Another Year With(out) Penicillin

It’s almost a century ago today that antibiotics, as we know them, were first introduced into modern medicine. Sadly, Venezuela struggles to stay out of the pre-antibiotic era.

“When I woke up just after dawn on September 28, 1928, I certainly didn’t plan to revolutionize all medicine by discovering the world’s first antibiotic, or bacteria killer. But I suppose that was exactly what I did”.

— Alexander Fleming

On a September morning in 1928 the exact date varies according to the source , Scottish bacteriologist Alexander Fleming and his assistant, Merlin Price, casually observed something growing on a petri dish which had been carelessly stored during the summer break.

They would change medicine forever.

Few killers are more dangerous than bacteria. It doesn’t matter how important or accomplished you are, these deadly little microbes are equal-opportunity invaders: They’ve taken the lives of everyone from Tutankhamun and Simón Bolivar, to Karl Marx and Otto Von Bismarck. Just in the last century, we developed an effective weapon to counter them, and even now they kill people by the millions.

Antibiotics work by killing bacteria or inhibiting their growth and are usually produced in nature by a variety of organisms. But up until that September morning 89 years ago, we didn’t really know it. Fleming concluded research on something that was merely suspected, managing to isolate the source of so-called “mold juice,” identifying it as a byproduct of the Penicillium fungus. After renaming the juice “Penicillin,” Fleming began a series of attempts to purify the substance, eventually giving up altogether. It would take a whole team of brilliant biochemists and pharmacologists to finally produce a pure, stable form of the molecule that could be used to treat humans, ten years after its discovery.

The first recorded clinical use of antibiotics in Venezuela dates back to 1944, a year before it became widely available to the general public. Before staring at his culture plates, Fleming served as captain of the British medical corps during World War I, watching soldiers die from infected wounds. Today, almost 90 years later, Venezuelan doctors must face similar scenes, since neither penicillin nor any other antibiotic, are easily found in local hospitals or drug stores.

The World Health Organization’s list of Essential Medicines for Venezuela includes 7 different forms of penicillin and its derivatives, all of which are pretty hard to find at any pharmacy.

Part of the problem is that producing antibiotics isn’t just mixing the ingredients; penicillin, and many other antibiotics, come from fungi that can grow virtually everywhere, but to purify and produce a substantial quantity of the needed molecules, you need a complex and expensive infrastructure in a carefully monitored environment. Many pharmaceutical companies that sell antibiotics in Venezuela produce tablets, but the molecules come from abroad.

That’s why, in 2011, the chavista government decided to cut the middleman out and produce the medicines itself, building factories in Anzoátegui, Carabobo and Miranda. In alliance with the Portuguese and Colombian governments, the idea was to buy equipments in Europe and have the production in-house. Eugenia Sader, then Minister for Health, said that the project was already underway, and would be finished by 2012. The only thing existing today from the factories are these lines you’re reading, with money vanishing as of 2015, a classic mark of Sader’s tenure.

That bill is ultimately paid by the innocent. Sick people’s families in Venezuela face frustration after they’ve toured every pharmacy around, only to come back empty-handed and tell their doctors they can’t afford that same mold juice discovered almost a century ago. Just three days of treatment are equivalent to a month’s income. The World Health Organization’s list of Essential Medicines for Venezuela includes 7 different forms of penicillin and its derivatives, all of which are pretty hard to find at any pharmacy, and are plainly nonexistent in the public health system. The government’s carelessness, along with the economic collapse, has turned Venezuelan hospitals into little more than ugly hotels where patients who are fortunate enough to secure a bed can be sick with a roof over their heads.

In a country back to the pre-antibiotic era, we helplessly bear witness, just as Fleming did, to war stories in hospitals where the battle is fought by patients and their families, not only against disease but also against a government that does nothing to protect them.

Happy anniversary this is not.