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>The health industry as a whole, has been weakened by the discovery of antibiotics and designer molecules, and as a result now spends too many resources on looking for killer chemicals (antibiotics and other drugs).

What!? antibiotics are for the most part the most important discovery in medical history, period. They by far saved more lives than virtually any other treatment and make many other treatments possible.

These two things are not incompatible. Yes, antibiotics are awesome. Yes, we messed up because these days you can convince your doctor to give you antibiotics for viral infections (they will tell you it's useless though) and take as little as you want of it, and create more resistance problems.

And make implants possible as well.

It means you don't die when you go into surgery, you don't die from burns, you don't die from severe bone fracture, and cancer is actually treatable.

Chemo and radiation therapy tend to reek havoc with the immune system, certain types of cancer leave you with little to no white blood cells period.

Without antibiotics you could not have these treatment regiments at all as without preemptive and reactionary antibiotic treatments many cancer patients would die.

Without anti virals and antibiotic other conditions with compromised immune system including HIV would be considerably more fatal as well.

This is a category mistake. Treating bacteria (foreign pathogens of an entirely different species) and treating cancer (which are rogue cells belonging to individuals) are not the same thing.

What you're describing is the normal pharmacological approach to cancer treatment. Because these are the individual's own cells sharing the vast majority of its characteristics with normal, healthy cells, you have to go deep into the handful of mutations that occur that cause unmitigated cell proliferation (leading to cancer). These are targeted for treatment.

Bacteria are a foreign species and have all sorts of foreign biochemistry that can be taken advantage of. The health industry is not doing anyone a disservice by going after the low hanging fruit. Why climb through the 3rd story window when you can waltz through the front door?

Boosting the body's defense mechanisms could carry more risk that just attacking the organism. Boosting chemotaxis (WBC migration) to an area will increase inflammation which has it's own set of potentially dangerous risks. Sensitizing the adaptive immune system's to bacterial antigens runs the risk of autoimmune attack on similar-looking antigens in the host.

This isn't like D&D where you can take one point from "bactericidal" and put it into "immune boost." There are big systems in play and hardly anything can be reduced "one weird trick."

> Look at the molecular machinery of the Polymerase Chain Reaction which makes copies of DNA molecules

Antifolates, topoisomerase inhibitors, imidazoles, rifamycins are classes of antibiotics that target pathogen DNA/RNA synthesis.

> Not to mention the Ribosome which is the molecular machine in your cells which manufactures protein molecules https://en.wikipedia.org/wiki/Ribosome

Aminoglycosides, tetracyclines, oxazolidinones, peptidyl transferase, macrolides, lincosamides, and streptogramins are all classes of antibiotics that target bacterial ribosomal units.

> And there is Reverse Transcription which converts RNA molecules to DNA molecules

Using reverse transcriptase pharmacologically would undoubtedly be dangerous, difficult, unnecessary, and ineffective. You'd basically have to engineer a virus that knows how to use reverse transcriptase that also targets the right pathogen and rewrites a portion of its DNA.

Crazy - I never actually took a step back and wondered if we could boost our defense as a strategy.

In a geeky way, we keep drinking health potions to recover HP but if we had a shit ton of armor then we wouldn't need the HP potions to begin with. :)

This is called immunotherapy and it is not mutually exclusive, and it is being worked on to treat certain diseases. However it's not nearly as simple as you might think and many immunomodulatory drugs have considerably worse side effects.

Immunomodulatory drugs to some extent "predate" modern antibiotics before the antibiotic boom and the advancement in modern wide spectrum antibiotics immunomodulatory drugs were commonly used to treat severe infections.

The side effects of these drugs are very very severe, can be fatal, and can cause hereditary malformations Thalidomide is probably the most famous case of a "wonder drug" going very very wrong it is still used today in extreme cases of leprosy and to treat some cancers.

https://en.wikipedia.org/wiki/Thalidomide

But just to be clear these type of treatments are just as "designer" molecules as any other drug, there are no magic fixes in medicine you find the most effective vectors to attack a disease and you use them.

But overall >Crazy - I never actually took a step back and wondered if we could boost our defense as a strategy.

This is a bit silly, we have had vaccines before we had antibiotics :) we wash our hands, keep ourselves clean, dress wounds etc. these are all "defense boosting" strategies, and they both predate and coexist with "offensive" treatments.

An upregulated immune system is often the cause of autoimmune disorders, and is an inflammatory state (with health impacts as well). "Boosting our defense" is not a zero-risk strategy.

On the other hand, "Immune Boosting†" products are rampant and they get to make all kinds of unsubstantiated claims about their capacity to Boost the Immune System so long as they either claim to be homeopathic or market themselves as supplements and include the boilerplate disclaimer that never seems to harm sales:

†These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.

These are all excellent points and we should definitely be pursuing all available avenues. I don't think this is and either/or proposition - we should look into anything that can help.

Things like genome therapy are unfortunately a long way off so we need to look for antibiotics in the meantime.

You are really overcomplicating this. The gut is about 70% of the immune system. Gut health and old fashioned lifestyle approaches that limit the transmission of germs is simple, easy, inexpensive and has been around for millenia.

It also smacks of religion and "boring, uptight" lives. So, it is nigh impossible to sell the idea.

Perhaps that will get easier as people start dropping like flies from horrifying diseases. But, for now, no one wants to hear it.

Tell that to the people who died en masse from bacterial infections before the discovery of penicillin.

Those folks also lacked the internet, where ordinary people can look up extraordinary things that previously could have only been learned by a select few privileged people, if at all.

We also have a global economy of a sort that did not exist previously. Things that would have been exotic not that long ago can be acquired readily by people who aren't wealthy by first world standards.

People used to routinely suffer scurvy, which is almost unheard of today because a) we know what causes it and b) ordinary people have no trouble getting citrus fruits. This was not true, say, 200 years or so ago.

So "old fashioned lifestyle approaches" requires the internet and global access to non-native food sources.

It requires knowledge.

And global access to non-native food sources exists since the 15th century.

The difference is whether mostly everyone has access to it.

So yeah. I'd say he's right and I'd bet your fancy shmancy genetic engineering won't wield anything significant but for a residual percentage of very specific cases.

As has most medical technology. The overwhelming majority of diagnostics are still made via question/answer, palpation and hearing.

Mass promiscuity has consequences, just like poor sanitary habits have them.

No amount of technology will change that.

Gonorrhea is not a gut pathogen. Nor for that matter is MRSA.

I did not say they were. Bone marrow is also an important part of the immune system. That does not mean it only comes into play for bone infections.

Bone marrow produces lymphocytes, which are disseminated throughout the body. What mechanism of action are you proposing for "gut health" (also define what gut health means) to prevent an STI?

I've read that even mental disease has been linked to digestive problems.

The body is a complex adaptive system. We still lack methodology to properly and effectively study such systems.