It’s likely the last thing you want to learn about now—a growing public health threat rivaling the coronavirus—but experts predict that antimicrobial resistance (AMR) may take as many as 20 million lives annually by 2050. AMR is an often-ignored concern that the pandemic is bringing to light. Frantic efforts to save COVID-19 patients sometimes include overprescribing antibiotics, which is accelerating resistance and reminding clinicians just how few approved antibiotics there are. As a stopgap measure, Merck, Roche, Johnson & Johnson and 17 other large pharma companies have established a $1 billion fund in support of smaller life sciences organizations working on new antibiotics.
Many of these smaller companies have invested tremendously in finding a novel compound, and now they lack the funds needed to carry out clinical trials and earn approval. Even some companies that get their antibiotics approved can’t find a way to sell them profitably. This was the case for three US-based antibiotics startups that went bankrupt in just the past year.
This underscores a larger issue: financial incentives don’t exist for big pharma to invest in antibiotics. When a new antibiotic is approved, doctors are usually instructed not to prescribe it but rather save it unless infections stop responding to older treatments. This state of affairs gives us slim chances of having antimicrobial agents that will be desperately needed during some future event (like a pandemic) ahead of time.
The $1 billion fund will support more than 20 antibiotics companies that have already found a promising new compound. Within ten years, it aims to bring two to four novel antibiotics to market. But public health experts make it clear that bigger, systemic change is needed—specifically, revised policies to increase reimbursement for antibiotics shelved as last-line therapies.
The major difference between AMR and COVID-19 is that it’s building slowly, rather than swiftly spiking, which makes the threat abstract and difficult for many politicians and decision-makers to appreciate. AMR killed 700,000 people across the globe in the past year.
Though still in early stages of research, IBM is developing a polymer that may be able to augment existing antibiotic therapies. Microbes develop mechanisms to counter the effects of antibiotics, and the IBM molecule may be able to suppress those counter-efforts. In a laboratory setting, it has shown promising results, in tandem with antibiotics, against even multi-drug-resistant bacteria.
“Antibiotics are the mortar that holds the entire health care system together,” Eli Lilly CEO David Ricks told the New York Times. “We make drugs for diabetes, cancer and immunological conditions, but you couldn’t treat any of them without effective antibiotics.”