz says. "And they get letters back saying, 'You must be kidding. It can't be true.'"

Back in Europe, says Horowitz, the growing of livestock was often organized and regulated in a way that funneled meat straight to the wealthy or the landed aristocracy. In the new world, though, meat was much easier to find. Grazing lands were close to cities; sometimes . Farmers quickly realized that raising animals was a good business. Cities set up markets for them. "And the result is a flourishing of the livestock industry, very early in American history."

As a result, when new technology came along, like railroads and refrigeration, American entrepreneurs were able to jump right in and use it to turn beef into a centralized, national industry.

"Why could they sell chilled beef in New York in the 1880s? Because New Yorkers had been getting beef in their markets and butcher shops for at least a hundred years. So we have this new meat coming in? It's a little cheaper, let's give it a try!" Horowitz says.

That's been the story ever since: , more efficient meat production, and Americans kept saying — "Hey, it's a little cheaper, let's give it a try!"


What? I'm Irish and my grandparents ate meat, fish or eggs pretty much every day of their lives


Then your grandparents were unusually wealthy. My grandparents certainly didn't.


Or perhaps you're just older, so your grandparents were from a different generation?


Well not in the post WW2 germany my grandparents lived in.


It all seems like a vicious cycle of us discovering better ways to fight bacteria and feeding more and more people at the same time at the same price or less. Everything adapts bla bla bla.

This could all be alleviated if we just took a step back as a society and took control of our own lives, food included. Maybe spending 20-30 minutes a day on growing your own supply (where applicable) isn't the worst thing in the world if it came down to it.


That's a very modest estimate of the time involved if you start talking about people growing a significant portion of the calories they need.


Absolutely, but maybe there is more then one wrong here. Plus the nutrition you get from mass farming these days is less then desirable. It's not about quantity ,but quality as the cliche says.

I understand this is not possible everywhere but I grew up on a pretty small suburban home that grew maybe 50% of its own vegetables outside of winter. Having moved to a heavy industrialized nation and moving that down to 0% I can see the difference in quality when eating mass produced food.

Again, not everyone if willing or able to do this, but where applicable it should be encouraged and promoted instead of looked down upon as another hippy mentality blabedibla...


One should ban antibiotics for animals world wide.

I wouldn't go quite that far. I am on record here on HN as agreeing with a doctor who said in an interview,

"Q: Do you think we have enough data to know what’s happening with the antibiotics used on the farm?

"A: I think we know enough to say that we need to be doing a better job of improving appropriate use of antibiotics in all sectors, humans and animals.

"Q: But the agriculture sector is different, because antibiotics have been used there for a long time with an eye toward improving the growth of the animals, really for food purposes, to make them bigger and fatter with less food. Does that concern you as a use?

"A: Certainly the CDC believes quite firmly, and I think there are a number of veterinary experts here and in other places who agree with the stance that we should never be using antibiotics in agriculture or in people for any other purpose than to treat infections.

"Using antibiotics to promote growth in animals is not a good use of antibiotics. It’s not careful use of this really delicate and invaluable resource."[1]

I am also on record as saying, responding to a passage in another thread-opening article,

>> "What Europe did: In the EU, all antibiotics used in human medicines are banned on farms—and no antibiotics can be used on farms for 'non-medical purposes,' i.e., growth promotion." <<

I'd like to see the United States follow that lead immediately, and I write this as a man who has several uncles and cousins who are farmers, including some who raise cattle. It makes sense to me to have lines of defense against transmission of animal-infecting, and especially antibiotic-resistant-animal-infecting, microbes to human beings, by controlling what animals raised as lifestock eat and how they are treated with veterinary medicines.[2]

Animals get sick, both on and off the farm. Careful veterinary practice can enhance human health, by reducing sources of zoonotic infections. The epidemiologists who work to prevent human disease also keep track of news of animal infections on the farm and in the wild.[3] With this in mind, I can't agree with the policy idea

One should ban antibiotics for animals world wide.

expressed in the parent post. We should be careful about the use of antibiotics, many of which were originally "natural" substances emitted by microorganisms as a defense against other microorganisms, and we should use antibiotics mostly to treat cases of actual human or animal disease, and also use other infection control measures to prevent the spread of infectious diseases either to humans or to nonhuman animals, wherever they live.

AFTER EDIT:

Meanwhile, in human medicine, the development through natural selection of multiple-drug-resistant strains of tuberculosis is very alarming. I wish India were doing better in controlling tuberculosis. Both a newspaper in the United States, which did much to break the story,[4] and a newspaper from India[5] are in agreement with official sources from both countries[6][7] that much more needs to be done to stop the spread of drug-resistant strains of tuberculosis in India, which could threaten the health of the whole world. (A century and a half ago, tuberculosis was perhaps the world's leading cause of death.)

[1] https://news.ycombinator.com/item?id=6599795

(expressing agreement with the quoted expert in the thread-opening article)

[2] https://news.ycombinator.com/item?id=5674781

[3] http://www.cdc.gov/ncezid/

http://www.cidrap.umn.edu/

[4] http://online.wsj.com/news/articles/SB1000142405270230344420...

[5] http://articles.economictimes.indiatimes.com/2013-06-23/news...

[6] http://www.iom.edu/Reports/2012/Facing-the-Reality-of-Drug-R...

[7] http://www.tbcindia.nic.in/pdfs/RNTCP%20Response%20DR%20TB%2...


> I write this as a man who has several uncles and cousins who are farmers, including some who raise cattle

All of whom would not be harmed by outlawing the indiscriminate use of antibiotics in agriculture.

Right now we have a situation where people raising cattle can make more profit by using antibiotics, this drives down the cost of meat to where farmers raising cattle naturally can't compete on price (and must charge a premium for antibiotic-free meat).

If the laws were changed, no one would use antibiotics, consumers would pay an extra 50 cents / pound of beef and the farmers would remain equally profitable. In fact, it might make the midwestern family farm viable again, right now they can't compete with the massive cattle lots, but such regulation could make raising 10-100 head of cattle a worthwhile endeavor again.


The FDA has asked nicely for industry to please stop using antibiotics in feed:

http://online.wsj.com/news/articles/SB1000142405270230444460...


As an extremist libertarian, one whom doesn't even want the FDA to exist in the first place, I can say that the failure of the FDA to control this outrageous overuse of antibiotics is just insane.

Even extremist libertarians think that the government should be able to exert its' powers in order to prevent contagion. This is a clear example of the government failing in one of its core responsibilities.


Really? If you never wanted the FDA how could the government ever accomplish that feat? (which it currently isn't)

Wouldn't an extremist libertarian say something related to the market sorting it out?

I am genuinely interested in your opinion. (tragedy of the commons and all that)


There's no singular school of thought, but yes libertarians almost universally favor government prevention of contagion. It's also not unusual for us to favor some environmental regulations (though by no means approved by all of us!).

Markets are only one facet of a healthy functioning society. You still need government and it's courts and law enforcement. Civil courts deal with the negative externalities (pollution, contagion, etc), not markets. There are of course myriad instances of humans banding together on their own to solve tragedy of the commons issues, without the courts or regulation, but of course in the US anti-trust laws would prevent such coordination as "cartel like behavior".

But let's assume the "ultimate extreme libertarian society", in which even the air we breathe has been privatized. The air shareholders would still need to use the courts to enforce their ownership rights against polluters (a factory, for example). Without the authority of the court to back them up, the air shareholder would never be able to actually force the factory to pay for the right to pollute. The market helps ensure reasonably efficient allocation of air rights, but the courts (government) are still required to actually make the system function.

And finally, to answer your first question: Why would you need an FDA to restrict antibiotic use in agriculture? Normal courts, cops, and laws can't do that?


One needs to be very clear about US libertarian which is largely a conservative movement and libertarians in the rest of the world, who are largely considered left wing liberals and/or anarchists.

The Tea Partiers of the world hijacked the term and repurposed it for their own weird definition, I think it was that lot at any rate.


The viewpoints expressed above are straight mainline US libertarian points. 90% of US libertarians would agree in whole or part with what I said.

I don't know of any left wing liberal libertarians anywhere in the world. The anarchist libertarians (called minarchists or anarcho capitalists typically) are probably more common in the US than outside of it. Some Tea Partiers actually are libertarians, many are not.

As with everything, some people swing more left others more right. Everyone is different. But the points I presented in the previous posts are mainline libertarian points agreed upon by virtually all of them (us).


To your last point, I guess I would say that it seems like it would put a heavy burden on the police to regulate all activity that we would make illegal. Can you imagine a beat cop driving his car out to the farm to verify if illegal antibiotics were being used? The example is purposefully ridiculous, obviously.

If we create a specialized arm of the police who specialize in things like air pollution, crops, etc, are we not just recreating the same government entities that are being railed against?


No, because hypothetically we just did a mark&sweep garbage collection.

The FDA/DEA/etc do all sorts of things - failing to regulate antibiotics, preventing women from purchasing birth control without a doctor's permission, sending people to jail for possessing herbs, etc. If we nuke it all and recreate the important bits, it's a great way to eliminate everything we don't need.


It'd be a lot easier than trying to prevent the entire human population from taking recreational drugs.


Cant argue with that!


Taken to its extreme (which it has been): (1) "normal cops" need specialists to enforce rules the average beat cop doesn't understand. (2) "normal laws" are vague, imprecise and take years of debate to clarify, so we have "ministers/secretaries/directors" empowered to nimbly and precisely interpret the broad laws.

The specialists in the cops become their own sub-department. The ministers need a 'place'. Lo, why not put them together, and while we're at it, note this is very much a national 'common' problem, so lets have them all work at the federal level.

Not saying I agree that it's the way it should be, but the reduction is inevitable.

(For the record, they I think it should be is the FDA is needed, but its powers and practices need better alignment to its intended mission)


One of the unfortunate truths of current human society is that economic incentives are far more powerful than polite requests for group cooperation.


That's not an ill of modern society, it's just basic game theory.

http://en.wikipedia.org/wiki/Prisoner's_dilemma


No, it's modern society or even simply human nature.

Game Theory is a method of examining it.


This is not the Prisoner's Dilemma - the "prisoners" are allowed to talk to each other and coordinate in this case. Say all the farmers in the US sign an agreement not to use antibiotics. They also pay a small fee for policing this agreement amongst themselves to make sure that nobody is cheating. This gives a result completely different from that of the Prisoner's Dilemma.


Tragedy of the commons.


Only partially true. You assume beef is an inelastic commodity; that we must consume our beef and will pay any price come hell or high water. True for some people, perhaps :P but other people may eat less meat, eat smaller portions, or switch to being vegetarian. The reality is that a world with expensive beef means less overall consumption of beef.

In short, prohibiting indiscriminate antibiotics would make it easier on farmers who already forgo them, but it could still hurt GP's farmer relatives (assuming they're currently guzzling down antibiotics) because the overall market for beef would shrink.


You're assuming that farmers would produce the same volume of beef.


This ignores supply/demand, higher costs would definitely drive down demand, which would lower sales volume and potentially lower total revenue and profit.

(Though I think it's a good idea regardless.)


> Antibiotics for industrial animal farms are one of the reasons bacteria develop multiple resistances.

I have the impression (but haven't really checked any real sources on this) that the carefree use of antibiotics on farm animals is mostly an American thing. And that the use of antibiotics in animal farming is much more regulated in Europe. Don't know for sure, though. And don't know about the rest of the world.


Antibiotics on the farm are banned in the EU for anything but treating infections. This seems to be a largely an American problem. The real problem is that American politics are broken and adding even sane common-sense regulation against a mountain of lobbyists and corrupt politicians is an uphill battle that usually ends in failure (patent reform bill recently) or various compromises that kill any chance of the bill being very effective (ACA).

I think the US is a case study in how this level of "direct democracy" usually gets gamed by monied interests.


It would be interesting to see the incidence of multi-drug resistant bacteria in the US vs. the EU.

Most people get MDR infections from other people, not from animals. I'm not saying animal to human infections don't occur, they obviously do, but it's not a major source of transmission.


Certainly true. My dad is a veterinarian and said its quite heavily regulated in germany and possibly Europe


Routine dosing is already banned in the EU


Unfortunately, you are right.

Startup idea: cheap consumer-oriented broad spectrum antibiotic detection kits for meat and fish.


Check for a lack of an organic certification label. The end.


Well, you have to believe the USDA Organic label is actually being used correctly[1]. I say this as a USDA-Organic fan who tries his best to buy his family only things that carry that label. I'd buy a setup that allowed me to test my food; I thought about this awhile back[2].

1. http://www.ams.usda.gov/AMSv1.0/ams.fetchTemplateData.do?tem...

2. https://twitter.com/SMTDDR/status/347885004606545920


Thats a great idea. But how to apply this in supper market?

You could only check it after buying, and slapping the so called bio-butcher, if he sells you antibiotic meat, with the meat he sold.


It would enable an effective labeling program.


Of the many topics that seem to capture the attention most readily, tales of the apocalypse to come are perhaps the most compelling.

For reasons I don't completely fathom, people gravitate toward stories of impending doom much more readily than stories of impending happiness. History shows that 'good' unexpected things happen just as frequently as 'bad' unexpected things happen, and consequently we get a lot of change but not necessarily all bad change or all good change.

Still you can write a blog post that the economy is near the breaking point, our civilization is mere moments away from collapse, or that some calamity is on the verge of wiping us out, and get all the page views you can monetize.


Perhaps people want to know about impending doom in the faint hope they can do something about it, while they don't read about impending happiness because- well, who wants to prevent happiness?

Also, articles about impending happiness can wind up making you unhappy. Just think of all the "Cancer cured! (in mice)" articles, as well as product vaporware.


I think that is an excellent insight. Basically people are more invested in 'stopping' doom than they are in 'starting' happiness. A number of interesting behaviors fall out of that using a strict action selection type mechanism.


All it takes is for one impending doom, and bam! You'll never again have the luxury of even being able to think about happiness.

Course, most dooms aren't that final, and I agree that we should focus on the positive (such as, how can we change our actions to affect a positive outcome?), and a critical eye towards doomsayers is always called for (as is a critical eye to those who promise happiness), but ignoring problems usually doesn't make them go away (especially serious ones).


This article isn't some "2012" doomsday nonsense.

This is a real and pressing concern, indeed has been a concern for decades.


Just like the global food shortage that Malthusians assured us was bound to happen, the ozone layer fading away and UV rays destroying us all, Y2K breaking every computer on the planet.

This time it's for real. This time, technology and human ingenuity isn't going to save us.


The ozone layer survives because people caught it in time and banned the chemicals causing the problem.

We could do the same thing with antibiotic overuse and it would indeed prevent disaster. That's pretty much what every article about the problem advocates, explicitly or implicitly. Well that, and funding more research on new antibiotics, which we're not doing much of right now.

Just waving our hands and trusting to the magic of technology and ingenuity isn't going to get us out of this. We have to actually do something about it.


There is a story:

A man is walking to a village when he falls into a puddle of quicksand. His attempts to escape are futile and he is nearly about to die when a farmer happens by and hauls him out. The farmer tells him that he should watch out for that puddle. The man suggests placing a sign there to warn travellers, to which the farmer remarks, "Oh, we had one. But no one was falling in, so we took it away.".

About the ozone layer:

* https://en.wikipedia.org/wiki/Vienna_Convention_for_the_Prot...

* https://en.wikipedia.org/wiki/Montreal_Protocol

How quickly we forget the lessons of the past!


I'm struggling to understand how anyone could possibly be aware that there was a threat to the ozone layer, but also think that it magically solved itself. The catalyst action of CFCs is not remotely controversial, no more than the IR absorption spectrum of CO2.

Whether it's environmental disasters or internet social media activities, there's an interesting bias towards thinking that the status quo is stable, just because it's been that way for a few years. Stuff changes. Take a step back and actually look at the whole picture.


The ozone layer healed itself despite the fact the Chinese continued to produce and release MASSIVE amounts of CFCs after the signing of the Montreal Accord in 1987. It wasn't until 2007 or so until they stopped. However, the layer stopped thinning in 1997 [1]. Interesting no?

[1] http://www.reuters.com/article/2007/06/27/environment-china-...


Your article does not say that China was producing such massive quantities of CFCs that the efforts of all other signatories to the treaty were negated. What your article does say:

> Scientists largely credit the Montreal Protocol, signed by about 150 countries, with reversing the depletion of the ozone layer


This graph shows that in 1997, reductions in CFC had just begun, yet the ozone hole had been reversed.[1]

Also, apparently there isn't agreement that the hole has gotten better: "Work has suggested that a detectable (and statistically significant) recovery will not occur until around 2024, with ozone levels recovering to 1980 levels by around 2068."

So which is it?

[1]http://en.wikipedia.org/wiki/File:Ozone_cfc_trends.png


> Just like the global food shortage that Malthusians assured us was bound to happen,

How many times can we get lucky with rapid, unforeseen advances in technology?

> the ozone layer fading away and UV rays destroying us all,

Avoided by being proactive

> Y2K breaking every computer on the planet.

Avoided by being proactive


"How many times can we get lucky with rapid, unforeseen advances in technology?"

An infinite number of times. There's no "luck" to it - there are people actively searching for solutions to this shit so we don't end up dead.


There is absolutely luck, it's in the timing. The Green Revolution happened to arrive before we hit Malthusian limits, but that wasn't guaranteed.

If an asteroid is going to strike tomorrow the only solutions that matter are the ones that are economically and technically feasible today.


There's no law of nature that says technological advance will solve every problem in time. There are many examples of societies that destroyed themselves.


And whether this is "the big one" or not, with this attitude, we'll never be ready for anything that actually does go seriously wrong. "It hasn't happened before, so it can't happen now" makes for nothing but a great epitaph.


These are cherry picked examples or anything. Besides some things actually get done in the expectation of a disaster (like banning ozone destroying chemicals or fixing Y2K bugs.)

Even in the current article, no one is saying this is going to happen for sure, just that it could if we don't do anything about it or invest in new antibiotics.


Everything you said is true. But so is the fact that people are starting to die of things that just a few years ago were curable.


Understanding downside is much more crucial for continual survival than upside: what is the worse case scenario, bottom line analysis - are the heuristic tools routinely used by people the world over.

A new solution to bacterial infection control problem is due and it might come with even greater benefits than antibiotics. The article makes us appreciate the pain of the problem and puts a greater value on achieving a solution.


Impending happiness comes from the trying to prevent impending doom, scientific advancement just doesn't come out from thin air.

That said, I'm not saying that people can't be overreacting in certain circumstances. But keep in mind this line of reasoning (ie things happen, and we can't do much) can be quite misleading and even dangerous in some cases (human can't cause global warming, how do you think some puny tiny human beings can do anything to the earth etc.)


Some would argue there's a fine line between nihilism (which is often misunderstood anyway) and stoicism . . .


This could be due to evolutionary adaption: for most of human history, prioritising information about "impending doom" over that of good news is a better survival strategy because, however pleasurable the good news, the impending doom could kill you. This might not be a effective strategy now, when sources of doom are often outside individual control, but we still do it.

Wikipedia has a page on "Negativity Bias" [1], which focusses on differential recall of positive and negative memories and is therefore not quite what you describe. The explanations section is also a bit light on facts.

[1] http://en.wikipedia.org/wiki/Negativity_bias


It's great to be optimistic about this as well, because humans will find a way.

http://en.wikipedia.org/wiki/Antibacterial#Alternatives

The alternative section is the largest section in wikipedia. Also, as more people die (sadly) more money and time will go into these alternatives.

I think you miss one point about doom and gloom; people can sometimes build something better in the ashes of failure. Looking into antibiotics, this seems inevitable anyway...

So we might as well create many, many effective alternatives as we shift towards living in a world where they are necessary.


I suspect this problem will self-correct. It's not that we've run out of choices: it's partially that pharmaceutical companies had the narrow view that developing new antibiotic drugs is less profitable than developing drugs for chronic illness (e.g., to control cholesterol); once catastrophe hits due to bacteria being resistant to all current drugs, it will be extremely profitable to work on this class of drugs again. Take a look at this interview with Dr. John Rex M.D., (V.P., Clinical Research, AstraZeneca) [1]

"Dr. JOHN REX: If you need an antibiotic, you need it only briefly. Indeed, that’s the— that’s the correct way to use an antibiotic. You use it only briefly.

And from an economic standpoint of a developer, that means you’re not— you’re not getting the return on the investment you’ve made because you’ve spent between $600 million and a billion dollars to bring that new antibiotic to market."

[1] http://www.pbs.org/wgbh/pages/frontline/health-science-techn...


Most things in the world eventually self-correct. But before that happens, many people will be hurt and die in the process.

For example, we could do away with CDC, FDA and building codes, and rely on Yelp customer reviews of drugs, restaurants and electrical contractors. Eventually the ones that kill people should get bad reviews and go out of business - but this won't help the first victims and their relatives.


Intriguing to think about. But what will probably happen is the lack of controls will allow for higher profits - the companies that kill people will have way more money to pay off Yelp to censor bad reviews.


The companies would pay to post fake reviews.

Oh wait. They already do that!

Deceptive marketing thresholds and punishments would have to be much higher.


True, but Yelp would lose all credibility, so it wouldn't be used to determine anything than dining out.


> Most things in the world eventually self-correct. But before that happens, many people will be hurt and die in the process.

Yes, I understand that, but my point is that this isn't some apocalyptic end to the world as we know it, and it helps to take the long view of how it will unfold and prepare accordingly. As insensitive as it sounds, it's more productive to look at why something bad happened and what we can do about it rather than lamenting that bad things happen in the first place.

Sadly, when you look at large groups of people, it's human nature to ignore problems that don't have short term profitable solutions.

People have known about this problem for decades and are unable to persuade the decision-makers to proactively prevent this scenario from happening; it'll be interesting to see how it unfolds as an emergency (probably not very well), and what will be done differently after the emergency is handled.

Perhaps non-profit groups like the Gates Foundation will work on antibiotic drugs in the future, simply because for-profit pharmaceutical companies aren't going to touch it because it isn't profitable enough. Or perhaps an international group will try to tackle this problem, similar to how they try to tackle other global problems (which isn't promising: look at how we're globally handling environmental issues).

As for looking at this problem now, it may be profitable for people to pick up the dropped research in gram-negative antibiotics. The Hacker News crowd would most likely be interested in the bioinformatic aspect of this problem, modeling gram-negative bacteria and its interaction with various compounds.


> for-profit pharmaceutical companies aren't going to touch it because it isn't profitable enough.

may be it isn't profitable enough because the other problems they chose to focus on is more "important" in the eyes of society.

I see profitability as a measure of how important society sees a problem as. Not what people say, or what is morally important, but actual market decisions that drives such profits is the real source of truth.


> but actual market decisions that drives such profits is the real source of truth.

Right. Cue up the 2008 financial crisis.

> may be it isn't profitable enough because the other problems they chose to focus on is more "important" in the eyes of society.

Back to my original comment that this is a self-correcting problem: https://news.ycombinator.com/item?id=6771657

But I doubt that society at large evaluated that certain things (that are currently very profitable) are more valuable than avoiding the situation of running out of effective antibiotics. I posit that there's so much information overload, this problem is simply overlooked by the masses (due to human nature) until it's too late.


It won't self-correct overnight. It takes decades of research to identify new antibiotics, ensure they are safe and effective, get them approved, and bring them to market.

And you're assuming that there is still a large supply of potential antibiotics waiting to be discovered and which can be discovered relatively quickly. Our current batch of antibiotics already attack bacteria in very different ways. How many new classes can we invent which are effective against bacteria but non-toxic to humans?


I've seen comments on HN when this point was raised, that newer antbiotics are also held back for serious cases so sales turn out lower during the patented life of the drug, which provides a further disincentive for developing them.

It's also been pointed previously on HN out that vaccines are one-shot drugs that are still developed (indeed, my kids have had 6-in-1 and MMRV combination vaccines, which reduce the number of shots needed by kids-I don't know how that works out for drug companies, but I doubt it increases their volumes) .


One problem is that antibiotics are themselves somewhat toxic to humans. As the friendly ones become ineffective, the less friendly ones come into play.


Holy hell, antibiotics are used on fruit?

To be honest I was a bit smug because I don't eat meat.

So much for that. Wow we are in trouble.


Me too, but apparently it's true. At least for the US.

"Antibiotics can also be found in vegetables and fruits. The U.S. Department of Agriculture funded a study to test this. Scientists took manure from animals that were given antibiotics. They grew different plants in the manure and then tested its leaves. What they found was alarming:

1. The antibiotic was present in fruits, vegetables as well as the vegetable leaves.

2. The amount of antibiotic in the plant was directly related to the amount in the soil.

3. The plants absorbed antibiotics in the soil as it grew.

4. Crops that grow underground might absorb even more antibiotics from the soil. Examples of such crops include potatoes, radishes, and carrots."

http://www.consumer-health.com/services/cons_take66.php


And how much was in the fruit? This reminds me of the "there are prescription drugs in our drinking water" alarmism. Are they in there? Sure, are present in an amount that is biologically active? No. We're talking picograms of drugs.


And yet every time I mention my organic farm share all I get is condescension about what "snake-oil" organic farming is.


I see a lot of people here dismissing this as a non-problem because it wouldn't be of apocalyptic proportions. I don't think anybody with two brain cells to rub together would say losing antibiotics would be an extinction event, that's not the point. The point is that infections will likely become the number one killer, it already is number two[1].

[1]: https://en.wikipedia.org/wiki/List_of_causes_of_death_by_rat...


When We Lose Antibiotics, Here’s Everything Else We’ll Lose Too

Well I guess all hope is lost then. The title isn't, "If We Lose Antibiotics" after all.

So why bring it up at all? There are no (ahem) prescriptions for fixing the problem in the article. Just a clear, terrifying outline of most of the bad things that are going to happen. And a plug for her book that presumably has the cure? I read the Amazon reviews of the book (currently 25) and there isn't much of a mention of what the purpose of reading the book is. In fact the main purpose of reading the book based on the reviews I read is that it is supposed to scare the bejesus out of you. Again, to what purpose?

Should I be advocating against livestock use of antibiotics? Should I be advocating for tighter control of prescribing antibiotics?

This could be the scariest thing in the world but honestly it seems more like sensationalist journalism and an attempt to sell a book than a call to serious action.


You admit that the problem is real and serious, but then ask what is the point of raising the issue, and accuse the author of sensationalism? Really?

Read the last three paragraphs of the article. The point of it and book (which was published almost three years ago) is to raise awareness of the issue. We are so close to the edge here that "scaring the bejesus" out of people might now be worth a try, since nothing else seems to be changing our behaviour?


You seem to be so caught up in this issue that you just aren't listening. Here is my point spelled out again:

There are two parts to a legitimate campaign to fix this. Educate people on the problem and educate people on the solution. Why does this article only focus on the problem and then have an advertisement for her book?


"Why does this article only focus on the problem"

Because we already know what the solution is and it is described in numerous articles, books, papers and reports published over several decades. If you want to know what you should be advocating then read them. Please don't just say "So why bring it up at all?"

This article is just about the consequences of failure to adopt a solution. There is no requirement that every work on antibiotic resistance has to adopt the problem/solution structure that you require.


So the important thing is not to educate people on the solutions. The important thing is apparently to scare people. If they want to find solutions then they have to find them on their own by reading "numerous articles, books, papers and reports published over several decades". Is it a coincidence that scaring people sells books and offering solutions only helps to fix the problem? I wonder what the motives of people who write books like this truly is?

What a load of nonsense. I find it hard to believe you are serious.


Aren't drug resistant bacteria weaker though? Like reproducing slower, spreading less, being more likely to be defeated by your own immune system?

Also antibiotics would still be good against most bacteria since only some have evolved antibiotic resistance. I know they can sometimes spread to other species of bacteria, but they still would be at a disadvantage outside of places that use antibiotics. If you just got cut or something with random bacteria in it wouldn't you probably be ok?


On the whole, drug resistant bacteria will likely remain as capable in other characteristics. Due to the complex nature of DNA (specifically gene functions), genetic codes tends to be multipurpose. When select for any one attribute (e.g drug resistance) you could potentially affect zero or more other attributes. You just won't know which ones (based on today's bio-genetics understanding). So there is no reason to expect drug resistant bacteria to be weaker.

You are right bacteria have proven very cable at appropriating useful DNA from across the species. Also, we can reasonably expect drug resistant bacteria to spread just like other bacteria spreads (i.e varied methods and levels of difficulty). Among the factors that affect the spread of bacteria is the mobility of the host. If a host dies in timely fashion the bacteria spreads less and if they linger around longer the opportunity to spread increases. Like other infectious pathogens, this is mainly species dependent. When a multitude of antibiotic resistant bacteria spread around sufficiently are a common stay in the ether then they become part of the random bacteria that would likely infect if you just got a cut.


I don't we can make exactly this generalisation, but certainly from the existence of superbugs responsible for one disease it follows

1. neither that those superbugs will come to dominate the bacteria responsible for that disease (superbugs might never be strong outside the hospital, say)

2. nor that superbugs will emerge for many other diseases.

She's painting a worst-case scenario, which has a consciousness-raising value, but no one should be saying that doom is upon us.


> If we really lost antibiotics to advancing drug resistance — and trust me, we’re not far off

When did journalists become biomedical experts? I don't want to read a story about a serious subject that says "trust me".


> When did journalists become biomedical experts?

When they write books on the subject? http://superbugthebook.com/

She seems to specialize in medical topics. I don't see any mention of official credentials, but that's not the only way to learn things.


From her biography

> She has won numerous journalism awards and held fellowships with the Dart Center for Journalism and Trauma at Columbia University, the Henry J. Kaiser Family Foundation, the East West Center, the Knight-Wallace Fellows of the University of Michigan, Harvard Medical School and the University of Maryland.

She isn't an MD or PhD, but when it comes to medical journalism, that's a pretty impressive list.


For what it's worth, journalists can and do talk to subject experts. Whether they quote their sources in a casual non-scientific article for Wired magazine is another thing.

For more info (e.g., of a journalist talking to doctors and such), take a look at: http://www.pbs.org/wgbh/pages/frontline/hunting-the-nightmar...


The recent data I've seen suggests that level of multi-drug resistant infections has actually leveled off or dropped slightly.

Is it a problem? Yes. Are we close to the end? No.


Watch that PBS Fromtline episode on antibiotic resistance.


In that case it would be better to write:

> If we really lost antibiotics to advancing drug resistance — and many experts agree we may not be far off


I'd say this would be worse. "many experts" is a weasel word, implying an authority behind the statement, but providing no proof of it. And "trust me" is at the least plain and honest.


Nothing we do on the human scale compares to the routine use of antibiotics on the agricultural scale, especially when it comes to animals...


Are we really going to care that heart surgery is no longer viable when deadly pandemics are spreading around the world killing percentiles of the population?


If you're interested on antibiotics there's a good Frontline piece on "gram negatives".

http://www.pbs.org/newshour/rundown/2013/10/frontline-asks-h...

Their point was that it's not "when" we reach this point ... we already have.


There is a nice simulation game where the goal is to kill all of humanity by evolving a disease:

https://play.google.com/store/apps/details?id=com.miniclip.p...

You can learn a thing or two about the problem space just by playing the game.


Is this happening actually a bad thing? With vast over population about to occur, it seems like this might be a natural solution to a difficult problem. If all the sick people start dying again as would have originally happened things like plagues/wars will be considerably more devastating.


Are you seriously asking whether people dying earlier is a bad thing?


Yes.


I would love to know the current status of using viruses (bacteriophages) to replace antibiotics.

http://www.technologyreview.com/news/409905/using-viruses-to...


There's considerable promise in phage therapies as an alternative to antibiotics. And they may well not suffer the same problems of resistance since phages are targeted to specific bacteria.


Why would that prevent evolution any differently?


Bacterial antibiotic resistance increases with exposure to the antibiotic. With targeted treatment there is less exposure for a given clinical effect. Therefore lower resistance.


Unfortunately, by the time there are enough regulations regarding the use of antibiotics (for livestock and agriculture) worldwide, it might just be too late.


This article is talking as if all bacteria would suddenly become resistant to everything. I doubt it would be so sudden are more of a gradual decline.


Mass hysteria and fear mongering, in the name of book sales. Blah, blah, blah. I'm not worried. I believe engineering can solve whatever microbiology and pharmaceuticals can't. But in the spirit of the article...

FLEE! FLEE FOR YOUR LIVES!!!


Well, I've yet to use antibiotics, and I hope I never have to. The only time I've been given some was after a minor surgery.


> Tattoos.

This triggered my FUD detector.


bring on the cricket protein powder




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