the words to his song, hard rains are going to fall. it will be auctioned off in june in new york city. thank you for watching aljazeera america. i'm del walters in new york. and check us out 24 hours a day by going to aljazeera.com. m is next. thanks for watching. >> you're sick. you take the medicine meant to cure your illness. that's what we do. but with increasing regular layerty the medicine won't work. the . thi it's the "inside story." >> hello, i'm ray suarez.

if you know a really old person ask them what it was like before antibiotics. people regularly died from common diseases or infections or suffered long and hard until an illness passed. then came medicines that meant millions no longer died from pneumonia , tuberculosis, or suffered from long-term debilitation from diseases like gonorrhea. making wonder drug after wonder drug more available and drove prices steadily down. but we overused some drugs, improperly used others, and now the infections themselves evolved. now the great gift to the world, cheap effective treatment for potentially fatal ailments is now in the future. >> reporter: the world may be heading to a post antibiotic era, modern medicines can no

longer stand up to common infections like me known i can't, e. coli and mrsa. >> over the last 20 years bacteria has developed sophisticated resistence and we don't have the antibiotics to treat the patients. >> reporter: the "world health organization" released it's report wednesday warning that it's not a thing of the future, it's happening right now . >> what happened in the last 25 years is we used antibiotics with an extremely low level of caution, and the rules about the use of antibiotics has been forgotten. >> key findings of the who report include increasing resistence to the treatment of last resort. it's spread to all regions of the world. medical professionals are seeing

drug-resistant infections including pneumonia and bloodstream infections common in hotels, e. coli and gonorrhea, more than 1 million people are newly infected around the world every day. all of these age old diseases could come back to kill. one example of a growing problem is staphylococcus or staph infections common in hospitals. if you get mrsa, then you have a 64% grater chance of dying than if you caught a non-resistant form of staph infection. right now doctors and hospital workers are fighting a new disease spreading throughout the middle east. the middle east respiratory syndrome virus or mers has killed 100 people in saudi arabia alone.

mers can lead to viral pneumonia. it's caused by a virus that is common in camels for decades but only discovered in humans in 2012. there is no known vaccine to prevent its spread. recently spoke about april's 73% spike in infections. >> hopefully that we will -- >> this is a scene that the world could see soon if antibiotic medicining can fight the medicined. they're encouraged only to use antibiotics when prescribed by a doctor, fully completing prescriptions and never sharing medicine. the who said drug resistence is a serious threat which has the potential to affect anyone of any age in any country in every region of the world.

>> to help you better understand why drugs that work so well for so long are increasingly not much help against disease we're joined by a doctor from the center for bio security. dr. annie sparrow, deputy director of the human rights director at mount sinai hospital in new york, and geneva, switzerland, the doctor who leads the team studying answered microbial resistence. let's go back to when these drugs were first introduced. was it always understood that this was a threat waiting out in the wings that some day resistence was going to be a problem? >> yes, indeed, from the very beginning. we have been alerted, the one

discovering penicillin, and he, at his noble prize speech he already alerted the world that resistence to antibiotics would arise. once we start using these precious drugs the more we use, the faster they would become ineffective against the bacterial infections. >> was there a threshold that was crossed to get the who so concentrated on this problem. with my kids, our pediatrician would say we're not using this drug or that drug with things like ire infections. my kids are fine today. what is it that is now making this something that the world should be more concerned about?

>> well, as you have said we have reached the point where we are facing a spread of bacteria. and the pipeline for development and production to antibiotics is dry. for many years after the discovery and the start of use of penicillins we had a belief we would be able to create new drugs. but the reality is that there are challenges , and there are several other in the end that result in the void that we are observing .

the world has not seen a new class of antibiotic s, so we are now in a situation where high levels in all parts of the world world, therefore on that if on one hand we have quite a spread, a concerning spread. on the other hand the pipeline is different drive for new alternatives, new options. so we are really reaching this point where we may be facing more and more friendly situations where it is not treatable . >> we'll talk more about drug development and challenge there is, but let's get real basic for a moment.

how does resistence happen? >> resistence is not new to bacteria. the earth is probably more bacteria than any other type of creature on the planet. bacteria used to fight among each other and they develop resistence mechanisms that they use in order to survive. what happens now when humans take antibiotics, those antibiotics are now being shown to the bacteria that live in our body and may be causing an infection or that i be there harmlessly, and then pre-existing mechanisms are turned on, and they're turned on the bacteria. as alluded to earlier, alexander fleming realized we would run into this problem if this was not used judicially because this is normal behavior for bacteria in order to survive. >> so you've got bugs in your system. you introduce this compound to

kill them, and they get used to having them around? >> they see it and start developing mechanisms almost like missiles defense systems, they learn how to cut them up, pump them out and they have genes in their chromosomes that they can turn on and they can pass it to their neighbors. they can also do--they can also sense when there is more of them in going in different forms. what is called the bio films. they get into this formation that makes it very hard for antibiotics to penetrate them. they have a whole host of defenses against antibiotics. this is something that they evolutionarily grew up with. this is not anything new for them. >> dr. sparrow in those countries in the world where medicine isn't as easily come by, where people can't necessarily visit doctors as often or as thoroughly, how does this cross the line from being merely inconvenient to something

that is really dangerous. a public health threat? >> it's nothing new. it's been around for a relong time. very longtime. we're talking about viruses, mers, h.i.v. malaria, and all manner of microbes, we're talking bugs not just bacteria, but bugs. this problem has been around as long as we've had any kind of treatment for these pathogens, and they're better at it than we are. they're better at surviving, and we're seeing a progressive acceleration of this threat, which has been around since penicillin was invent ed.

gonorrhea doesn't kill us like malaria and tb do, and they are quite difficult to treat. we're seeing a serious global threat with disease that is predominantly affect those in the developing world, but also mers, in the hospital, in the community, which lead to very serious mortality, and we may experience that in the developed world, to add to the considerable burden of bacteria viruses. as you know polo has now appeared in the middle east and iraq. so we're in a very pre-darius global health situation where the pathogens are getting stronger and our ability to fight them are getting smaller. >> we'll come back and talk

about diseases like malaria and tuberculosis and what can be done in the face of increasing resistence. this is "inside story." stay with us. >> the debate that divides america, unites the critics, a reason to watch al jazeera america the standout television event borderland, is gritty honesty. >> a lot of people don't have a clue what goes on down here, the only way to find out, is to see it yourselves. >> taking viewers beyond the debate. >> don't miss al jazeera america's critically acclaimed series borderland on al jazeera america also available on demand

>> i'm ali velshi, the news has become this thing where you talk to experts about people,

and al jazeera has really tried to talk to people, about their stories. we are not meant to be your first choice for entertainment. we are ment to be your first choice for the news. >> welcome back to "inside story." i'm ray suarez. the word antibiotic comes from antibiosis. which literally means one organ harmful to another. human medicine learned how to kill the bad bacteria that can make us sick. it turns out bacteria evolves faster than humans do. in the report in the race against harmful bacteria there is growing evidence that they are winning, and antibiotics are losing. what have humans done? we heard from all of you in the course of the program that this is not new. this has been going on in one way or another for a long time,

but the way that humans use medicine, is it making it worse? >> it is definitely making it worse. what's happened, people have gotten so accustomed to not hearing about infectious diseases, any time they get a cough or cold they go to the doctor. the doctor gives them an antibiotic, and they get better, and they think it was the antibiotic that made them better when it was really a virus that went through its normal course. they then know what tools are going to be used against them in the future, so the injudicious use of antibiotics has contributed to the rise of resistence. that's why you're seeing this call for stewardship from doctors in the outpatient setting and hospitals and for patients not asking for antibiotics for everything and be satisfied that they can be treated with ibuprofen and

systematically rather than putting physicians in an awkward position where they have to be placed at the mercy of the patient who may file a complaint if they don't get an antibiotic. >> dr. is that you ho we got multi pl puttelly drug resistence tuberculosis? >> yes and no. i would like to say that i agree with everything that has been said. we give antibiotics with a very low threshold. for something like a cold, son come , theywant something, and i may nt have a way to diagnose it, but we hear what happens, we prescribe the wrong drug, it doesn't work, and at the same time it gives patients serious side-effects

and that increases resistence. unfortunately, a patient comes in. they take the drug for a certain number of days. the if a patient starts taking the drug and then stops, maybe saving the drug for another time he gets the illness, you can see how this feeds the process. in tb, the threat has to be a very consistent process of treatment for a very long period period. it comes on top of this process,

and it ex-asse exacerbates the problem. and the infectious ratio whether we're talking measles it's hig higher and spreads quickly when you have man families and many live closely together. these diseases are highly contagious. you can see how that confluence of resistence .

>> when someone comes in and has drug resistence, do the costs go up treating them, and when does it really strain resources? >> yes, indeed. it is true when the second line drugs they are associated with much higher costs. of course, this as to the burden of the healthcare system. it has been demonstrated

with the costs associated, in this case the bacteria resistence was as high as the cost for the entire er in europe. so showing proportionately the burden not only on the cost but also in mortality can be higher. but i would like to join my colleagues in the sense that we do need to improve prevention of infection in the first place . not only rely on the use of anti- microbial drugs. when it comes to having to treat we have already lost some battles. the first battle is th the batte

of prevention, improving sanitations conditions, improving vaccinations, and development of vaccines that could very present infection and improve infection control in hospitals. everyone knows that healthcare facilities can really be hot beds for spread of anti anti-microbial infections. you even if we all present measures of course it's natural that you continue to have infections. now how to deal with infections, this is a major, major challenge. there are reports that we issue today that show that the capacity is very limited particularly in the african countries.

and in some . >> we're going to take a short break. it's already been mentioned that it's been a long time that new drugs has been developed. why not? is it the expense? is it the difficulty in the testing? and what happens if we don't find new drugs. this is "inside story."

>> this edition of the program we're talking about the the who say it's the threat of global health. improper use, improve prescription, if we start putting the right measures in place can we squeeze a couple of years of useful life out of the best known drugs until we have to bridge us to the new

generation of anti-microbial. >> we're faced with global threat of infectious diseases from the pneumonias, tb, malaria malaria, and other killers that are killing the world's children and people. so what we need is political will. there is no money in the drug for malaria and tb, really, and they are based--the problems are faced by the world. the sanitation, the vaccines, to look at these things that help us fate th face the threats. >> ca

can pharmaceuticals still make a profit? >> yes, we're bringing in partners together to open the dialogue on how to on one hand to stimulate the development of new drugs. but on the other hand look at anti-antibiotics not as commercial goods but public goods. so reimbursement to the expenditures in the development of new drugs should not be be--should --so once developed the new drugs we have to preserve them. but this is not the only measure that will surface in tackling new drugs. if we do not take care of better practice in prescribing only

using and prevention just having new drugs will not solve the problem. because you see again the emergence of anti-microbial resistence, and you're not addressing the fact that we need a better use of medicines, anti- anti-microbial medicine. >> is that our assignment in this country where we're not suffering from a widespread way of tuberculosis. can we in our daily health practices be helping to solve this problem or at least make it less? >> i think there are a lot of other factors in this problem. in the united states we don't have tuberculosis and malaria at the

same levels as the developing world, i think you need to focus on preventing the infections in the first place. we know that these organisms live in nursing homes, and communities and when people come to the hospital they can spread that , and compliance with that is lax and not as good as it should be. we have learned that hand washing is not as good as it should nobody hospitals. and then there is the question that she mentioned with new drugs. that's not the solution. >> thank you doctors for all your good advice today. that brings us to the end of this edition of inside story. thanks for being with us. in washington, i'm ray suarez.

[cheering] >> attack another official building in the eastern ukraine city. >> you are with al jazeera live. coming up, talks between the governments, and rebels restart. protests in turkey. and police in northern ireland question the leading republican