"Shane Smith:" "This week on "Vice," the race to find new antibiotics." "(speaking English)" "Smith:" "And then, illegal palm oil plantations are destroying the rainforest." "Dr. Ian Singleton:" "It's one of the biggest, most important forest plots in the whole of Southeast Asia, and there's a really serious threat now to just wipe it off the map." "It's pure greed." "(shouting)" "(cheering)" "We're traveling upriver into the jungles of Malaysia." "It looks like a pretty large fire over there." "The amount of smoke and how much it's spread is incredible." "In recent years there's been a worrying increase in so-called superbug infections." "Centers for Disease Control warning hospitals nationwide about a growing number of superbugs." "Male Reporter:" "There's a new deadly superbug spreading in hospitals across America." "Half of all the patients who get it, die." "Smith:" "As the number of outbreaks continues to increase, the horrifying reality is that simple infections, which used to be completely treatable by antibiotics, are now potentially fatal." "The nightmare bacteria are now completely untreatable." "To find out what can be done as more and more antibiotics continue to lose their effectiveness, we sent Thomas Morton to meet with some of the world's leading scientists to try to find out what the future holds for antibiotics." "(birds chirping)" "Hi, it's Thomas." "We're traveling upriver and into the jungles of Malaysia to find the drugs that humans will use in the future, because all of our current drugs are gonna stop working." "Morton:" "Dr. Chris Wiart is one of the last working ethnopharmacologists, who are scientists who go into the wilderness to look for plants that can be turned into medically-viable drugs in humans' ongoing war against disease." "(Wiart speaking)" "Morton:" "What makes the Malaysian rainforest promising is that it's extremely old." "There are parts of the jungle that human eyes have never seen." "It's also, like all jungles, a hyper-competitive place where plants and animals are constantly forced to adapt to survive." "(Wiart speaking)" "Is this really what we're doing?" "Uh... (laughs)" "Uh... (laughs)" "I think this is the trail." "Holy shit." "Morton:" "Part of the reason more drugs don't come out of the rainforest is because people of Dr. Wiart's expertise are hard to come by." "Identifying medicinal plants isn't a common skill anymore in our pill-centric world." "(Wiart speaking)" "Morton:" "That's amazing." "(Wiart speaking)" "Morton:" "Yeah." "(Wiart speaking)" "(Wiart speaking)" "Okay." "(Wiart speaking)" "Morton:" "No." "Oh, I missed that." "(Wiart speaking)" "Ooh." "Right." "We've already found a lot of things just by, like, stopping for a few seconds." "Morton:" "One of the reasons a lot of these drugs probably haven't been found is 'cause, first of all, it's hard to find the plants, because they're in the fucking jungle, and you got to come here and get into the jungle." "And then, second of all, you'd expect new antibiotics to look like the craziest plants in the jungle." "It'd be like weird, rare orchids that you have to, you know, climb a mountain and snip." "But they're not, they just look like this." "You have to really know what you're looking for to find stuff that could be potentially useful." "So, the thrill of the find is a plant that looks exactly like this, but slightly different." "Wiart:" "Oh!" "Uh-huh!" "Morton:" "Oh, wow." "(Wiart speaking)" "Morton:" "Right, just bow it." "(Wiart speaking)" "We're just very carefully taking some branches off a tree in hopes of curing mankind of disease." "(Wiart speaking)" "Morton:" "Mm-hm." "(Wiart speaking)" "Morton:" "Yeah." "Have you seen this plant before..." "in the jungle?" "This is the first time?" "Wow." "(Wiart speaks)" "When Dr. Wiart goes out into the jungle and finds plants, they have to be tested." "This is his lab at the University of Nottingham, Malaysia campus." "We're gonna see how plants get turned into drugs." "Mogana Rajagopal:" "This is the lab where we have the fresh plants." "So once we actually grind them, place it in a vessel like this, and we'll fill it up with the solvent, then we will have all the goodies here." "Morton:" "Plant matter is run through a battery of tests to extract its constituent chemicals, figure out what they are, and then try them against an array of bacterial antagonists to see if they'll make good medicine." "Unfortunately, this process can take years for each chemical, and that's not even getting into the human trials that are required to bring a new drug to market, which can take up to a decade." "In the meantime, outbreaks of drug-resistant diseases have been increasing with insane speed." "The CDC estimates that over two million Americans get antibacterial resistant infections every year, killing a total of 23,000." "David L'Heureux contracted one of these superbugs, an extremely drug-resistant strain of an intestinal bacteria called Clostridium difficile." "He survived the initial infection, though not all of him." "David:" "So now I wear this bag here, which you will see through the day that, all of a sudden," " you'll start seeing a lump here." " Okay." "And then you'll know that I'm starting to fill up." "Morton:" "That pouch is called an ileostomy bag." "David's stomach empties directly into it, because he no longer has an intestine." "David, who, by the way, was a paramedic, contracted his bacterial infection while consulting at a hospital in China." "When he got back to the States with severe diarrhea, his doctor put him on an IV of Cipro, a powerful broad-spectrum antibiotic." "Instead of fighting the C. diff, however, due to its resistance, the Cipro effectively cleared out the rest of the bacteria living in his GI tract, including the good, healthy kind, thereby allowing the C. diff" "to go from infecting part of his intestine to colonizing the whole thing." "That night, I started having some abdominal pain." "The next day, the abdominal pain was getting a lot worse." "My fever was increasing." "I knew something was wrong." "I went to see my physician." "I was very dehydrated, so he hospitalized me." "I called my friends and said, "Listen, I'm in the hospital,"" ""but I should be getting out, and I should see you guys in a couple days."" "And that's the last thing I remember." "Morton:" "Since it had colonized his entire intestine, thanks to the antibiotics, David's infection progressed at a terrifying pace, leading doctors to put him in a months-long coma while they tried and failed to treat it." "I had got what was called toxic megacolon, meaning that my colon was so badly infected, it was dying." "They made the incision, I was so swollen, there was so much pressure in there, it started to open up my abdomen on its own as soon as they started to cut." "They basically took out my intestine, which was approximately this big at that point." "Whoa." "So that's where all the pressure and the size came." "And they took it all out and they were able to save a little bit of it." "I don't have a lot of small intestine left, and now I'm gonna go ahead and just put it on." "I would recommend to anybody, if you don't need an antibiotic, absolutely stay away from it, and if you don't need to be in the hospital, don't go." "Morton:" "According to the CDC, up to half of all antibiotics prescribed worldwide aren't fully needed." "This overuse directly accelerates bacteria's buildup of resistance, rendering more and more antibiotics completely useless against diseases they used to kill on sight." "Because hospitals use antibiotics, they're a hotbed for antibiotic-resistant diseases." "There's actually a class of diseases called "hospital-acquired infections,"" "which you get while you're at a hospital being treated for something else." "Antibiotic resistance has been a problem for a very long time." "What is different now than before is that in the past, we always had another antibiotic that would bail us out of the problem of resistance." "We don't have that luxury anymore." "We're out in some instances." "There are patients for whom we have no antibiotics." "These are nightmare bacteria that have now developed resistance to every single antibiotic that we have available to us." "So, what happened?" "Why did we stop discovering as many new antibiotics?" "The development of new antibiotics got a lot harder." "The easier targets for antibiotics were all discovered and exploited." "So if we don't keep up on the other side of the equation with drug discovery, we will continue to find ourselves challenged more and more with infections that we can't treat." "Morton:" "As traditional lab-based research yields fewer and fewer new antibiotics, science has turned its attention to one of the planet's last natural pharmacopoeias..." "Caves." "Put your weight on the rope." "Morton:" "This cave is fucking enormous, Jesus Christ." "This is insane." "This is Cagle Cave in, uh, Tennessee." "Brian is coming down on the next rope behind me." "He is a chemist who is, uh, in the field of drug discovery, but instead of rainforests, he is, uh, looking for microorganisms in the bottom of gigantic holes like these." "Hopefully, there will be things in here that are helpful for the discovery of antibiotics." "Ah!" "Brian:" "We're gonna collect probably about 20 or 30 samples from all over the cave." "So we tend to focus on wet things, because life likes water." "What kind of life lives down here?" "Lots of different species of bacteria." "It's very competitive, so they're competing for the sparse amount of nutrients that eventually drip their way down to the percolating soil." "And they do what they have to do to survive, whatever that's going to be." "(grunts)" "I mean, with my eye, but when I look at this wall here, you see little circular things." "That's life." "There's some yellow ones, and there's some Grey ones, and Grey-blue, right?" " Mm-hm." " Those are consortia of microorganisms." "Okay, like little towns." "Yeah, you can see them going all the way up." " Yeah." " I can't think of anywhere else in nature where I can see a colony of bacteria growing on the wall." " Why is that?" " It's a great natural environment for exactly the kind of organisms that we're looking for." "Bachmann:" "Antibiotics probably saved more people than any other medical breakthrough." "It's an arms race at the molecular level between these microbes." "So we're gonna just have to be continuously working to replenish our sources to fight these things." "Morton:" "While the average cave trip nets some 20 to 30 good samples, they hit the same bottleneck as Dr. Wiart's plants when they get to the lab." "Isolating and assessing individual chemicals for medical viability is a time-devouring process, mostly predicated on trial and error, and time is a resource we don't have." "There, you know, have been discussions for a long time about the post-antibiotic era, and we're there now." "What is the post-antibiotic era like?" "Like, what does that mean for medicine?" "The failure of antibiotics could be devastating for the practice of medicine." "Before antibiotics, patients died of simple infections." "Patients who got cuts and scrapes and then those got infected, patients who developed pneumonia." "It would mean that we're less able to do the types of invasive procedures and treatments like chemotherapy and organ transplants, where we depend on effective antibiotics." "Much like the discovery of antibiotics transformed the practice of medicine in a good way, the loss of effective antibiotics would transform medicine in a horrible way." "Morton:" "Worse enough, the natural environments that may harbor the drugs that'll prevent modern medicine from regressing to the age of leeches are not environments we're doing a great job preserving." "(chainsaw revving)" "And if the past few decades are any indicator," "Malaysia's developers are a lot more interested in tearing down the forest to make way for palm oil plantations than keeping it pristine for potential drug discovery." "(Wiart speaking)" "The clearing of tropical rainforests threatens more than just the search for new medicines." "As the jungles are burned, they release enormous amounts of carbon into the atmosphere." "Now, one of the biggest threats to rainforests in Southeast Asia is the mass cultivation of palm oil." "It's an ingredient in almost everything we buy at the grocery store." "So we sent Ben Anderson to Indonesia to see first-hand the devastating effects of the booming palm oil industry." "So we've just driven onto a palm oil plantation." "And you can see every half-mile or so just another perfectly straight row connecting all these perfectly straight lines of palm trees." "We just drove through miles and miles of palm oil plantations, and then got our first glimpse of what's left of the primary rainforest here." "But as soon as you get your first glimpse of the rainforest, you also get your first glimpse of that rainforest being destroyed." "Just knocking down trees, like me knocking down a candle on a birthday cake." "A hillside like this, it feels like it's an afternoon's work." "Anderson:" "But despite it being done so openly, this deforestation is completely illegal." "Indonesia is the number one palm oil growing nation in the world." "It has increased its output by nearly 700% in the last 20 years." "This surge in production has been driven by the increased worldwide demand for palm oil." "It's virtually impossible to avoid palm oil in the modern world." "It's in many of the foods we eat..." "Packaged bread, noodles, cookies and ice cream..." "And in a lot of our household goods..." "Toothpaste, cosmetics, soaps and detergents." "And it's this demand which is driving deforestation around the world." "Since 2000, more than 14 million acres of tropical rainforest have been destroyed." "And even though ecosystems like this one are supposed to be protected by the Indonesian government, the destruction is continuing almost unabated." "To find out the extent of illegal palm cultivation here in Indonesia, we spoke with Glenn Hurowitz, managing director of Climate Advisers, and an expert on the palm oil industry." "Historically, 60-80% of palm oil comes from illegally- established plantations." "A huge percentage of the industry is based on illegal land grabs." "A palm oil company decides, "We want to plant in a certain area,"" "and regardless of whether it's a protected forest, they will go ahead and plant." "The Indonesian government requires a whole series of permits in order for a plantation to be legal." "Unfortunately, a palm oil company often finds it more efficient to bribe a local official to get the rights to the land." "And government officials at all levels have their hands out for bribes." "Anderson:" "These bribes seem to go a long way because producers are not only illegally cutting down these protected forests, but are also displacing the indigenous communities living there." "And whatever protest they've made to stop these practices have fallen on deaf ears." "(shouting in foreign language)" "(shouting) (crowd shouting)" "Anderson:" "We met with residents of North Aceh, one of the areas most affected by deforestation." "When we drove here, we passed lots of palm oil plantations." "Did all of that area used to look like this rainforest?" "(speaking foreign language)" "Anderson:" "They said that they've already started resisting and took me to see an excavator that had been stolen from one of the palm oil companies." "They've admitted that they confiscated one of these as a tactic to try and discourage the company, but no one is admitting who set this one on fire." "But clearly the message is that if this continues, then things like this are just a taste of what's to come." "(man speaking foreign language)" "Anderson:" "Elsewhere in Sumatra, other people have also started taking matters into their hands." "Rudi Putra, a biologist by trade, leads a campaign to dismantle illegal palm oil plantations, even if he has to do it tree by tree." "(Putra speaking English)" "Anderson:" "All Rudi is doing is enforcing the law, but he still needs the protection of local policemen while he works." "Humans aren't the only ones affected by the destruction of the forests." "Once abundant, many species of wildlife now face extinction." "(air rifle poofs)" "(speaking foreign language)" "(people speaking foreign language)" "(people speaking foreign language)" "Anderson:" "So can you describe what happened today?" "We're catching wild orangutans, and we don't really want to do that." "Anderson:" "This is Dr. Ian Singleton, conservation director of the Sumatran Orangutan Conservation Program." "He finds himself having to hut through the fast-disappearing Indonesian rainforest with his tranquilizer gun trying to capture these apes before they are killed so he can move them to a safer and bigger patch of forest." "When you have to do this, it means you've already kind of failed, you know?" "The ideal situation is to protect the forest and stop any more forest being chopped down, but most of the area has already been converted to palm oil and the orangutans are dying as we speak." "(people speaking foreign language)" "Singleton:" "They will get an opportunity to live a long and productive life." "All the other orangutans that we don't manage to get out of these areas, they're not going to do that, they're going to be dead probably within the year." "And this area is supposed to be protected, isn't it?" "It's part of the Leuser Ecosystem, yeah, a national strategic area for its environmental function." "The biggest, most important forest plots in the whole of Southeast Asia." "There is a really serious threat now from the Aceh government's special plan to just wipe it off the map." "Just ignore it and pretend it never existed and open the whole area to palm oil plantations." "It's pure greed." "Anderson:" "To clear the land they cover, cash-hungry producers simply burn the forest to the ground." "The biggest problem with oil palm now is in order to clear the land properly and prepare it for oil palm you've got to burn it." "Anderson:" "This is conservationist Mike Griffiths, who's been fighting to save the rainforest for the last three decades." "Griffiths:" "This is a relatively small one, believe it or not." "The big ones are picked up on the satellite." "Anderson:" "On what kind of scale, nationally?" "It's industrial grade." "So hundreds, maybe even thousands of fires, just like this across the whole country daily." "Sure." "Yeah." "From the oil palm plantation's point of view, it's a very good system." "It's not very complicated, and it's cheap." "I mean, now you can't see 10-15 meters..." "Let's get out of here." "Anderson:" "It feels like dusk, but it isn't, is it?" "That's just the smoke." "Griffiths:" "A lot of people throughout the whole of this province are now suffering from respiratory problems because of this pollution." "Anderson:" "The health threat that the smoke poses is only a small part of the problem with these fires." "As Mike then went on to explain, it's the specific nature of the forest itself that has even larger, global ramifications." "Griffiths:" "The burning of the forest produces a huge amount of carbon dioxide." "Only a small part of which is subsequently sequestered back into the oil palms themselves." "Anderson:" "So the palm oil trees don't soak up anywhere near as much carbon as the burned trees release." "But what makes the burning in Indonesia so much worse is the ground it so often sits on, which is called peat land." "Griffiths:" "If it's on peat soils or peat swamps, then you release massive amounts of carbon dioxide." "Anderson:" "For example, when rainforest in the Amazon is burnt down it releases 400 tons of carbon per hectare." "In Indonesia, when the rainforest sits on peat land, more than six and a half times more carbon is released." "Most of the carbon is actually stored in the peat itself." "So when you burn it, that contributes massive amounts of carbon dioxide to the atmosphere." "So this sounds like, literally, the worst possible place you could burn the trees and what's in the ground before turning it into a palm oil plantation." "Absolutely." "It will never fully recover." "Easily destroyed, very difficult to rebuild." "Anderson:" "Is there a point of no return?" "Griffiths:" "Yes." "And how close are we to that point?" "I think we are at the 11th hour and about the 53rd minute." "Anderson:" "The only way to see the scale of this enormous devastation is from the air." "First, we saw miles of palm oil plantations in neat, perfect rows." "(Anderson speaks)" "But it wasn't long before we saw the first fire." "And soon, we were surrounded." "Burning peat land is a carbon bomb for the climate." "You know, forests are the lungs of the earth." "They're breathing in massive amounts of carbon dioxide and breathing out oxygen." "And peat lands and forests are one of the biggest carbon storehouses in the world." "The tragedy of this is that there's millions of acres of degraded lands all across Indonesia where palm oil companies could plan, but too often they haven't done it." "Anderson:" "In an attempt to fight this, many of the largest buyers of palm oil have made pledges ensuring that their supply comes from sustainable source." "But since policing every part of the supply chain is so inconsistent, even with the best intentions, it's difficult to stop the unsustainable oil from making its way into our consumer products." "Hurowitz:" "The nightmare scenario is that the big palm oil companies continue clearing forests on a vast scale, not only in Indonesia, but in new frontiers, in Papua New Guinea," "Africa, and the Amazon." "Anderson:" "Unsustainable palm oil production is on the rise." "It's now being adopted across Southeast Asian," "West African, and Latin American forests." "The palm oil industry is here to stay." "Globally, palm oil is a $50-billion-a-year industry." "Half of the consumer products that you find in the grocery store contain some amount of palm oil in them." "Anderson:" "Until consumers of these products demand to know where their palm oil is coming from, it's unclear how much will really change, and these vital carbon-capturing forests around the world might soon disappear."