Solving the antibiotic resistance problem is now the focus of my life. I have just completed a review of possible solutions based on using some current non-antibiotic drugs to break resistance of our last-line-of-defence antibiotics. There are some real opportunities so all may not be lost, but we need to progress these ideas rapidly to head off the scenario Jim O'Neill outlines. I will be meeting with him in January. 

I travel in India each year and the last two years have scared me. New Delhi ground water contains bacteria with what's called 'NDM carbapenemase', meaning it breaks open and destroys our most powerful antibiotics. Yes, it's literally in the streets. Up in the Himalayas in South Tibet my traveling companion get a nasty chest infection. There's a lot of TB and pneumonia in the area. I walked into a pharmacy and bought without prescription the antibiotics I wanted for her. 

?And it's not just South Asia. Resistant bacteria are now becoming a problem in Greece and Italy. I think we have less than a decade to get on top of this problem.

Eoin Treacy's view

Thank you for this detailed email. In the context of human survival this is a much more pressing issue than climate change and yet doesn’t get nearly the same media attention. Humans are the thinking ape and we really do need to get busy with a solution to the fact that some bacteria have evolved to combat our best defences. There is every chance a solution can be reached but it will take time, coordination, ingenuity and capital to achieve it. The economic impact of failure is truly mind blowing.  

This report from the US National Library of Medicines carries some additional information on the NDM-1 gene. 

Like other metallo-ß-lactamases, NDM-1 inactivates all ß-lactams (including carbapenems) except monobactams. It is the most recently discovered carbapenemase that is spreading rapidly worldwide (13, 15, 17, 31). NDM-1 producers have been identified mainly in the United Kingdom, India, and Pakistan (9), but numerous studies within the last year reported NDM-1 producers from many countries in Europe (18, 22, 25), Asia, Africa, Australia, and North America (4, 6, 16, 23). Most of the patients infected by NDM-1 producers are from India, Pakistan, or Bangladesh or have traveled in the Indian subcontinent. This indicates that the Indian subcontinent is a reservoir for the gene encoding NDM-1 (32). In addition, several isolates of NDM-1-producing Enterobacteriaceae have been reported from the Balkan states (10) and the Middle East (Oman and Iraq) (19, 21), suggesting that those areas are other reservoirs of NDM-1 producers (10). The blaNDM-1 gene is associated with neither a single strain nor a single plasmid backbone, since it has been identified in unrelated Gram-negative bacterial isolates and species either on the chromosome (Acinetobacter baumannii) or on different plasmid types (6, 7, 20). NDM-1 has been identified in Escherichia coli, an agent of community-acquired infections that is widely disseminated in the environment and water (32). In addition, it has been identified recently in other environmental bacterial species, such as Vibrio cholerae (32). The NDM resistance trait is usually associated with multiresistance and pandrug resistance.