• Introduction

  • No more pills

  • End of chemo

  • Easy fitness

  • Custom organs

  • No-scar surgery

  • Fixing DNA

  • Brain training

  • Sharing data

  • Personal sensors

  • New super drugs

The CNN 10: Healing the Future

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Ideas that can save lives

In medicine, innovation is life and death.

Every advancement means another mother, another brother, another grandparent who could be saved. A new drug could cure cancer. The next surgical tool could prevent patients from bleeding to death on the operating table. A DNA discovery could free thousands from chronic pain.

They say hope is the best medicine. That hope lies in the hands of scientists working in labs around the country.

Bioengineers at the University of Michigan who are creating organs with a 3-D printer.

Oncologists in Pennsylvania who are turning cancer patients’ own cells into warriors.

Surgeons in Washington state and Alabama who are learning to operate without making a single cut.

They hope that by doing so, they can save lives.

But in order to truly heal the future, we have to do more than treat the sick and fix the broken. We have to make wellness a priority. So architects are working to design better communities; computer programmers are developing smart devices to keep us on a healthy path; neurologists are learning how to train the brain to stave off dementia.

As part of our focus on innovation, CNN is featuring 10 inventions or people that are changing the world. We’ve looked at cars, startups and visionary women. Now it’s time to honor innovations that will affect your body and your mind.

These 10 ideas are revolutionizing health care -- from the operating table to the kitchen table. Even those that don’t come to fruition as imagined will have forged a path for another that will one day save a life.

May we present The CNN 10: Healing the Future.

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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Introduction
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Just give it to me in a chip

1 of 10
The goal
Better manage chronic diseases
How we’ll get there
Implantable microchips will make taking daily medications easy
Real-life example
A microchip gave eight women their osteoporosis drug for four months
How close are we?
MicroCHIPS plans to release its first product to the public in 2017

Did you take your meds today? At the right time? All of them?

Following your doctor’s orders can be cumbersome, especially if you’re supposed to take more than one pill a day.

That’s why scientists are working to develop microchips that can be preloaded with medications and implanted in our bodies, programmed to administer drugs at a given time, interval and/or dose. A doctor would theoretically be able to adjust the dose, or stop the drug altogether, by remote control.

Massachusetts Institute of Technology researchers Robert Langer and Michael Cima started working on this idea with John Santini in the 1990s. Langer and Cima are on the board of directors of MicroCHIPS, a company trying to make the idea a reality.

In a 2012 study, they implanted a chip under the skin below the waistlines of eight women with osteoporosis. Over four months the device delivered regular doses of an osteoporosis drug normally given by injection. The study showed this method was safe and effective.

Since then the device has improved considerably, says Robert Farra, MicroCHIPS president and chief operating officer. The current version is about the size of a Scrabble tile and can deliver more drugs than before.

The company is aiming to release its first product to the public in 2017, which will likely be a hormonal contraception device that can be turned on and off wirelessly and releases a consistent daily dose. It will have the ability to offer progestin and estrogen together, like a combination birth control pill.

The first version of this device will likely last five years, but it’s possible to create one that could remain in the body and effectively deliver drugs for up to 16 years.

“The MicroCHIPS implantable drug delivery device is the greatest advancement in delivering medicine since the first tablet pill was developed in 1876,” CEO Bradley Paddock says.

Another device is being developed for other chronic conditions, including multiple sclerosis. It may even lead to new therapies, Langer says, because the device protects unstable drugs.

The device could also transmit data to hospitals and doctors so “you could have permanent records of exactly what you took when.”

Further down the line, the chip could serve as a rescue device, releasing medications for heart attack, stroke or allergic reaction in at-risk patients.

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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1 of 10
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Safer ways to fight cancer

2 of 10
The goal
Treat cancer, without killing healthy cells
How we’ll get there
Using targeted therapies based on cancer cells’ genetic makeup
Real-life example
Doctors used this teen’s immune cells to put his cancer into remission
How close are we?
31 targeted cancer therapies have been approved, and more are on the way

When 14-year-old Nick Wilkins’ leukemia resisted chemotherapy, radiation and a bone marrow transplant, his doctors turned to the real pros: Nick’s own immune cells.

Using an experimental treatment, the doctors taught Nick’s immune system to attack his cancer in much the same way he’d fight off the common cold. Two months later, Nick went into complete remission.

Twenty-one other young people received the same treatment, and 18 of them had similar responses to Nick’s.

The University of Pennsylvania and other medical centers are testing the targeted approach in more patients, and doctors are cautiously optimistic it might work to treat other types of cancer.

"This is absolutely one of the more exciting advances I've seen in cancer therapy in the last 20 years," says Dr. David Porter, a hematologist and oncologist at Penn. "We've entered into a whole new realm of medicine."

In the last five years the Food and Drug Administration has approved more than 20 targeted cancer therapies for tumors with specific genetic markers, according to the American Association for Cancer Research.

One approach deprives cancer cells of essential nutrients. A drug using this approach was approved in February after a clinical trial showed it shrank tumors in nearly 58% of patients with a rare blood cancer.

There are also drugs that contain man-made antibodies that glom on to cancer cells and, once inside, release toxic chemicals.

"I call them smart bombs," says Dr. Patricia LoRusso, who investigates experimental drugs at the Karmanos Cancer Institute in Detroit and helped develop a therapy approved last year for late-stage breast cancer.

A similar concept still in the early stages of experimentation loads a drug onto star-shaped particles of gold 1,000 times smaller than the diameter of a human hair to cause DNA damage inside the nucleus of cancer cells.

“If you shut down the brain (of the cancer cell), the whole cell is going to die,” says Teri Odom, a materials science professor at Northwestern University.

In time, researchers hope to use a lot less chemotherapy to fight cancer.

"These more elegant and targeted approaches will ultimately do away with the less elegant, less targeted traditional (therapies),” says Dr. Renier Brentjens, director for cellular therapeutics at Memorial Sloan-Kettering.

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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2 of 10
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No willpower required

3 of 10
The goal
Make the healthy choice the easy choice
How we’ll get there
Changing our environment to incorporate daily activity, easy access to nutritious foods
Real life example
Redesigning Times Square to make it more pedestrian-friendly
How close are we?
Coming soon to a city, office, school or home near you

Living a healthy, active lifestyle today is hard. It requires planning. Willpower. Perseverance.

But in the future, fitness might not be so difficult. Experts are working to change our environment so that the healthy choice is the easy choice – or not a choice at all.

“A healthy city … makes it easy for people to get fresh air, exercise and meet people,” says Jeff Risom, a partner at Gehl Architects, which is leading the way in designing public spaces that naturally increase wellness.

Imagine: Instead of jumping on the treadmill for a half hour at 6 a.m., then sitting all day at work, you bike to and from the office and skip the gym altogether. Instead of watching The Food Network while reheating a frozen pizza, you walk with your partner to eat with friends at the little farm-to-table café near your condo.

“You can change the built environment to improve health,” says David Burney, chairman of the board for the Center for Active Design. “It’s just finding ways to reverse this culture where we always drive everywhere, always take the escalator … and make people more active in their everyday lives.”

The Center for Active Design focuses on four areas: transportation, active buildings, recreation and food access.

This means creating safe bike lanes, crosswalks and sidewalks. It means placing stairs more prominently than elevators. It means increasing access to public transportation and to parks. It means offering tax incentives for supermarkets to open in food deserts so families can easily buy fresh produce. These changes are being implemented across the country in hotels, schools -- even affordable housing units.

And changing our environment is about more than just fighting obesity. Wellness real estate company Delos recently debuted its first residential building, which features supportive flooring to protect your back, vitamin C-infused showers, circadian rhythm lighting to help you sleep, and germ-prevention kitchen countertops.

While these New York lofts sell for millions of dollars, the concepts could eventually be used in houses and apartment complexes around the country. Delos has developed a WELL Building Standard, along the lines of the LEED certification for environmentally green buildings, so other companies can follow suit.

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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3 of 10
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Creating body parts from dust

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The goal
Create custom human organs
How we’ll get there
Using 3-D printers and biological materials
Real-life example
Doctors saved a baby who couldn’t breathe with a 3-D printed splint
How close are we?
Hearts, lungs and livers are decades off. But windpipes and blood vessels are close.

The long metal table in the University of Michigan biomedical engineering lab is covered by a film of white dust. Scattered across the table are opaque-colored objects shaped like ears, noses, vertebrae, and jawbones – all made from biological material.

A few feet away, a small room houses a quietly humming 3-D printer – about 6 feet tall and almost as wide. In a windowed opening near the middle of the machine, a metal platform, piled with the bio-material, moves up and down as a laser transforms the dust into a tiny splint.

That splint will prop open part of a dying baby's lung.

"It's magical," says Dr. Glenn Green, a pediatric otolaryngologist at U-M who later implanted the splint. "We're talking about taking dust and using it to build body parts."

It’s called bioprinting, and it is one of medicine's most exciting frontiers. Eventually these machines could be used to print fully functioning organs, using a patient's own cells. In other words, custom-made organs.

Today, researchers at Cornell University are bioprinting ears using human cells. A 3-D printed skull recently replaced a 22-year-old's diseased one at University Medical Center Utrecht in the Netherlands. Wake Forest researchers are studying how to print skin directly onto burn patients. And at U-M, two babies have had bronchial splints implanted.

"If you would have told me 10 years ago that we could get a patient image, make a model, design and print it in a span of a day and a half, it would have blown me away," says Scott Hollister, a professor of biomedical engineering at UM who engineered the splints.

For now, 3-D printing of viable solid organs like hearts, lungs, livers and kidneys still dwells in the sci-fi realm. Figuring out how to make it real will likely take decades.

But lab-created flat and tubular organs – think skin, windpipes, and blood vessels – could be routine options for patients in as little as 15 to 20 years, says Dr. Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine.

"We are just starting to see the real potential of these technologies for the future," he says. "It's going to open up so many different avenues not just for what we can think of today, but things we never before thought possible for patients."

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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4 of 10
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Less pain, shorter recovery

5 of 10
The goal
Eliminate excessive bleeding, infection and pain
How we’ll get there
Performing surgeries through the body’s natural orifices
Real-life example
Surgeons can fix chronic acid reflux disease without a single incision
How close are we?
May be decades before all procedures are done this way

“We probably won’t be doing surgery anymore,” says Dr. Bradley Needleman, director of the Center for Minimally Invasive Surgery at the Ohio State University’s Wexner Medical Center, when I ask him about the future of surgery.

Come again?

Three things have plagued surgeons for centuries, he explains: bleeding, pain and infection. But minimally invasive techniques are reducing these threats, and endoscopic procedures are expected to evolve until nearly all surgeries are done without a scalpel.

Surgeons will be operating on everything from the heart to the brain through one of a patient’s natural orifices, like the mouth. It’s called natural orifice translumenal endoscopic surgery, or NOTES. Fewer incisions mean fewer infections, less risk of excessive bleeding and shorter recovery times for patients.

Clinical trials are under way on NOTES gallbladder removal, but a surgery to correct acid reflux disease is the only one frequently performed this way today.

Without a clear view of your insides, doctors will need better technology and imaging to assist them in the OR, says Dr. Carlos Pellegrini, head of the department of surgery at the University of Washington.

Today, when a surgeon operates on a tumor, it’s difficult for him or her to distinguish between cancerous cells and healthy cells.

But what if surgeons could superimpose a virtual MRI image on top of the real-life organ?

What if they could inject a patient with a dye that makes deadly cells glow?

“You could see exactly where the tumor is and you could make a perfect resection,” says Pellegrini.

Surgical robots are becoming smaller and more precise; a surgeon may eventually be able to perform an entire operation by controlling a robot with his or her mind. Scientists are even experimenting with virtual reality in the OR.

An orthopedic surgeon in Alabama, for instance, recently did a shoulder replacement with the help of a surgeon in Atlanta using Google Glass and a technology called VIPAAR.

“It’s not unlike the line marking a first down” on a televised football game, Dr. Brent Ponce says. “Using VIPAAR, a remote surgeon is able to put his or her hands into the surgical field and provide collaboration and assistance.”

And while surgeons may be doing less cutting to treat patients, they won’t be out of a job altogether. Pellegrini says preventive surgeries especially, such as the ones we’ve seen for breast and ovarian cancer, will increase dramatically as DNA testing becomes more common.

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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5 of 10
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Cleaning up your genetic code

6 of 10
The goal
Fix DNA mutations to cure genetic diseases
How we’ll get there
Replace faulty DNA with synthetic healthy DNA
Real-life example
Scientists inserted a gene to treat the genetic disease beta thalassemia
How close are we?
Worked for some individuals and now in clinical trials

Patients dealing with devastating genetic conditions like cystic fibrosis or sickle cell anemia today can do little except manage their symptoms. But in the future, doctors may be able to address the root cause of these diseases by infusing a copy of "correct" genetic material to patch up the problem, cell by cell.

Experimental gene therapy has advanced in recent years to treat blindness and Parkinson’s disease in people. Current therapies strap “good” DNA to the back of a virus, which carries it to cells throughout the body.

Compared to early attempts, which had dangerous side effects, the results have been promising, says Mark Levin, a partner with Third Rock Ventures, which is bankrolling several new gene therapy companies.

One of those companies, Voyager Therapeutics, is targeting Parkinson’s and other neurological disorders. Another, Bluebird Bio, is running a clinical trial for patients with childhood cerebral adrenoleukodystrophy, the disease that inspired the movie “Lorenzo’s Oil.”

But delivery by virus is still a blunt approach. The holy grail, says Bluebird boss Nick Leschly, is the ability to replace faulty DNA. That’s the long-term goal of Editas Medicine, whose technology literally edits out harmful mutations – at least in a test tube.

“Some people describe what we do as molecular surgery,” says Kevin Bitterman, Editas' interim CEO. Eventually, he hopes to develop DNA repair therapies for everything from Alzheimer’s to heart disease.

As genetic technology becomes more accessible, doctors could become more like computer programmers than pharmacists, says Austen Heinz, who runs Cambrian Genomics. The company uses 3-D printing to make synthetic DNA for drug companies. With a few keystrokes, Heinz says, a future doctor/programmer could rewrite our genetic program and print off a few million copies on a laser printer.

The biggest hurdle, say Heinz and others, is knowing which genes to target. “The next step is to edit the embryo to fix simple disorders, like cystic fibrosis or Huntington’s, that are caused by a single gene,” he says. “But most diseases are really complex. In the near term, it’s beyond human comprehension.”

Yet he says the challenges can be overcome. “The good news is that you don’t have to totally understand autism or mental disorders to fix them. You just have to clean up the (genetic) code.”

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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6 of 10
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A smarter, faster you

7 of 10
The goal
Sharpen the brain’s ability to interpret, reason and remember
How we’ll get there
Using computer programs and apps to strengthen brain connectivity
Real-life example
Baseball players improved their eyesight and batting averages using an app
How close are we?
Not very. Progress is measurable but small.

Whether you’re a baseball player looking to improve your eyesight or a baby boomer hoping to prevent dementia, science wants you for a few brain training experiments.

Researchers are trying to develop ways to sharpen perceptual, reasoning and memory skills using computer programs and phone apps that challenge those capabilities.

A recent study, for example, used 19 college baseball players to test an app called UltimEyes. The app exercises the brain area that controls vision, the visual cortex. The players improved their vision by 31% on average; some even developed eyesight that tested better than 20/20.

Still, these are early stages for brain training. Many programs have been commercially released without any scientific evidence behind them, says Susanne Jaeggi, who leads the Working Memory and Plasticity Laboratory at the University of California, Irvine. There is no one game that’s scientifically proven to boost brainpower for everyone.

“I don’t think we will ever get one game that we can just throw at people, and it will work for everyone and make people smarter,” Jaeggi says. But “it looks like people can get better in problem-solving and reasoning, under certain circumstances.”

So far, the beneficial effects -- beyond getting good at one game -- are measurable but small. Her work has seen the most gains in people who begin at a disadvantage, such as older adults and children with attention problems.

In a children’s game that Jaeggi works on, the user watches a frog jump between lily pads, and must press a key when the frog is on the pad it had been on just before. This gets harder as the user is asked for the frog’s position two jumps prior, three jumps prior, etc.

This is called an “adaptive dual n-back” task, which involves deciding whether stimuli you are given match stimuli that were presented in a previous instance. It is aimed at improving reasoning and problem-solving abilities.

The principle can be found in games by Lumosity, Brain Fitness Pro and BrainTwister, according to a 2013 study.

It’s not foolproof, however. While Jaeggi has published research showing that this kind of training does improve some intelligence measures, a separate 2013 study failed to confirm the benefits on the same kinds of tasks.

As for preventing dementia, no program has proven effective – but researchers are still trying.

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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7 of 10
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Finding patterns in patient data

8 of 10
The goal
Make big data accessible to advance medical research
How we’ll get there
Supercomputers will analyze electronic health records
Real-life example
IBM’s Watson is fighting cancer
How close are we?
We could see these systems running as soon as 2015

What is "helping fight cancer," Alex?

After a stellar performance on "Jeopardy!," IBM's supercomputer Watson has turned its smarts toward a more ambitious goal: putting cancer patients into remission. Watson will be helping oncologists find DNA-based treatments for glioblastoma, a rare aggressive brain cancer, in a new partnership between IBM and the New York Genome Center.

It's all part of the era of "big data." Electronic health records are being used to recognize disease patterns, boost doctor coordination and assist with diagnosis and information-sharing around the globe.

Although the technology already exists to identify DNA-based treatments for patients, the process is difficult and time-consuming. Determined doctors must correlate data from a patient’s individual genome sequence with information from scientific journals and clinical records.

That’s where Watson comes in. The cloud-based system can analyze thousands of patients’ data to match similar symptoms and gene mutations, and will continue to "learn" as new patient scenarios and research data come along.

The American Society of Clinical Oncology is working on a similar initiative called CancerLinQ.

“Today, we know very little about most patients with cancer – from the molecular characteristics of their tumors to the outcomes of their treatments – because these details are locked away in unconnected electronic and paper records,” according to ASCO. The system will coordinate that data, allowing doctors and patients to access more personalized treatment options based on real-world patient experiences, and give researchers a wider pool of clinical trial candidates.

While the benefits of experts working together are unquestioned, the rise of electronic health records and their growing use raise a host of issues about patient privacy and ethics.

For big data projects, "built-in" security is mandated by the federal Health Insurance Portability and Accountability Act. But "there's a hacker out there one step ahead," says Joan Kiel, chairman of HIPAA compliance for Duquesne University in Pittsburgh.

Those with terminal or chronic diseases, however, may see privacy as a secondary concern.

"Most healthy people are extremely protective of their privacy and they want confidentiality," says Richard Bookman, senior adviser for program development and science policy at the University of Miami's Miller School of Medicine. "Sick people want to get well."

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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8 of 10
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Monitoring your every move

9 of 10
The goal
Stay healthy by constantly monitoring our bodies
How we’ll get there
Personal sensors embedded in our clothing or implanted under the skin
Real-life example
One biohacker embedded a device in his arm to transmit temperature data via Bluetooth
How close are we?
In development now, coming to the market soon

How did you sleep last night? OK, that’s an easy question. But do you know your blood sugar, oxygen and hydration levels? Are you coming down with a cold? Does your body need more protein?

Thanks to sensors that track our every move and send detailed health information to our devices, we know the answers to many of these questions. And wristbands are only the first incarnation. The newest sensors will be sewn into your clothing – or even implanted under your skin.

So-called biohackers are tinkering with implant ideas that are growing ever more sophisticated. An internal compass can lead injured hikers to the nearest doctor; retina implants are helping the blind to see. One CEO embedded a microcomputer in his arm to collect and transmit temperature data via Bluetooth.

A New Zealand company is in the early stages of developing a bandage that will change color or use noise to let you know if it’s too tight or too loose. Another company is developing socks that record foot pressure, body temperature and heart rate as you exercise, and send that data to a device attached to the sock’s cuff.

Activity monitors may soon be prescribed by your doctor and synced to your electronic health record to ensure you’re walking the recommended daily mile, says Shane Walker, associate director of medical devices and healthcare IT for IHS Technology. Also on the horizon: constant analysis of urine, stress hormones and blood oxygen levels.

While it’s one thing to collect such data, the next step is figuring out what we do with it, says Mike Abbott, general partner at venture capital firm Kleiner Perkins Caufield & Byers.

Sensors in the future will be able detect patterns and offer suggestions – recommending you turn in early, for instance, since you didn’t sleep well last night, or telling you to drink more water after measuring an increase in your basal temperature, Abbott says.

A sensor may warn you that you’re getting sick, Walker says. It could advise athletes on daily exercise for maximum performance – or recommend they rest to avoid injury. Contact lenses may help monitor and treat glaucoma. Ingestible sensors may tell you more about your digestive system.

Sensors are “a must-have” thanks to the rising cost of health care, Abbott says. “We’ve got to invest more in preventive medicine.”

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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9 of 10
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Fighting superbugs with super drugs

10 of 10
The goal
Kill antibiotic-resistant bacteria before they kill us
How we’ll get there
Stop overuse of antibiotics, create new antibiotics and decode superbugs’ DNA
Real-life example
The FDA has plans to phase out use of certain antibiotics in farm animals
How close are we?
Fourteen new antibiotics are in clinical trials

Not all bacteria are bad. There are approximately 100 trillion good bacteria inside our bodies that outnumber our own cells 10 to 1. They help us digest food, make vitamins, even fight cancer.

In fact, less than 1% of bacteria cause disease in humans. But in mere decades, humans have managed to turn this 1% into a group of superbugs. We’ve helped them evolve into deadly, unstoppable killers by prescribing antibiotics when they won't work and using them to raise bigger pigs and cattle.

Conservative estimates suggest in the United States alone, 2 million people get antibiotic-resistant infections each year, and at least 23,000 die because the drugs we have no longer work.

Yet as dire as the warning signs are, there is hope.

Earlier this year, the FDA announced that all but one antibiotic manufacturer in the United States would stop selling antibiotics over the counter for nonmedical purposes.

And after a real dry spell in antibiotic development, there's a treasure trove of potential new ones in the research pipeline, according to Dr. Anthony Fauci, who heads the NIH's National Institute of Allergy and Infectious Diseases.

Fourteen new antibiotics are in clinical trials. By June, two of them may get FDA approval. Though not all the others may make it that far, the chances are looking good for having more anti-bacteria weapons in our medicine cabinets.

There’s another fascinating approach on the horizon that may help us stay ahead of superbugs: mining other bugs for their natural antibiotic capabilities.

They're called actinomycetes. These good superbugs have learned to survive by secreting antibiotics to fight off other microbes. Preliminary studies indicate 80% to 90% of the antibiotics produced by these actinomycetes have yet to be discovered.

But rather than growing an army of actinomycetes to fight deadly bacteria, scientists are studying their genes -- looking for the key to making these natural antibiotics. If they find it, the genetic code could help humans match wits with superbugs for years to come.

Editor’s note: Which idea or invention do you think will have the biggest impact on the future of medicine? Vote here and explain why in the comments below.

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