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.

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A new German law wants to force mothers to reveal their child’s biological father

The so-called “milkmen’s kids law” would seek protection for men who feel they have been duped into raising children they believe are not biologically theirs – at the expense of women’s rights.

The German press call them “Kuckuckskinder”, which translates literally as “cuckoo children” – parasite offspring being raised by an unsuspecting innocent, alien creatures growing fat at the expense of the host species’ own kind. The British press have opted for the more Benny Hill-esque “milkmen’s kids”, prompting images of bored Seventies housewives answering the door in negligées before inviting Robin Asquith lookalikes up to their suburban boudoirs. Nine months later their henpecked husbands are presented with bawling brats and the poor sods remain none the wiser.

Neither image is particularly flattering to the children involved, but then who cares about them? This is a story about men, women and the redressing of a legal – or is it biological? – injustice. The children are incidental.

This week German Justice Minister Heiko Maas introduced a proposal aimed at to providing greater legal protection for “Scheinväter” – men who are duped into raising children whom they falsely believe to be biologically theirs. This is in response to a 2015 case in which Germany’s highest court ruled that a woman who had told her ex-husband that her child may have been conceived with another man could not be compelled to name the latter. This would, the court decided, be an infringement of the woman’s right to privacy. Nonetheless, the decision was seen to highlight the need for further legislation to clarify and strengthen the position of the Scheinvater.

Maas’ proposal, announced on Monday, examines the problem carefully and sensitively before merrily throwing a woman’s right to privacy out of the window. It would compel a woman to name every man she had sexual intercourse with during the time when her child may have been conceived. She would only have the right to remain silent in cases should there be serious reasons for her not to name the biological father (it would be for the court to decide whether a woman’s reasons were serious enough). It is not yet clear what form of punishment a woman would face were she not to name names (I’m thinking a scarlet letter would be in keeping with the classy, retro “man who was present at the moment of conception” wording). In cases where it did transpire that another man was a child’s biological father, he would be obliged to pay compensation to the man “duped” into supporting the child for up to two years.

It is not clear what happens thereafter. Perhaps the two men shake hands, pat each other on the back, maybe even share a beer or two. It is, after all, a kind of gentlemen’s agreement, a transaction which takes place over the heads of both mother and child once the latter’s paternity has been established. The “true” father compensates the “false” one for having maintained his property in his absence. In some cases there may be bitterness and resentment but perhaps in others one will witness a kind of honourable partnership. You can’t trust women, but DNA tests, money and your fellow man won’t let you down.

Even if it achieves nothing else, this proposal brings us right back to the heart of what patriarchy is all about: paternity and ownership. In April this year a German court ruled that men cannot be forced to take paternity tests by children who suspect them of being their fathers. It has to be their decision. Women, meanwhile, can only access abortion on demand in the first trimester of pregnancy, and even then counselling is mandatory (thereafter the approval of two doctors is required, similar to in the UK). One class of people can be forced to gestate and give birth; another can’t even be forced to take a DNA test. One class of people can be compelled to name any man whose sperm may have ventured beyond their cervix; another is allowed to have a body whose business is entirely its own. And yes, one can argue that forcing men to pay money for the raising of children evens up the score. Men have always argued that, but they’re wrong.

Individual men (sometimes) pay for the raising of individual children because the system we call patriarchy has chosen to make fatherhood about individual ownership. Women have little choice but to go along with this as long as men exploit our labour, restrict our access to material resources and threaten us with violence. We live in a world in which it is almost universally assumed that women “owe” individual men the reassurance that it was their precious sperm that impregnated us, lest we put ourselves and our offspring at risk of poverty and isolation. Rarely do any of us dare to protest. We pretend it is a fair deal, even that reproductive differences barely affect our lives at all. But the sex binary – the fact that sperm is not egg and egg is not sperm – affects all of us.

The original 2015 ruling got it right. The male demand for reassurance regarding paternity is an infringement of a woman’s right to privacy. Moreover, it is important to see this in the context of all the other ways in which men have sought to limit women’s sexual activity, freedom of movement and financial independence in order to ensure that children are truly “theirs”.  Anxiety over paternity is fundamentally linked to anxiety over female sexuality and women’s access to public space. Yet unless all women are kept under lock and key at all times, men will never, ever have the reassurance they crave. Even then, the abstract knowledge that you are the only person to have had the opportunity to impregnate a particular woman cannot rival the physical knowledge of gestation.

We have had millennia of pandering to men’s existential anxieties and treating all matters related to human reproduction, from sex to childbirth, as exceptional cases meaning women cannot have full human rights. Isn’t it about time we tried something new? How about understanding fatherhood not as winning gold in an Olympic sperm race, but as a contract endlessly renewed?

What each of us receives when a child is born is not a biological entity to do with as we choose. It is a relationship, with all of its complexities and risks. It is something worth contributing to and fighting for. Truly, if a man cannot understand that, then any money wasted on a Kuckuckskind – a living, breathing child he could get to know – has got to be the least of his worries. 

Glosswitch is a feminist mother of three who works in publishing.