Superbugs a problem in China, here, and everywhere. And don’t just blame it on Chinese doctors.

The UK’s news publications don’t claim to be mellow in their approach to reporting the news.  America’s FOX News Channel’s headlines and pre-fabricated story narrative can seem tame by comparison.  A good rule of thumb is to question any headline from a UK newspaper that likens a current event happening in the real world to something that can only happen in comic books.  Like, for example, this headline from earlier in the week:

China threatens world health by unleashing waves of superbugs

This title hints at impending doom, like some kind of giant China robot has opened a cage full of  six legged superbugs with mutant powers who are hell bent on ravaging my home town with their laser eyes and super strength.

The content of the article is, like always, much tamer than the headline.  Chinese doctors and farmer claim “some scientists” (*also, always beware when no specific ‘scientists’ are named) are to blame for a worrying escalation in drug resistant bacteria.

“Chinese doctors routinely hand out multiple doses of antibiotics for simple maladies like the sore throats and the country’s farmers excessive dependence on the drugs has tainted the food chain.”

To be sure, the situation in China is worrying. Of course, the article fails to mention the fact that the situation is equally worrying in much of the world.  Overprescribing of antibiotics to humans, overuse of antibiotics in agriculture,  and drug resistant bacteria are  big problems in America, the UK and Europe,  South and Latin America, Australia, Russia, India and anywhere else that antibiotics are readily available.  In the UK, it should be added, antibiotics panic is a favorite way of pundits to get the public riled up.  I think its because the threat of country-wide infection is a particularly frightening prospect for people living on islands; there’s only so many places that one can run to get away.

Once you get past that, the article tells us little else except that doctors in China are incentivized to subscribe more (again, this is a problem almost everywhere), and pharmacists will sell people antibiotics without a prescription (a problem in most developing and underdeveloped countries).  The Shanghaiist, on the other hand, asks a useful question about the situation:

But why do so many Chinese doctors feel the need to over medicate their patients?

While it’s possible the doctors are just overeager to care for their patients’ well being, a more convincing argument points to the underlying systematic deficiencies of the ailing Chinese health care system.

Public health experts have pointed out that China has an underfunded health system where medical centers take up to half of their operating income from selling drugs, a haphazard solution to the semi-privatization of the entire industry.

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When you add that to the fact that all medical professionals are treated – and paid – like public officials (which, incidentally has caused a shortage of doctors here since long grueling years of study don’t translate to much more money), it’s no wonder the doctors become pushers. And as the doctors become pushier, Chinese people become more suspicious. Says Helen Ye, a Beijing resident, “”We go to clinics for colds, but we don’t trust the doctors because they are all being paid by the drug companies and so they over-prescribe.”

I have talked about the problem of doctor compensation many times, and so I agree with the Shanghaiist’s analysis.  It is, however, missing a key component.  The doctor-patient relationship is a two way street.  Studies have shown, again and again, that patients want antibiotics for colds and other ailments that do not require them.  It is also true that patients will pressure doctors into giving them those prescriptions.  Doctors can prescribe all the drugs they feel like, but if patients refuse to take them then the doctors actions don’t much matter.

Also, taking or not taking antibiotics responsibly (responsibly means taking antibiotics for as long as the doctor/box says that the antibiotics should be taken) is a major determinant as to whether or not drug resistance develops.  This, again, falls on the patient.  For drugs to be taken responsibly, doctors and public health officials must educate patients. This, again, has proven to be difficult everywhere in the world.