Infectious Diseases Are Poised for a Deadly Comeback

Doctors Without Borders staff member at the Ebola treatment Center in Monrovia. (Photo: Caroline Van Nespen/MSF)

Infectious Diseases Are Poised for a Deadly Comeback

Many of the medical breakthroughs of the last century could be lost through the spread of antimicrobial resistance. Doctors and hospitals urgently need new medicines

https://www.thestar.com/opinion/contributors/2018/02/10/infectious-diseases-a-p…

It is hard to imagine a world without effective drugs to treat infectious disease but that is where we are headed.

"Previously treatable infectious diseases like tuberculosis, malaria and pneumonia are poised to overtake cancer and diabetes combined as the world greatest killers, and this is exacerbated by emerging agents of infection, such as Ebola and Zika virus."

The World Health Organization (WHO) has been sounding the alarm and working hard on the ground with user-friendly messages and infographics for health practitioners and patients alike: Seek professional advice when you're ill. Don't take antibiotics for colds. Minimize the exposure of animals to antimicrobials as growth promoters or preventive therapeutics.

But without new weapons in our medical tool kits, we are playing with fire. Many of the medical breakthroughs of the last century could be lost through the spread of antimicrobial resistance. Previously treatable infectious diseases like tuberculosis, malaria and pneumonia are poised to overtake cancer and diabetes combined as the world greatest killers, and this is exacerbated by emerging agents of infection, such as Ebola and Zika virus.

Drug resistance not only threatens our ability to cure common infectious diseases but is set to undermine major medical advances such as surgeries, organ transplantation and the treatment of cancer.

It is expected that by 2050, millions of people globally will die each year as the infectious diseases of previous centuries return to their old force.

Doctors and hospitals urgently need new medicines, but the source might surprise you: high-performing academic research labs are on the front lines generating these new discoveries. That's in part because the economic models of for-profit pharmaceutical companies have not favoured the development of new treatments for infectious diseases.

Now more than ever public institutions need to fund fundamental research if we're going to protect public health and outwit these ever-evolving deadly microbes.

There are many reasons pharmaceutical companies aren't doing this work. Treatment times are typically short compared to drugs for chronic diseases like diabetes or heart disease and microbial resistance can quickly render new drugs obsolete. It is academic scientists then who must chart the future course and populate the pipelines of new "targets" for drug development.

Now more than ever public institutions need to fund fundamental research if we're going to protect public health and outwit these ever-evolving deadly microbes.

These targets can be the core biochemical machinery of the microbes themselves: My lab at the University of Toronto's Faculty of Medicine studies the fundamental mechanisms through which pathogens evolve to resist treatment. It also studies the cellular machinery the pathogens exploit to wreak their havoc on their human hosts. Understanding this fundamental biology is the crucial first step in the discovery of new medicines.

One of our recent discoveries identifies the Achilles heel of fungal pathogens: a "chaperone" protein that, when crippled, blocks a series of cellular functions and prevents those microbes from becoming resistant to medicines. We need more of these targeted discoveries -- and we need them quickly.

In Canada, there is now a historic opportunity to accelerate this kind of discovery-based research that will have a direct impact on our ability to bring new medicines into hospitals and doctors' offices.

Scientists are united in urging the federal government to adopt the full suite of recommendations in the Naylor Report, the comprehensive review of fundamental science commissioned by Science Minister Kirsty Duncan.

We've done the math: the increase recommended amounts to $9 per Canadian a year -- less than the price of a movie ticket.

This is a once-in-a-generation opportunity. Canada has a strong track record in research but our researchers have struggled for years watching excellence go unfunded. Talent moves with opportunity, and many of us fear we will lose the next generation of bright minds. That is not a scenario from which Canada could quickly recover.

In infectious disease, the WHO's message to nations is explicit. Greater innovation and investment are required in research and development of new medicines, vaccines and diagnostic tools, if we are going to stay ahead of disease-causing microbes.

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