In 2007 I was accused of being a “sensationalist and scaremonger” by the UK Department of Health’s chief nursing officer after I’d said the problem of antibiotic resistance affected thousands of hospital patients – and would get much worse if something wasn’t done.

Two years ago I felt vindicated when England’s chief medical officer stated that “the rise in antibiotic resistance is comparable to the threat of global warming”. And this week we’ve had further evidence of the gravity of this issue with a warning that the world is on the verge of a “post-antibiotic era”. Scientists have discovered bacteria in patients and livestock in China resistant to the antibiotic that is used when all other treatments have failed.

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Official recognition of the scale of the problem at least increases the prospects of developing workable solutions that may prevent our current direction of travel. To illustrate what a world without antibiotics would look like, I have a photograph from the pre-antibiotic era in London, in 1932 – it shows children being treated for tuberculosis in three rows of beds outside a building. In those days whether you lived or died was sheer luck – the only treatment was fresh air.

The huge importance of antibiotics within healthcare globally cannot be overstated. A US study in 1999 calculated that the introduction of antibiotics in 1936 caused deaths in the US to fall by 220 per 100,000 within 15 years. All other medical technologies combined over the next 45 years reduced deaths by only 20 per 100,000 people. The euphoria over the healthcare benefits of antibiotics was encapsulated in 1960, when the US surgeon general announced that “infectious disease is conquered”.

So why has this optimism given way to the apocalyptic scenarios that are now commonly expressed? About 25,000 patients a year die in the European Union from an infection caused by a bacterium that is resistant to more than one antibiotic – and on current trends this is predicted to grow to 390,000 a year by 2050.

There are billions of bacterial cells in our intestines that have very beneficial effects: killing them is not rational

The use of antibiotics exerts a Darwinian selection pressure for acquisition of resistance by the target bacteria, and resistance arising anywhere in the microbial world can ultimately be transferred to disease-causing bacteria. In addition, the antibiotic discovery process is now in terminal decline. The golden age of antibiotics took place in the 1930s to 1970s, with at least 11 new classes discovered; since then there have been only two new classes of antibiotics.

Many antibiotics today are “broad spectrum” – they kill a broad range of bacterial species. The unfortunate side effect is that, along with the disease-causing bacteria, many other bacteria in the patient’s intestines are also killed. This puts the treated patient at risk of acquiring a serious infection such as C difficile. And there are billions of bacterial cells living in our intestines that have very beneficial effects: killing them is not a rational thing to do.

Correctly prescribed antibiotic therapy is of obvious value to the health of the patient but this comes at a cost to society, due to the antibiotic resistance that potentially puts everyone else at higher risk. Because of this antibiotics are a critically needed, shared societal resource whose true value is not, at present, reflected in their price, especially compared with, say, anti-cancer drugs.

There is thus a need to improve the economic incentives for the development of antibiotics. The Infectious Disease Society of America has proposed a fee levied against the wholesale price of all antibiotics that would help to fund development. This is the equivalent of a toll charge to pay for public roads.

The 2015 Review on Antimicrobial Resistance called for an innovation fund of $2bn over five years, funded by the pharmaceutical industry. The fund would guarantee a return on private companies’ investment if they produced an antibiotic that filled an unmet need. This proposal is aimed to achieve the development of 15 new antibiotics in a decade and, unlike the IDSA model, recognises that antibiotic resistance requires a global solution.

But these both assume resistance is largely an economic problem, and therefore significantly underestimate the scientific difficulty of developing new antibiotics.

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Until last month I was still pessimistic about our chances of avoiding the antibiotics nightmare. But that changed when I attended a workshop in Beijing on a new approach to antibiotic development based on bacteriocins – protein antibiotics produced by bacteria to kill closely related species, and exquisitely narrow-spectrum.

My research over 37 years involved the study of a number of bacteriocins that can kill a range of clinically important bacteria. I – and many other researchers – did not believe they could be useful clinically because injecting a “foreign” bacterial protein into a patient is likely to induce a severe immune response that would make the antibiotic inactive. There were therefore gasps of amazement in Beijing at data presented from several animal studies showing this was not the case.

If you consider a killing domain as a red Lego brick and a targeting domain as a yellow Lego brick, you can make hundreds of different hybrid proteins consisting of one red and one yellow brick to make what I refer to as a series of novel bacteriocin-derived antibiotics (BDAs). In fact, several BDAs have already been designed to kill target bacteria, fungi and even tumour cells.

The ability to use the BDA system to continually make novel antibiotics significantly de-risks the development of antibiotics process and in my opinion offers a significant ray of hope in the present gloom. It is now for governments and health organisations to make sure they make the most of this unexpected breakthrough.