Bottles of antibiotics line a shelf at a Publix Supermarket pharmacy August 7, 2007 in Miami, Florida. Photo: Getty Images
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What next, when the drugs won’t work?

The government has made progress on the urgent crisis of antimicrobial resistance, but sustained public pressure is still needed, says Zac Goldsmith.

On accepting his part of the Nobel Prize for the discovery and isolation of penicillin, Alexander Fleming warned: “There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to nonlethal quantities of the drug make them resistant.” From the moment these miracle drugs became available, there has never been any doubt about the link between misuse of antibiotics and resistance to them. But despite that, we have spectacularly failed to heed Fleming’s warning, and as a consequence we now face the prospect of losing modern medicine as we know it.

Dame Sally Davies, chief medical officer for England, has described an “apocalyptic scenario”. She has warned of a return within 20 years to a “19th-century environment”, in which routine operations carry a deadly risk. The World Health Organisation has said that we are hurtling towards a “post-antibiotic era”. 

In 2006 there were just five cases where patients failed to respond to even so-called last-resort antibiotics, but last year that number was 600. Clearly we must hope new antibiotics are developed, but there is no escaping that the principal cause of this crisis is our industrial-scale misuse of the antibiotics we already have. Even in this age of irresponsibility, it is hard to imagine anything more reckless. 

Now that the medical establishment has sounded the alarm, you’d expect this, perhaps the greatest single threat to our health, to top the political agenda and dominate the tabloid news. If only. 

In fairness, the Department of Health has issued stronger guidance to GPs and hospitals. But very little is being done to limit misuse of antibiotics in agriculture. In many nations globally, the use of antibiotics for animals exceeds the amount used for human medicine. A 2012 report produced by the Soil Association suggests that the overall use of antibiotics per animal on UK farms increased by 18 per cent between 2000 and 2010. The problem is even worse in the US, where non-government studies have estimated that upwards of 70 per cent of antibiotics are used on farms.

At the same time, we are fast losing our traditional antibiotics to resistance: penicillin for staphylococcal wound infections, ampicillin for infections of the urinary tract and ciprofloxacin for treating gonorrhoea. We are increasingly having to use reserve antibiotics and, worryingly, seeing the spread of resistance to them as well. 

The link between misuse and resistance is not disputed, and so we have to ask why emergency action isn’t being taken. There is no philosophical or ideological reason why any of the mainstream parties should be reluctant to engage. After all, the solutions involve responsible use of what drugs we have, and the promotion of science. 

So why aren’t the newspapers hounding ministers for action? Why aren’t MPs being bombarded by angry letters? In short, what makes this crisis different, and less important to policymakers than the Aids crisis of the 1980s, which successfully galvanised drug companies and the authorities? 

One answer perhaps is that there is less focus – there is no single infection to fight, no single drug to be found. But more significant, I believe, is the influence of vested interests. If intensive farms have grown dependent on antibiotics, then their removal would require significant changes. Not surprisingly, the resistance put up by agribusiness lobby groups is immense, and I believe that explains a lack of urgency in the Department for Environment, Food and Rural Affairs (Defra).

It would be wrong to suggest there has been no progress. Last year I initiated a debate in parliament on the matter and, in response, a UK health minister told me: “Routine prophylactic use of antibiotics in both humans and animals is not acceptable practice. I am writing to Defra to ensure that existing veterinary guidance makes that very clear.”

Then last year, the Cabinet Office confirmed it would look at resistance as a national security issue. The government subsequently announced a “Five-Year Antimicrobial Resistance Strategy”, which was published by the Department of Health and Defra. The Prime Minister has also openly described the issue as “an extremely serious problem”.

However, we still lag far behind many other countries in terms of concrete steps. The Netherlands, for instance, has endorsed a 50 per cent reduction in livestock antibiotic sales from 2009 levels by 2014. The bottom line is that governments here and elsewhere must prioritise human health over short-term vested interests, and that, I believe, will be achieved only with sustained and intense public pressure. That will happen, but we must hope it does so before a crisis sets in.

Zac Goldsmith is the MP for Richmond Park (Conservative)

Zac Goldsmith is the Conservative MP for Richmond Park and North Kingston.

Photo: Getty
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Leaving the cleaning to someone else makes you happier? Men have known that for centuries

Research says avoiding housework is good for wellbeing, but women have rarely had the option.

If you want to be happy, there is apparently a trick: offload the shitwork onto somebody else. Hire cleaner. Get your groceries delivered. Have someone else launder your sheets. These are the findings published by the Proceedings of the National Academy of Sciences, but it’s also been the foundation of our economy since before we had economics. Who does the offloading? Men. Who does the shitwork? Women.

Over the last 40 years, female employment has risen to almost match the male rate, but inside the home, labour sticks stubbornly to old patterns: men self-report doing eight hours of housework a week, while women slog away for 13. When it comes to caring for family members, the difference is even more stark: men do ten hours, and women 23.

For your average heterosexual couple with kids, that means women spend 18 extra hours every week going to the shops, doing the laundry, laying out uniform, doing the school run, loading dishwashers, organising doctors' appointments, going to baby groups, picking things up, cooking meals, applying for tax credits, checking in on elderly parents, scrubbing pots, washing floors, combing out nits, dusting, folding laundry, etcetera etcetera et-tedious-cetera.

Split down the middle, that’s nine hours of unpaid work that men just sit back and let women take on. It’s not that men don’t need to eat, or that they don’t feel the cold cringe of horror when bare foot meets dropped food on a sticky kitchen floor. As Katrine Marçal pointed out in Who Cooked Adam Smiths Dinner?, men’s participation in the labour market has always relied on a woman in the background to service his needs. As far as the majority of men are concerned, domestic work is Someone Else’s Problem.

And though one of the study authors expressed surprise at how few people spend their money on time-saving services given the substantial effect on happiness, it surely isn’t that mysterious. The male half of the population has the option to recruit a wife or girlfriend who’ll do all this for free, while the female half faces harsh judgement for bringing cover in. Got a cleaner? Shouldn’t you be doing it yourself rather than outsourcing it to another woman? The fact that men have even more definitively shrugged off the housework gets little notice. Dirt apparently belongs to girls.

From infancy up, chores are coded pink. Looking on the Toys “R” Us website, I see you can buy a Disney Princess My First Kitchen (fuchsia, of course), which is one in the eye for royal privilege. Suck it up, Snow White: you don’t get out of the housekeeping just because your prince has come. Shop the blue aisle and you’ll find the Just Like Home Workshop Deluxe Carry Case Workbench – and this, precisely, is the difference between masculine and feminine work. Masculine work is productive: it makes something, and that something is valuable. Feminine work is reproductive: a cleaned toilet doesn’t stay clean, the used plates stack up in the sink.

The worst part of this con is that women are presumed to take on the shitwork because we want to. Because our natures dictate that there is a satisfaction in wiping an arse with a woman’s hand that men could never feel and money could never match. That fiction is used to justify not only women picking up the slack at home, but also employers paying less for what is seen as traditional “women’s work” – the caring, cleaning roles.

It took a six-year legal battle to secure compensation for the women Birmingham council underpaid for care work over decades. “Don’t get me wrong, the men do work hard, but we did work hard,” said one of the women who brought the action. “And I couldn’t see a lot of them doing what we do. Would they empty a commode, wash somebody down covered in mess, go into a house full of maggots and clean it up? But I’ll tell you what, I would have gone and done a dustman’s job for the day.”

If women are paid less, they’re more financially dependent on the men they live with. If you’re financially dependent, you can’t walk out over your unfair housework burden. No wonder the settlement of shitwork has been so hard to budge. The dream, of course, is that one day men will sack up and start to look after themselves and their own children. Till then, of course women should buy happiness if they can. There’s no guilt in hiring a cleaner – housework is work, so why shouldn’t someone get paid for it? One proviso: every week, spend just a little of the time you’ve purchased plotting how you’ll overthrow patriarchy for good.

Sarah Ditum is a journalist who writes regularly for the Guardian, New Statesman and others. Her website is here.