The outbreak of scarlet fever in Hong Kong earlier this year caught the attention of specialists at the World Health Organisation. We think of scarlet fever in developed societies as a disease that was pretty well vanquished decades ago. So the emergence of a scarlet fever outbreak in a modern city like Hong Kong and in mainland China was something of an unexpected event. But more disquieting was the suggestion that the bacteria causing the disease had become resistant to certain antibiotics. Happily, the worst of the outbreak is over, but the global problem of drug resistance is definitely not.
The discovery early last century of penicillin and antimicrobial drugs changed the course of history. Science began to gain the upper hand in the war on disease, and, at last, scourges such as leprosy, tuberculosis, gonorrhoea, syphilis and many more could be mastered. But now many of those miracle drugs and the generations of others that followed could finish up in the rubbish bin as increasing levels of drug resistance threaten their effectiveness.
This is already leading to infections that are difficult to treat and sometimes impossible to cure. Many of them require longer and more expensive hospital stays, and are more likely to kill. Some signs of the times:
Last year, at least 440,000 new cases of multidrug-resistant tuberculosis were detected globally.
The malaria parasite is acquiring resistance to even the latest generation of medicines, particularly in the Mekong region of Southeast Asia.
Resistant strains causing gonorrhoea and shigella are now limiting treatment options.
Resistance is emerging to the antiretroviral medicines use to treat people living with HIV.