The CDC has told us that superbugs and wider drug resistance
is already
here to stay and killing thousands every year.

The report and the advice are sound — hospitals need to be
cleaner and medical practices better to prevent the spread of antibiotic-resistant
pathogens. But two reasons that drug resistance is on the rise are barely
covered. This is partly because CDC has no control over either problem, but it
is also due to the nature of the problem as I’ll explain.

Both problems relate to India, although not exclusively so.
In a recent blog,
I wrote about how the price of many antibiotics is too low, which often leads
to inferior production methods. This inferior manufacturing is usually through Indian
production with Chinese chemicals, making substandard products. This is one of
two key drivers of antibiotic resistance, particularly in many emerging markets.
The other is the widespread availability of antibiotics in Indian pharmacies that
should only be available for expert dispensing in hospital.

For example, levofloxacin and myriad carbapenems are widely
available in emerging market pharmacies. Carbapenems are only ever dispensed in
hospitals in Western nations and are used, ironically, when infections are
proving resistant to other antibiotics. Yet these same antibiotics are used far
less carefully in emerging markets, which propels resistance to even these last
resort products.

Access to Indian antibiotics have probably saved millions and improved tens of millions of lives, but now they threaten to drive population-wide resistance to even well-made products.

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