Antibiotics: a tragedy of the commons?

 

In his famous 1968 essay “The tragedy of the commons” Garrett Hardin argued that “freedom in a commons brings ruin to all”. In a nutshell, he proposed that there is an initial benefit to increasing one’s own herd, because even though the pasture is eaten down even further, each herd still increases in total yield, but there is a crushing delayed cost in that eventually the common land becomes a desert. Something has to give: individual needs or common resources.

Currently, the needs of individuals lead them to take antibiotics. Those who, in the rush to take something for a cold, or those living in laxer countries across the world take antibiotics as a matter of course as an over the counter drug, are the front runners of egotism. Despite my lay knowledge of antibiotic resistance, I have taken them, for a number of apparently legitimate reasons i.e. prescribed for conditions in which antibiotics were clearly indicated, and have followed the full course of the prescription. Nonetheless, there remains the possibility that I carry antibiotic-resistant organisms that I can pass on to someone else. Other persons, including persons more altruistic than me who have avoided antibiotics, may succumb to those organisms. So, our individual gains in fighting the bugs within us may lead to all bugs winning the war against us.

The sting in the tail is that, in our society, when a person is in dire need of an antibiotic they are probably in a hospital surrounded by other carriers of dire-need resistant bugs, and these are provided with an ideal breeding ground among immune compromised humans. Hospitals are in an arms race: strong and stronger antibiotics being deployed against stronger and stronger bacteria. “We can still always find something that works” said Hannah, the cheerful lady doctor in the casualty department in the small hours of the morning, faced with my fast-fading elderly relative with a pneumonia acquired at that same hospital earlier that week. Others in the casualty station who had come off motorbikes or had been involved in disagreements which had ended in bleeding eye sockets gathered round in companionable communality, exchanging jokes and accepting offers of mugs of tea. No green clad nurse required any of us to wash our hands, nor would it have made much difference. Call all hospitals the grand International Congress of Bugs that Bugger up Humans. I know that these bugs hold the original title deeds to the entire biome, but there is no real need to give them such strategic advantages.

In other writings Garrett Hardin made clear that, in his view, the tragedy of the commons had corollaries:

1 The commons must be protected: A community that renounces war as a means of settling international disputes still cannot survive without that discriminating form of altruism we call patriotism. It must defend the integrity of its borders or succumb into chaos.

2 The commons must be managed: A managed commons, though it may have other defects, is not automatically subject to the tragic fate of the unmanaged commons.

3 Ultimately the commons can only be protected and managed by force: All persuasion takes place through coercion, mutually agreed upon by the majority of the people affected.

4 Managing the commons requires managing fertility in the long term: Remember the competitive exclusion principle: if fertility varies in a population that is offered options in fertility, then as generations succeed one another, the pro-natalist elements in the population will, in time, displace the ones who conscientiously limit their fertility. If the world is one great commons, in which all food is shared equally, then we are lost. Those who breed faster will replace the rest. Sharing the food from national territories is operationally equivalent to sharing territory; in both cases a commons is established, and tragedy is the ultimate result.

5 Managing the commons requires the management of immigration: Controlled immigration becomes the default position of population policy. A heavy burden of proof falls on anyone who proposes doing away with border control.  In a less than perfect world, the allocation of rights based on territory must be defended if a ruinous breeding race is to be avoided. Overpopulation can be avoided only if borders are secure; otherwise poor and overpopulated nations will export their excess to richer and less populated nations.

As you will expect of me by now, I can put forward a strong counter-argument. First of all, medieval man was not stupid: commoners usually had well defined, circumscribed rights, and it was the breaches of those rights which caused particular commons to be stinted. The few remaining commons in contemporary Britain are covered by the Commons Act 2006 which protects against abuses. In current times global problems arise when the oceans are treated as unregulated commons. If fish are freely available, then the very biggest factory ships should hoover them up from the depths.

Although although our planet is finite, there is still scope to increase its productivity. Private land owners can use better land management, irrigate, use artificial fertilizer, and improve the genetics of the plants and the animals. As regards the more general issue of global public health, infections might be controlled by other techniques to attack bacteria, even if new antibiotics prove difficult to develop. The problem of the remaining commons might be ameliorated by requiring that prospectors pay for defined licences before they can draw on common resources like the oceans. It is the fact of these global resources being held “in common” which makes them liable to exploitation. Title deeds (private property) are the best protection against resource mismanagement (common ownership), because owners have strong incentives to preserve their capital, commoners less so. 

Even under current circumstances with still-rising populations and all the problems of warfare and local conflicts, food is winning out over hunger. It may seem that resources will always run out, but so far human ingenuity has provided for our needs. The stone age did not end because of a shortage of stone. Bronze replaced it. Malthus may be right in the end, but if humankind has sufficient wit, that end may be a very long time coming. In short, the brain might win out over the stomach and the genitals. My money is on intelligence, but it may be a close run thing.