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Given the enormous urgency of the problem, why is it taking so long to move promising solutions toward trials and availability? Because there's little money in it, says Tufts' Boucher. The government is sinking billions into research, but the private investment to turn that research into manufactured drugs and devices has not materialized. Drug companies, says Boucher, have little prospect of profiting off a drug that isn't likely to be taken by millions of people or fetch prices of tens of thousands of dollars per dose. “The economic model is broken,” she says.
考虑到这个问题的巨大紧迫性，为什么要花这么长时间才把有希望的解决方案推向试验和可用性？塔夫茨大学的鲍彻说，因为里面几乎没有利润。政府投入了数十亿美元用于研究，但将研究转化为制造药物和设备的私人投资尚未实现。鲍彻说，制药公司很难从一种不太可能被数百万人服用或每剂售价数万美元的药物中获利。“经济模式被打破了，”她说。
Managing the Bugs
管理缺陷
Although antibiotics are truly miracle drugs when they work, our current problems have arisen in part because medicine has relied too heavily on them. Doctors prescribe them for ear infections, sore throats and urinary tract infections. Surgeons use them to prevent postoperative infections. Because bacteria can develop resistance, antibiotics make the most sense as part of a holistic approach to managing the spread of bacteria and dealing with infections. As antibiotics begin to lose their usefulness, medical experts are now coming around to emphasizing many-pronged strategies for keeping the bugs at bay.
尽管抗生素在发挥作用时确实是神奇的药物，但我们目前出现的问题，在一定程度上是因为药物过于依赖抗生素。医生开这种药是为了治疗耳部感染、喉咙痛和尿道感染。外科医生用它们来预防术后感染。由于细菌会产生耐药性，抗生素作为控制细菌传播和处理感染的整体方法的一部分最有意义。随着抗生素开始失去效用，医学专家现在开始强调控制细菌的多重策略。
Being quicker off the mark to identify and respond to potential outbreaks with extra precautions and targeted antibiotics could slow or prevent outbreaks. New tests under development would allow health workers to rapidly and cheaply identify the genes of any bacteria found on or near patients. “We can't do molecular screening on every patient who walks through the door for every organism. That would be looking for a needle in a haystack,” says Shenoy. “But if we can screen high-risk patients quickly enough, we can take appropriate actions.” It would certainly be an improvement over the standard techniques for identifying bacterial outbreaks, developed 150 years ago.
通过额外的预防措施和有针对性的抗生素，更快地识别和应对潜在的疫情，可以减缓或预防疫情的爆发。正在开发的新测试将使卫生工作者能够快速、低成本识别在患者身上或附近发现的任何细菌的基因。“我们不能对每一个进入门内的病人进行分子筛选。那是大海捞针，”谢诺伊说。“但如果我们能足够快地筛查高危患者，我们就能采取适当的行动。”与150年前发展起来的鉴定细菌爆发的标准技术相比，这无疑是一个进步。
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