On a recent visit to hospital I was struck by the precautions against MRSA and its fellow antibiotic resistant bugs. Whilst not wishing to see these practices abolished - they are all we can currently do to avoid the threat - I could not help reflecting that
(a) This is a war we cannot win, for the 'enemy' is far more numerous than we are, does not fear death, and can evolve much faster than we can.
(b) It is a self -inflicted problem. These bugs did not exist until we bred them, and
(c) nobody seems to be thinking of an alternative strategy.
When you think of it, the current approach is entirely warlike. The precautions we take are to kill off the pathogens either with drugs or by triggering the body's defences early so that invading pathogens can be defeated before they become too numerous. Even the language used in treatment is warlike.
This is very similar to the 'war' we fought against our insect 'enemies'. Pesticides like DDT were initially highly successful but within a decade or two, evolution had rendered the pesticides virtually useless. Worse, the chemical was being concentrated in longer-living creatures higher up the food chain who because of their slow breeding rate were unable to adapt as fast as the insects. At the top of the food chan, of course, was man. The use of these chemicals had to be abandoned. Present methods include introducing predators and finding more resistant varieties. A much less aggressive approach but ultimately sustainable and successful.
Getting back to infectious diseases then, we need to do some serious rethinking. Given that we are effectivly fighting not just the disease but its ability to evolve, we are really setting ourselves up against evolution itself, and as we are ourselves the product of evolution we are taking on an 'enemy' a great deal smarter than us. It is a battle we cannot win, taken directly.
So here are some alternative approaches which might be tried.
1. Displace the bugs with less deadly variants. By encouraging the population of variants which are less dangerous to us, we could effectively displace the ones that kill us. This might be done on a macroscopic level in hospitals for instance, by deliberately breeding the less dangerous ones and spreading them within the building. It might also be tried within the body. The idea is to allow the benign variant to occupy the niche which might otherwise be occupied by a less benign strain, preventing it gaining a foothold.
2. Modify the human and animal immune system to make it less prone to the deadly pathogens. This would create an environment more attractive to less deadly variants thereby establishing environmental pressure towards harmless bugs.
3. Consider aiming towards symbiosis. This has already been done for us by nature. Our intestines are packed with bacteria and organisms that would kill us very quickly and unpleasantly were they to get into the blood stream. However, evolution has arrived at a concordat. They live in our gut, and receive a small part of the food we eat, whilst they assist us in digesting it. A mutually advantageous arrangement.
There is some evidence that other parasites have evolved to a near symbiotic relationship too. In a recent experiment, a number of sufferers from irritable bowel syndrome were given eggs for a tapeworm that could live briefly in the human gut. In nearly all the cases, the IBS symptoms either vanished or were greatly alleviated before the experiment was terminated and the unfortunate worms flushed out. The experimenters were said to be going on to find out what chemical the worms were releasing so it could be synthesised in a tablet, but I feel this is an indication of an unthinking adoption of the 'war' paradigm yet again.
So there you have it. None of these approaches is easy, indeed they are currently impossible. For the time being, we can do no more than is being done at present with antibiotics, drugs and disinfection. But we should be aware that all of these are - one by one - going to fail and the war will go to the bugs. It's most unlikely that we can think faster than evolving bacteria.
What am suggesting is that work should be going on along the lines I'm recommending in parallel with conventional medical research. Given time, I'm sure this will bear fruit. We've given the Mars approach a fair trial, and we should look at where its landed us. Perhaps its time to let Venus have a chance.
Venus always wins in the end. Read your Homer!
