According to the encyclopedia of Philosophy, Prisoner’s Dilemma is used to describe human psychology when two completely rational people for some reason do not cooperate even if it is beneficial to both of them. It is usually due to a clash between the group and individual rationality. This game theory can be used to describe multiple human behaviors and the use of antibiotics is one of them. Antibiotic resistance in relation to emerging and non-emerging infectious diseases has become a growing public health problem. The problem is rooted in the misuse of antibiotics: both under and over-use with a common misconception like antibiotics can treat all kinds of disease and once the symptoms are over, you don’t need to complete the medication. The unregulated sale and over prescribing have resulted in antibiotic resistance (Heymann, 2009).
A scenario to explain a prisoner’s dilemma in relation to antibiotic prescription is when a patient comes asking for an antibiotic (who does not need antibiotics). The doctor faces a dilemma as he is expected to satisfy the patient while providing good health care but at the same time he is contributing to antibiotic resistance. And if he does not prescribe antibiotics, the patient is not satisfied and he loses the patient and revenue but will help society (“Prisoner’s Dilemma in the Doctor’s Office,” 2016). Here, the dilemma to think about this individual gain or the society’s causes the prisoner’s dilemma and in most cases, the individual benefit wins.
Another scenario explained by Heymann is the use of antibiotics in agriculture and animal husbandry(2009). Farmers use antibiotics to immediately solve the issue and improve growth. Animal products and plants in the form of food reach the human body and can be a cause of antibiotic resistance. And these food products are not limited to one country, they might be exported worldwide. So, the whole world faces antibiotic resistance.
In both scenarios, the doctors, patients, and farmers can be benefitted from the regulated antibiotic use but what happens is they tend to oversee the immediate and personal benefit more than collectively as a society in long run. They weigh the benefit of impact and take a decision of using antibiotics (even if it can create resistance in long run) which is the result of the prisoner’s dilemma. Despite the fact that they know the harmful impact of antibiotic resistance, they use it. It can be associated with the cost-benefit analysis.
So, what can be done to decrease antibiotic resistance? Since antibiotic resistance is totally linked with infectious diseases, the first priority would be to limit the spread or emergence of any such diseases. Internationally organizations like WHO aimed in stopping cholera, plague, yellow fever, and smallpox by pre-establishing control measures and international borders. Early warning systems to prepare the countries can also help limit and control infectious diseases. Timely availability of surveillance information and technical resources for health security is a must. And most importantly when we are already facing the impacts of antimicrobial resistance, the international strategy for antimicrobial resistance framework to regulate the rational use of antibiotics along with inter and intra-sectoral coordination like agriculture, animal husbandry and alike should also be in priority to not worsen the case. (Heymann, 2009). The same can be continued. Strengthening public health laboratories so as to identify the outbreaks the soonest as possible is required both at the national and international levels.
On a national level, following the antibiotic resistance framework can be very effectively followed by strict regulations on selling those medications. It is so much easier to buy antibiotics without a prescription in many developing countries as compared to countries like Norway. Also, policies on public awareness of the rational use of antibiotics are required to remove the myths associated with it. We have seen almost all the policy measures applied in the current context of COVID-19, an international organization like WHO is dealing with the early warnings, predictions, surveillance, and data management and coming up with updated recommendations to limit the disease with its technical expertise. Whereas, the different nation has adopted different policies nationally like the rules for quarantine and lockdown. Countries are coming up with different research and some countries like Russia are already working on vaccines. Strengthening the country’s resources in that case as expert manpower, strong research, and health care facilities are a few examples and not forgetting the sides of emergency preparedness.
In this world of interdependence and interconnectedness, infectious diseases can affect all countries. So, the best way to cope with it is development& medical cooperation through a joint effort.
References
- A. Lansang, & M. Gulliford (Eds.), (5th ed. ed., Vol. Vol. 1, pp. 1264-1273). Oxford: Oxford University Press.
- Prisoner’s Dilemma in the Doctor’s Office. (2016). Retrieved from http://blogs.cornell.edu/info2040/2016/09/04/prisoners-dilemma-in-the-doctors-office/