Women, antibiotics and the Longitude Prize
Across the world many leaders are speaking out about the challenges our global society faces as antibiotic resistance grows and our medical arsenal to defeat infection shrinks. In the last few months the World Health Organization (WHO), David Cameron and Sally Davies (the UK’s chief medical officer) have all caught the headlines, speaking out about the scale of the problem. Overuse of antibiotics means that we appear to be heading for a future where conditions we currently think of as “cured” become rampant and life-threatening once more. It is therefore not surprising that the Antibiotic Challenge won the public vote for the Longitude Prize.
Sally Davies is, like me, a member of the Longitude Committee, as are computer scientist Wendy Hall and Kay Davies, who researches muscular dystrophy. Women in the UK are, unlike at the time of the first Longitude Prize 300 years ago, able to participate fully in all aspects of science. Although their numbers in the higher ranks of the scientific workforce remain disappointingly low, as a recent report by the Royal Society spelled out, they are at least able to get an education and participate in any field of science that excites them. Such involvement would have been inconceivable in Georgian England.
That’s not to say there weren’t women who worked in science at the time, but they are, almost literally, countable on the fingers of one hand and they were not conspicuously active in Britain. There was Laura Bassi (1711-78), an Italian and the first woman to become a professor at any European University. She worked at the University of Bologna where she taught Newtonian physics and studied gravity and hydraulics. Nevertheless her role was restricted by her gender (the Archbishop of Bologna insisted she was only allowed to lecture if specifically asked). Her available time and energy must have presented a restriction, too: variously reported as having 8 or 12 children, there must have been limited opportunities to pursue her science.
Another woman of science on the continent who flourished at the time was Emilie du Chatelet (1706-49), who was described by her lover Voltaire as “a great man whose only fault was being a woman”. One of du Chatelet’s claims to fame was a translation, with accompanying commentary, of Newton’s Principia into French, a text that is still used as a standard French translation. However, Voltaire found his lover’s ability to get to grips with the mathematics of Newton – something he could not do himself – more than he could stomach and he broke up with her. Consequently, the child whose birth ultimately led to du Chatelet’s death was fathered by another writer (the poet Jean Francois de Lambert).
Childbirth was a regular killer then. Although du Chatelet’s could not have been prevented by antibiotics (she seems to have died of a pulmonary embolism), a huge number of maternal deaths in the 18th century could have been prevented if they had been available. Indeed, many lives could have been saved if people had appreciated what a difference basic hygiene could make. Puerperal fever, caused by infection in lying-in hospitals due to failure to understand fundamental facts we take for granted now, was a major cause of mortality. The idea of washing one’s hands and using disinfection to prevent the spread of disease and infection wasn’t grasped for another century.
Puerperal fever in the west is all but unheard of now. If it occurs, antibiotics are (still) available to treat it. On the other hand, mastitis – historically known as milk fever – remains a common maternal problem for those who breast feed. Antibiotics can usually sort it out rapidly, relieving pain and fever, but this is the sort of situation where the Longitude Challenge might make a significant difference. There are a range of different bacteria that can cause the infection and, if it is slow to respond to treatment and it is deemed necessary to identify which bacterium is involved, it takes time to do the tests. Different antibiotics work best for different bacteria.
The draft criteria for the Longitude Prize are now available as a consultation document. Mastitis is one small example of where there is a need for a point-of-care diagnostic, but there are many different situations where a rapid, cheap test that can be administered readily by relatively unskilled individuals can make a vital difference to outcomes. Some further examples are given in the consultation document.
Now we need individuals and teams to come up with creative solutions, innovative ways to tackle this massive problem that our world faces. We need to move on from scatter-gun approaches to treating infection to find new diagnostics that prevent exacerbation of the current problem. In surgeries today, the pressure patients may put on GPs for medication, even when the infection is viral and so not susceptible to antibiotics, means a vast over-prescribing of pills that are worse than useless. Additionally, we need completely new approaches/classes of drugs to kill bacteria. Routes to interfere with their lifecycle and multiplication by attacking new parts of their cell machinery which haven’t yet been tried.
The global need for a solution to antibiotic resistance is urgent and vital for everyone’s health, in developed and developing countries alike. The Longitude Challenge prize in itself is not going to solve the entire problem, which is vast, but the aspiration is that it will provoke new teams to come up with innovative strategies. Now, unlike at the time of the first Longitude Prize, we can expect to find women fully participating in the challenge. Diverse teams lead to diverse solutions. Let us hope, for all our sakes, that the creativity this brings to the problem will lead to rapid and dramatic advances.
Athene Donald is a professor of experimental physics at the University of Cambridge and a member of the Longitude Committee. She tweets at @athenedonald