From Fighting for Freedom to Fighting Drug-Resistance to Save Modern Medicine – Part One

Colin Garner Coronavirus COVID-19, Learn more

Vicki Joughin, Antibiotic Research UK’s volunteer marketing and communications consultant considers how we’ve moved from fighting for our freedom to fighting drug resistance. She writes;

As we celebrate the 75th Anniversary of VE day, many of us are reflecting on the horrors of war and the loss of life. At Antibiotic Research UK we are also looking back on the history of penicillin and the part it played in helping the Allied Forces achieve victory in Europe.

The story of the discovery of penicillin by Scottish scientist Sir Alexander Fleming in 1928 is well known. But the part that penicillin played in the war effort and the scientific and government collaboration that took place to enable mass production of penicillin is less widely shared. Even though Fleming realised he had made a major discovery in the inhibition of growth of bacteria, he was unable to commercialise it as a drug, finding it too difficult to purify.

Fleming’s work was picked up by three Oxford scientists, Howard Florey, Ernst Chain and Norman Heatley, over a decade later. In 1940, they were excited to find that penicillin successfully treated mice injected with streptococcus bacteria. They published their findings in the medical journal The Lancet. The military importance of developing a more successful means of combating diseases and infection that had decimated armies of the past was recognised. Hence, in 1941, with a sense of urgency catalysed by the necessity of war, Florey and Heatley travelled to the United States. They shared their scientific knowledge and mould cultures with U.S. officials and scientists. This sparked a unique collaboration across academia, government and the pharmaceutical industry in both Britain and the USA. It enabled mass production, providing the military with large quantities of highly refined, commercial-grade penicillin. In just 5 years, this collaboration transformed the production of penicillin from a labour-intensive method which produced low volumes of crude penicillin to a highly refined version in 10,000 gallon tanks. In 1941 and 1942, scientists discovered its efficacy in treating wounds. Subsequently, the production increased from 400 million units per month in early 1943 to more than 650 billion units per month by the end of the war in 1945.

A lead scientist for the War Production Board’s (WPB) penicillin project noted “whatever course we were to take we had to be sure of that D-Day supply”. They achieved that goal and plentiful supplies were sent with the troops making the D-Day landings in June 1944. As a result of its efficacy against gangrene, the death toll from infected wounds dramatically decreased. Administration of penicillin on the battlefield also reduced the numbers of amputations significantly, as wounds were not left untreated before surgery was possible. A further problem on the battlefield was septicaemia (blood poisoning) which occurred when surgical procedures were performed with inadequately sterilised equipment. Along with the invention of antiseptics by the English surgeon Joseph Lister, penicillin was used to prevent infection spreading. Through the use of penicillin therefore, the army doctors were able to revitalize troops more quickly, hence it is sometimes referred to as the Allied Forces “secret weapon”.

Canon David Staples spent much of his childhood during the war years and has shared his memories with us: “During the blitz the hospitals were dealing with many casualties as protection against the shrapnel was very flimsy. I remember sleeping with my parents in their double bed with only a fireguard to protect us from broken glass. Because the hospitals were so busy I had my tonsils removed on the kitchen table by our doctor who arrived with his leather bag without antibiotics and sterile drapes!” He goes on to share his first memory of the use of penicillin: “It was in ointment form. We all had boils during the war due to our poor diet. I remember Mother bringing a tube of yellow penicillin ointment to clear up a nasty boil at the back of my knee which had caused me pain for weeks”.

man on an army base in World War Two

Even after the war, when National Service was compulsory for young men aged between 18 and 21, the conditions they were living in were as horrifying as the war years. This resulted in many infections, as Canon David Staples recalls from National Service in the Suez Canal Zone and Cyprus: “The living conditions in the tented camps were horrific and insanitary with latrines made out of deep trenches with no water and swarming with flies. Many developed dysentery and I developed blood poisoning. Thankfully an army nurse administered antibiotics regularly with a large hypodermic in my backside! I think they gave us medals simply for surviving.”

The story of the mass production of penicillin to help the Allied Forces win World War II is a remarkable one. It was brought about by an unparalleled collaboration between governments, industrial giants and renowned scientific establishments who had a common goal – which was not a financial one. Today, antibiotic or drug-resistant infections are cited by the WHO as one of the biggest threats to global health. It is estimated that resistant infections cause 700,000 annual global deaths currently, rising to 10 million by 2050. Although antibiotic resistance is now widely recognised as a threat to “modern medicine”, novel antibiotic discovery is not high on the agenda of governments, scientists and the pharmaceutical industry. Antibiotic Research UK is the world’s first and only charity fighting drug resistance.  You can read more about our research successes to date here.

Together we can keep antibiotics working. We will continue fighting drug resistance and working hard to save “Modern Medicine.”
References:
1) Bradley, Jeremy. “How Did the Invention of Penicillin Affect World War II?” classroom.synonym.com, https://classroom.synonym.com/did-invention-penicillin- affect-world-war-ii-8709.html. 1 May 2020.

Primary references used in the above:

• Healio EndocrineToday: Penicillin: An Accidental Discovery Changed the Course of Medicine
• History Learning Site: Medicine and World War Two
• Penicillin — Triumph and Tragedy; Robert Bud

• Penicillin — A Breakthrough in Medicine; Richard Tames

2) Quinn R. Rethinking antibiotic research and development: World War II and the penicillin collaborative. Am J Public Health. 2013 Mar;103(3):426-34. doi: 10.2105/AJPH.2012.300693. Epub 2012 Jun 14. PMID: 22698031; PMCID: PMC3673487.