During the post–World War II "wonder drug" revolution, antibiotics were viewed as a panacea for mastering infectious disease. But from the beginning, critics raised concerns about irrational usage and overprescription. The first generation of antibiotic reformers focused on regulating the drug industry. The reforms they set in motion included the adoption of controlled clinical trials as the ultimate arbiters of therapeutic efficacy, the passage of the Kefauver-Harris amendments mandating proof of drug efficacy via well-controlled studies, and the empowering of the Food and Drug Administration to remove inefficacious drugs from the market. Despite such victories, no entity was empowered to rein in physicians who inappropriately prescribed, or overly prescribed, approved drugs.
Now, in an era of emerging bugs and receding drugs, discussions of antibiotic resistance focus on the need to develop novel antibiotics and the need for more appropriate prescription practices in the face of pharmaceutical marketing, pressure from patients, and the structural constraints that impede rational delivery of antibiotics worldwide. Concerns about the enduring utility of antibiotics—indeed, about a post-antibiotic era—are widespread, as evidenced by reports from the Centers for Disease Control and Prevention, academia, and popular media alike. Only by understanding the historical forces that have shaped our current situation, Podolsky argues, can we properly understand and frame our choices moving forward.-- John E. Lesch, University of California
After being released from prison and winning South Africa’s first free election, Nelson Mandela presided over a country still deeply divided by fifty years of apartheid. His plan was ambitious if not far-fetched: use the national rugby team, the Springboks—long an embodiment of white-supremacist rule—to embody and engage a new South Africa as they prepared to host the 1995 World Cup. The string of wins that followed not only defied the odds, but capped Mandela’s miraculous effort to bring South Africans together again in a hard-won, enduring bond.
Watch a Video