THE problem with golden ages is that you don’t know it when you’re living in one, and we most certainly have been born into the golden age of medicine. Oh sure, the cold is still common and while we haven’t cured cancer we have at least controlled it to a great extent. Yes, we may get the occasional Ebola or Zika scare but the age of germ-induced apocalypse is certainly behind us.

That’s a really big deal when you consider how powerful a historical force disease is. Take what the Black Plague did to Europe: the death of millions enriched the survivors who inherited (or stole) the property of the dead and wages rose as labour became scarce. Surplus cloth (of which there was now plenty) was used as rag paper in the newly invented printing press, spurring a boom in literacy and feeding the Renaissance.

Other examples abound: the conquistador victory over the Aztecs is often attributed to their weapons and tactics, but smallpox — transferred from an infected Spanish soldier to the Aztecs — played a crucial part. The virus killed most of the Aztec army and close to a quarter of the population, who had no defence against this foreign plague.

All living creatures adapt, and bacteria are no exception.

Disease also acted as a defence, and many parts of the world were inaccessible to Europeans due to the prevalence of malaria until the discovery and mass production of quinine. This event enabled the colonisation of many parts of the world and signalled that a new age was dawning.

Then in 1940s, Alexander Fleming found the magic bullet. Antibiotics had been in use for centuries in traditional medicine, with Egyptians using mouldy bread to treat infected wounds and Russian peasants doing the same with warm mud. But Fleming determined and duplicated the method behind the miracle. Once-fatal diseases could now be cured by popping a mass produced pill.

But all living creatures adapt, and bacteria are no exception. Two months back, scientists in the US detected a ‘nightmare bacteria’, a strain of E. coli resistant to all known antibiotics. It was a discovery that the director of the US Centre for Disease Control says could be ‘the end of the road’ for antibiotics.

That’s not something to be taken lightly, and England’s chief medical officer, Dame Sally Davis, warns that the danger posed to England by antibiotic-resistant bacteria (ARB) is equal to the threat posed by terrorism. She has a point, given that antibiotic resistance currently accounts for an estimated 50,000 deaths in the US and Europe, while the global death toll is estimated at 700,000 per annum. If action is not taken, scientists warn the toll could reach 10 million dead a year by 2050.

In Pakistan, Shifa International Hospital’s Dr Ejaz reveals that 70pc of newborn infections in the country are the result of antibiotic-resistant bacteria, and in June a study conducted by Karachi University concluded that food being sold in and around public-sector hospitals in the city was contaminated with germs resistant to many commonly used antibiotics.

This not only means that patients who eat these foods can walk away with new and deadlier diseases, but also that these superbugs can infect visitors and, in fact, anyone who eats at the stalls around these hospitals.

Here, the problem was caused by the mixing of sewerage lines with water mains, improper hygiene in hospitals and the improper dumping of medical waste, but in a global perspective the rise in ARBs can be attributed simply to the overuse of antibiotics. Let’s put it this way: these are the battle-hardened grandchildren of the 0.1pc germs your hand sanitiser didn’t kill.

While simply increasing the potency and dosage of antibiotics will be counterproductive, the key to the future may well be found in the wisdom of the past. Recently, British scientists killed the modern-day superbug MRSA by using a cure laid out in a 1,000 year old Anglo-Saxon medical manuscript, and there is little doubt that many such cures from antiquity lay waiting to be rediscovered.

Other avenues of research are even more interesting, like the revival of the use of maggots — an ancient practice — to treat infected wounds. Their utility in dealing with ARBs was already displayed in 1989 when a University of California physician used maggots to treat a patient whose wounds were not responding to antibiotics.

Even more exotic is the work being done by Australian company Entocosm, which is working on extracting antibiotics from ants and flies. The logic here is that if flies spend their time feeding on refuse and rotting flesh, they must have powerful resistance to infection, and it hold true: tests showed that the flies’ anti-bacterial compounds were active against the golden staph superbug.

To sum up, we forced bacteria to evolve in order to survive and now we ourselves must evolve new methods in turn. It’s just a question of who does it better.

The writer is a journalist.

Twitter: @zarrarkhuhro

Published in Dawn, July 11th, 2016