Saturday, January 26, 2019

Profits or Anti-biotics

An apocalypse is looming, warn the public health experts. The spectre of humankind again falls prey to bacterial plagues. Infections we have conquered, such as pneumonia and typhoid, will return to kill us. Surgery and chemotherapy for cancer will carry huge risks. It’s a distant scenario as yet, but it cannot be dismissed as alarmist rhetoric. Antibiotics are no longer the cure-all for bacterial infections that they once were. Antimicrobial resistance is real. Microbes – both bacteria and viruses – are fighting back, developing resistance to the drugs invented to wipe them out. Tuberculosis has become a lot more difficult to treat.  In 2016, 490,000 people developed multidrug resistant TB, across every country in the world. To get better, they need newer, more expensive drugs for longer than the standard six months that treatment currently takes. There is every reason to think TB bacteria will develop resistance to the new drugs in time. Control of malaria is also threatened by drug resistance. Hospitals in the UK and elsewhere are struggling to treat potentially life-threatening infections caused by Klebsiella pneumoniae, a common bacterium found in the gut. MRSA, the so-called superbug that is a form of Staphylococcus aureus resistant to the antibiotic methicillin, is common. There is growing resistance against drugs used to treat the sexually-transmitted infections gonorrhoea, syphilis and chlamydia. And so it goes on.
Many pharmaceutical companies junked their antimicrobial portfolios some time ago. There was a conviction a few decades back that the war against infectious diseases had been won. Drug manufacturers saw a rosier, more profitable future in chronic diseases. Heart conditions, stroke and type 2 diabetes were and are the big killers today, worsening as obesity levels rise. And unlike infectious diseases, where people take a one-off course of drugs and are hopefully cured, those with chronic diseases could be on the drugs for life. That’s profitable.
There was another issue also causing the pharma bailout. Finding new antibiotic drugs became increasingly difficult. The easy ones had been developed. Companies often like to produce “me too” versions of bestsellers, with slight variations (they would say improvements) to ensure they can get a patent lasting 20 years and recoup their costs. There has been a dearth of new classes of antibiotics for decades.

Until Big Pharma sees big numbers and the colour of the money, the difficult challenge of finding the new antibiotics the world badly needs is not one they will readily pick up

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