How Should New Antibiotics Be Developed?

This may come as a bolt from the blue but private corporations are not in business for the public good. The entire idea behind a private corporation is to find a need, satisfy it, and make money doing it. That’s why power companies don’t implement the kind of redundancy security experts say our power grid needs—they cannot make money if they do it. And it’s why pharmaceutical companies aren’t investing in the development of new antibiotics as Robert Langreth frets about at Bloomberg Businessweek:

Achaogen Inc. spent 15 years racing to develop antibiotics against resistant superbugs. It targeted one of the most-feared superbugs lurking in intensive care units: carbapenem-resistant Enterobacteriaceae, or CRE, a strain that can kill up to half the people it attacks. Last June its first drug, Zemdri, which kills CRE bacteria in the test tube, was approved by U.S. regulators. From a public health perspective, Achaogen is a success. But as a business, it’s a failure. Zemdri’s sales in its first six months on the market were less than $1 million. Achaogen filed for bankruptcy in April.

The failure has set off alarm bells among infectious disease doctors and public health experts. Big drug companies have been exiting antibiotic research for years, prompting the U.S. government and medical charities to step in with research funding. Now health experts are realizing that research funding doesn’t matter if there’s no market for the drugs when they get approved. “We have a broken antibiotic market, and this is a stunning example of how broken it is,” says Helen Boucher, a doctor at Tufts Medical Center and treasurer of the Infectious Diseases Society of America. The IDSA is “very worried” that other biotechs with promising new antibiotics are going to collapse if something isn’t done, she says.

Developing new antibiotics is a lot harder than it used to be. The low-hanging fruit was picked long ago.

The article goes on to thrash a bit about strategies for dealing with the situation. Solutions aren’t that difficult to propose. There are some things we can’t expect private companies to do. It used to be that the thought of governments actually building and doing things wasn’t as horrifying as it has become.

We might also want to think about cracking down on the abuse of antibiotics, both here and abroad. Overuse and misuse are among the reasons that we need to find new antibiotics in the first place. Maybe we should be imposing trade sanctions on countries that sell antibiotics over the counter. Heresy, I know.