Should NASA go to Mars or back to the Moon?

Resistance in microbes—bacterial, viral, or protozoan—to therapeutics is not surprising or new. It is, however, an increasing challenge as drug resistance accumulates and accelerates, even as the drugs for combating infections are reduced in power and number. Today some strains of bacterial and viral infections are treatable with only a single drug, some no longer have effective treatments. The disease burden from multi-drug resistant strains of tuberculosis, malaria, hepatitis, and HIV is growing in both developed and developing countries.

Infections caused by resistant microbes fail to respond to treatment, resulting in prolonged illness and greater risk of death. Treatment failures also lead to longer periods of infection, which increase the numbers of infected people moving in the community and thus expose the general population to the risk of contracting a resistant strain of infection. When infections become resistant to first-line antimicrobials, treatment has to be switched to second- or third-line drugs, which are nearly always much more expensive and sometimes more toxic as well, e.g. the drugs needed to treat multidrug-resistant forms of tuberculosis are over 100 times more expensive than the first-line drugs used to treat non-resistant forms. In many countries, the high cost of such replacement drugs is prohibitive, with the result that some diseases can no longer be treated in areas where resistance to first-line drugs is widespread. Most alarming of all are diseases where resistance is developing for virtually all currently available drugs. Even if the pharmaceutical industry were to step up efforts to develop new replacement drugs immediately, current trends suggest some diseases will have no effective therapies within the next ten years.

More recently, the challenges of resistance are compounded by growing concerns about the possible use of biological weapons leading to large-scale disease outbreak or exposure. The ability to respond effectively to such exposures could be significantly compromised by the introduction of drug-resistant pathogens. The use of prophylactic drugs or therapies on large populations may also contribute to the development of drug resistance and thus increase both the immediate and longer-term challenges of treating infectious diseases.

A number of trends in human behavior increasingly contribute to the emergence of resistance to antimicrobial agents. Host behaviors such as noncompliance with recommended treatment and self-medication are among the most complicit problems associated with the development of resistance. Noncompliance with treatment occurs when individuals forget to take medication, interrupt the treatment as they begin to feel better, or are unable to afford a full course of therapy. Self-medication with antimicrobials almost always involves unnecessary, inadequate, and ill-timed dosing—creating an ideal environment for microbes to adapt rather than be eliminated. In many countries, antimicrobials are readily available to consumers without a medical prescription. Both noncompliance and self-medication are complicated in some countries by the availability of low quality antimicrobials (particularly antibiotics) that are poorly manufactured, counterfeit products, or expired.

Another factor contributing to the rise in antimicrobial resistance—over-prescribing by physicians—has been heavily influenced by patient expectations and demands. Growing patient awareness (not necessarily accompanied by understanding) of antimicrobial agents (largely from direct-to-consumer marketing) sets up an expectation when being treated that they should receive such treatments, even in the absence of appropriate indications. Multiple factors such as diagnostic uncertainty, lack of opportunity for patient follow-up, and lack of knowledge regarding optimal approaches on the part of the physician may influence the response to patient demands
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Once more the average life span is going up repeat up repeat up and the average health is also going up repeat up.

Eorl wrote:

It should be Mars. "We choose to go to the moon, to prove we still can" isn't going to inspire the world that much.

Not sure if it will be, or even should be NASA though.

Going to Mars first is like telling a baby to skip the crawling stage and start with walking. It should be the Moon, then Mars, then the outer planets.

I'm not sure it's possible to go Mars first at this point

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but that that's no justification for never doing adventurous things that don't have a clear path to a quick payoff.

the ability to wait for an open amount of time for a payoff that is not definable and may never happen is a luxury of the civilized world. Even in the best of times the budget for this type of endeavour has limits, and these are not the best of times. In my opinion the only project that is worth huge investment with unknown pay-off given our vast known investment needs is working on a new energy source that is sustainable and non-toxic. If you have a space program to work on that then I am all ears.

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Sorry this is complete nonsense since when was the last time we loss 1/3 of the known human race to a microbes for example.

the experts disagree with you....almost all of the drugs are well on their way to becoming useless, as the microbes have gained immunity. We have made the situation much worse by over using the drugs and not using them properly. The race is on to come up with new drugs in time, but there is zero reason for optimism. I think I remember reading that we got less than 1/4 of the lifespan that was expected out of the current drugs...because we are not organized and motivated enough to use them correctly. The scientists currently have nothing that looks promising. The future is a known if we don't have the drugs, given how packed like sardines humans now live.

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I'm not sure it's possible to go Mars first at this point

There is a solid argument that it is not possible to go to the moon....at this point.

You don't know what the hell you're talking about--as someone with a scientific background, you should know better than to start from assumptions for which you have no data. Crime, poverty and disease were not outside limits common throughout Europe at the time. You also seem to have missed a major point. Ferdinand and Isabella didn't spend any money on the expedition--they simply seized the assets needed for the expedition and handed it over to Columbus, providing letters of credit which were not in fact backed by anything other than an assumption that the dual monarchs would honor them, which in the event, turned out to be a foolish assumption.

Spain, in fact, did not exist at the time. The reconquista was only accomplished in 1492. Spain would not exist for several generations to come. Ferdinand and Isabella were a dual monarchy of Castille and Aragon, and the the territory from which they took the assets on which they then operated had been conquered from Andalusia, the former Muslim state in the southwest of the peninsula. No nation in Europe was spending money to improve the lives of their subjects, the concept was so alien to the times that no one would have even thought of it.

I saw your point, but you're missing mine. This was precisely a case of Ferdinand and Isabella gambling on a quick pay-off, and Columbus was expected to produce a quick pay-0ff, while the dual monarchs provided ****-all for financing. Columbus only convinced them because he claimed he saw a clear path and a quick pay-off. Of all period in European history, the middle ages and the early modern era were the most ruthlessly capitalistic. Virtually every overseas venture of any nation in Europe was a joint-stock operation (such as the Virginia Company or the Massachusetts Bay Company) or an entrepreneurial venture by military types (such as Cortez or Pizzaro).

There is just no possible way to compare any of the enterprises of the age of European exploration to present conditions, because the differences in societies and outlooks are so profoundly dissimilar.

As a side note, though, just out of curiosity, what about the story of Isabella donating her jewels?

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As a side note, though, just out of curiosity, what about the story of Isabella donating her jewels?

It was just that, a story. As has been observed by others, from the point of view of the aboriginal inhabitants, this was not necessarily a good thing for "mankind."

... Columbus, of course, came along at the end of the reconquista, and many of the unemployed soldiers of those campaigns against the Muslims followed his lead to the new world.

Another version I read was that the Inquisition came along at the end of the reconquista, and Columbus, with the aid of Spanish Jewish financiers went to look for a land around India that was supposed to be an autonomous land where Jews lived, and governed themselves (and the Spanish Jews leaving Spain would have another destination choice, rather than just Italy, Holland or Portugal).