November 13, 2024
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The US must lead the global fight against superbugs
Antibiotic resistance could claim 39 million lives by 2050, yet the pipeline of new antibiotics is running dry. U.S. policymakers can help solve problems
Color scanning electron microscopy (SEM) photo of bacteria cultured from a mobile phone. Tests have shown that the average handset has 18 times more potentially harmful bacteria than the men’s toilet flush handle. With frequent use, your phone stays hot, making it an ideal breeding ground for bacteria. With touchscreen phones, the same area you touch with your fingertips is pressed against your face and mouth, increasing the chance of infection. In tests, E. coli, Haemophilus influenzae, and MRSA were among the infectious bacteria found on the handset. Common harmless bacteria include Staphylococcus epidermidis, Micrococcus, viridans Streptococcus, Moraxella, and Bacillus species.
Steve Gschmeissner/Science Source
Most Americans can probably guess that heart disease, diabetes, and cancer are among the fastest growing causes of death in the world. But a rapidly accelerating health threat is now lurking in plain sight, despite its devastating consequences.
This threat arises from antimicrobial resistance (AMR), the evolved immunity of dangerous microorganisms to life-saving drugs. AMR killed 1.27 million people in 2019, more than malaria and HIV combined, according to the latest comprehensive global analysis. Now, a groundbreaking study lancet Without action, it is estimated that AMR will kill more than 39 million people over the next quarter century. The average number of deaths per year is projected to increase by nearly 70% between 2022 and 2050.
You don’t have to stay on this trajectory. But a change in direction will require decisive action from the U.S. government. As the world leader in drug development, the United States has a moral obligation to lead the way in solving this global problem. We need to accelerate research and development of new antibiotics and strengthen the patent system that allows so many new drugs to come to market.
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AMR occurs when disease-causing microorganisms, most often bacteria, evolve to evade drugs created to kill them and turn into so-called “superbugs.” A well-known example is methicillin resistance. Staphylococcus aureus (MRSA), multidrug-resistant tuberculosis; pneumococcus, Bacteria that causes pneumonia and can be resistant to penicillin. In 1993, fewer than 2,000 MRSA infections were recorded in U.S. hospitals. That number jumped to 323,000 in 2017, according to the most recent data available from the Centers for Disease Control and Prevention. Preliminary data points to another case of a superbug called . C.Auris It jumped five times between 2019 and 2022.
The main cause of AMR is the overuse and misuse of antibiotics. The more bacteria is exposed to a particular antibiotic, the more chance it has to mutate and become resistant. The danger is that if these essential medicines stop working, even mild infections will be difficult to treat. That would make routine surgeries and even common illnesses more dangerous, and it would make it much harder to fight infections, especially for people fighting cancer who have weakened immune systems. If action and investment are not taken soon to support the development of new antibiotics, we may revert to the pre-penicillin era, where simple cuts can become fatal.
However, despite the urgent need for new antibiotics, the pipeline for developing them is drying up. There are currently only four major pharmaceutical companies developing antibiotics, down from dozens just a few decades ago. The reason is simple. Because the economics of modern antibiotic development don’t work. On average, a single new drug takes 10 to 15 years to develop and costs more than $2 billion. However, profitability is necessarily low because antibiotics are typically used for short periods of time, between 7 and 14 days, and must be used sparingly to limit AMR. This built-in obstacle means businesses struggle to justify the cost and risk.
new lancet Research recommends several ways to fight back. One of them, of course, is the development of new antibiotics. In this area, the United States has an opportunity to demonstrate global leadership, expand its influence, and make a major difference.
The United States has the world’s best intellectual property protection system, which makes us a global frontrunner in biopharmaceuticals and dozens of other high-tech industries. Intellectual property protection, particularly patents, provides a window of market exclusivity through which companies can recoup their significant investments in research and development. Without reliable patents, few companies take the risk of developing new antibiotics.
Unfortunately, in recent years, some U.S. lawmakers have advocated reducing patent protection as a way to lower drug prices. But while these efforts are well-intentioned, they only make the situation worse. Attacking patents is not the right strategy, as it will only further discourage investment in the development of new antibiotics. This is likely to make it difficult to fight outbreaks of infectious diseases and super-powerful bacteria that are evolving and becoming more deadly each year.
There is no panacea for the ongoing AMR crisis. All stakeholders and segments of society take action. Ordinary Americans need to do a better job of letting colds and other respiratory viruses heal themselves, rather than relying on healthcare professionals for antibiotics. Not only are antibiotics ineffective against viruses, but attempts to use antibiotics to treat viral infections also result in resistance. Doctors also need to take more responsibility. As a physician, I know that many of my colleagues could be more judicious in prescribing antibiotics.
Finally, the American people need Congress to act more proactively. One solution to the antibiotic conundrum is a subscription model to encourage new research and development. Experiments have already been carried out under this type of system. Englandthe government would contract with a company to provide antibiotics for a fixed fee, regardless of the dose needed. This will give drug developers a more predictable revenue stream and enable them to invest in high-risk, high-impact antimicrobial research that will save lives when needed.
Former Secretary of State Madeleine Albright called the U.S. an “indispensable nation”,” It is essential to world progress and peace. Although some people dispute this characterization, it is true that the United States cannot solve all problems. However, pharmaceutical research and development is one area where we are already leading the way. Smart policies to tackle AMR can help ensure this leadership is maintained while saving millions of lives around the world.
This is an opinion and analysis article and the views expressed by the author are not necessarily those of the author. scientific american.
