Bacteria and fungi are increasingly evolving into “superbugs” immune to existing treatments. According to the World Health Organization, this phenomenon, known as antimicrobial resistance, is one of the top 10 public health threats currently facing humanity. In 2019, antibiotic resistance was associated with more than 170,000 deaths in the United States and nearly 5 million deaths worldwide.
The U.S. government has a long and mostly successful history of responding to national health crises, from funding Operation Warp Speed to accelerate the development of Covid-19 vaccines to establishing the Office of Public Health Emergency Preparedness in response to the anthrax attacks of 2001.
Better stewardship alone won’t combat the superbug threat. We also need to develop new antimicrobials. Many antimicrobials are often only prescribed briefly, like several days or weeks. Consequently, low sales make it hard for inventors to recoup the significant investments required to develop any new medicine.
As a result, many companies developing new antimicrobials—most of which are small—have been unable to commercialize new products successfully. Eight antibiotics developed by small companies have received FDA approval since 2013. Since their approvals, these companies have either filed for bankruptcy, been acquired or left the antibiotics space entirely.
One fix would be to replace the volume-based sales model with something like a subscription, in which drug developers are compensated for new treatments based on the value of the treatment to public health, regardless of the number of doses patients need.
Legislation that would do this is under consideration in Congress. A bipartisan group of lawmakers introduced the PASTEUR Act. Under the bill, the government would contract with a company for a set amount of funds for reliable access to an effective new antibiotic, essentially stabilizing a return on investment.
Passing PASTEUR should be one of Congress’ top priorities. AMR is a national security threat we know how to prepare for. It’s time our political leaders take advantage of that opportunity.
Phyllis Arthur is senior vice president for infectious disease and emerging science policy at the Biotechnology Innovation Organization.
