Issue No. 9: More cracks in the broken AMR market 

Updates on the Quest to Beat Antimicrobial Resistance

President-elect Joe Biden will inherit unprecedented challenges. A divided nation, an unstable economy, and a worsening pandemic — but not the one you’re thinking of. 

Antimicrobial resistance (AMR) poses an even greater long-term threat to society than COVID. Several strains of bacteria and fungi are already virtually immune to existing antimicrobials. And if we don’t act soon, these so-called superbugs could kill 10 million people per year by 2050.

Unfortunately, the biotech companies working on superbug treatments are struggling. A variety of factors have made antibiotics research and development extremely challenging — and the constant, unremitting losses are forcing big and small drug makers alike to abandon their R&D efforts. 

Almost exactly a year ago, the Superbug Bulletin highlighted the financial challenges facing the companies in the antibiotics market. Over the past year, things have only gotten worse. Companies are selling lab equipment, losing market share, and going under. 

Unlike COVID, which took everyone by surprise, we can see the superbug pandemic coming. It’s up to President-elect Biden and the new Congress to prepare accordingly and fix the broken market for antimicrobials.  

What is at stake?

Globally, AMR could become the leading cause of death by 2050. That’s because a world without antimicrobials — drugs ranging from antibiotics and antifungal medications to new technologies such as bacteriophages — would make even common procedures and treatments, from knee replacements to chemotherapy, highly risky. Without them, doctors would be forced to decide whether to weaken patients’ immune systems with surgery and drugs — thus making them especially vulnerable to untreatable superbugs — or forego treatment and watch their conditions worsen.

Consider that in the United States, around 40 to 50 percent of bacteria that cause infections during surgery are already resistant to preventative antibiotics. If that figure rises to 100 percent, C-sections and hip replacements could become death sentences.

“A lot of common surgical procedures and cancer chemotherapy will be virtually impossible if antibiotic resistance is not tackled urgently,” according to Dr. Ramanan Laxminarayan, director of the Centre for Disease Dynamic, Economics and Policy.

In this post-antibiotic world, even trivial cuts, scrapes, or bug bites could kill. Take MRSA, a strain of bacteria most commonly contracted through a break in the skin. Several antibiotics that were originally used to kill MRSA are now useless against it.

Superbugs also play a role in exacerbating our response to pandemics like COVID-19. For example, during the 2009 H1N1 influenza pandemic, up to 55 percent of deaths were attributed to secondary bacterial pneumonia, not influenza itself.

While we are still learning much about the ongoing COVID-19 pandemic, it appears superbugs are worsening this terrible public health threat. As many as one in five hospitalized COVID patients contract a secondary infection. That means patients could survive COVID only to later perish from an untreatable bacterial infection. As we consider how to prepare for the next pandemic, we must remember that an arsenal of effective antibiotics is critical to ensure we can adequately protect our nation.

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