\nProfessor of Biochemistry and Biomedical Sciences, McMaster University<\/p>\n
I grew up believing in the forward trajectory of progress in science and medicine \u2013 that human health would continue to improve as it had for hundreds of years. As I progressed through my own career in health sciences, I continued to be optimistic.<\/span><\/p>\n Now I have serious doubts.<\/p>\n Science is still working well, but deadly obstacles are blocking the way between research and progress in the field where I work: Antibiotics.<\/p>\n The threat to humankind is grave and growing worse by the day<\/span><\/a>, but for reasons that escape my colleagues and me, there appears to be shockingly little collective will to do much about it.<\/p>\n This week (Nov. 12-18) is World Antibiotic Awareness Week<\/a><\/span>. We need to talk about this threat. We need to develop models of public-private co-operation \u2014 to incentivize, fund and invest in antibiotic drug discovery and development.<\/p>\n Here\u2019s the problem: about 75 years ago, science brought penicillin into public use<\/a><\/span>, opening a new era in infectious disease control, much as sanitation had done before that. Infectious diseases such as pneumonia and strep, which had commonly been fatal even in my grandparents\u2019 day, were tamed \u2014 at least for a time.<\/p>\n Wendy Gould holds the cremated remains of her late husband George Gould at her home, in Aldergrove, B.C., in May 2018. George contracted a drug-resistant infection in a Vancouver hospital and died in an isolation unit at age 58. (THE CANADIAN PRESS\/Darryl Dyck)<\/em><\/p><\/div>\n In the generations that followed, life expectancy leapt by 25 years<\/a><\/span> and infectious disease tumbled from its No. 1 one spot among all causes of human death, where it had consistently ranked higher than bullets and bombs \u2014 even during the World Wars.<\/p>\n With cheap, abundant and effective antibiotics at hand, people in the developed world became complacent about controlling infection.<\/p>\n But this whole time, while we have been living our better, longer lives, infectious diseases have been working on a comeback, and today they are pounding at the door. In fact, they are already breaking down the door.<\/p>\n In a fast-forward example of Darwinian adaptation through natural selection, bacteria and other microbes are evolving to survive antibiotics. They will continue to adapt and they will succeed unless humanity builds new layers of defence in the form of new antibiotics and other creative approaches.<\/p>\n Governments of the world recognize the crisis, as they affirmed at a special high-level meeting of the United Nations General Assembly<\/a><\/span> in 2016 and at the G20 in 2017<\/a><\/span>.<\/p>\n The troubling part is that we know what we have to do to create new antibiotic therapies, and though the work is undeniably hard, there already exist some promising new alternatives to older drugs, and more are in the pipeline<\/a>.<\/span><\/p>\n Unfortunately, they are not yet available on the commercial market, and they may never get there unless something changes to make them viable \u2014 not as drugs, but as commodities.<\/p>\n The critical impediment to producing new antibiotics turns out to be our own economic model, which trusts the market to meet the demand. The invisible hand, as philosopher and economist Adam Smith<\/a><\/span> called it, is not working here, and what\u2019s at risk is all of the progress that antibiotics has made possible.<\/p>\n Read more: Canada could lead the fight for life in a post-antibiotic world<\/a><\/span><\/strong><\/em><\/p>\n This past summer in the United States, two pharmaceutical companies earned FDA approval<\/a><\/span> for new antibiotic compounds<\/a><\/span>. As soon as the markets learned those companies had created drugs that could literally save the world, their stocks fell<\/a><\/span>.<\/p>\n Sounds counter-intuitive, doesn\u2019t it? It turns out that spending hundreds of millions to create, test and market a new drug is a bad risk unless the drug can earn back the investment within the 20 years before its patent expires.<\/p>\n That\u2019s hard to do when you\u2019re trying to recover the cost one 10-day prescription at a time. And when you\u2019re prescribing the new drug only for infections that can\u2019t be resolved with cheap, traditional antibiotics, which still work in many cases.<\/p>\nPenicillin led to complacency<\/h2>\n
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Market will not meet demand<\/h2>\n
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\nPublic model is risky<\/h2>\n