The drugs don’t work: a global antibiotics crisis | FT Investigation

The drugs don’t work: a global antibiotics crisis | FT Investigation


We’ve got used to the fact that
if you have a small infection, if you have a cut, if
you need an operation, then you can use antibiotics and
the infection won’t be serious. Unless we get a grip on
resistance to the antibiotics, people will die
from these things. The issue of
anti-microbial resistance is up there with climate change. The World Health Organisation
says drug-resistant diseases already kill at least
700,000 people each year. But there could be 10m
deaths each year by 2050 unless new
antibiotics are found. There’s a serious lack of new
antibiotics under development. And the number of drug
resistant bloodstream infections increased by a third
from 2013 to 2017. So NDM-1 is a resistance
protein that’s able to break down antibiotics
and leaves them inactive. Now, originally, it came from
hospitals in India, New Delhi specifically. And now we’re seeing
the spread of that through to countries
such as Italy, where 350 cases have been
reported within the last six months. And that’s particularly
concerning, because we’re seeing the
spread largely due to travel. And that’s a real
problem, because it means that we’re all potentially
affected by this issue. The UK is leading the
hunt for new antibiotics. Much of the research
is taking place at the government backed AMR
Centre in northwest England. The antibiotic market is broken. There’s been no new
drugs for 30 years, because the reward to invest
in those products just isn’t there. Antibiotics are really cheap. They’re a dollar a strip. The value is not
there for somebody to bring a new one to
market at the moment. That’s part of what the
AMR Centre is trying to do, is bridge that gap between
discovery and proving the things in clinic. The AMRC partly
owes its existence to economist Jim O’Neill. His 2016 report for
the UK government found the widescale
use of antibiotics in industrial farming helped
bacteria adapt and thrive. O’Neill called for
a big reduction in the amount fed to animals. And he criticised the
pharmaceutical industry for cutting back on
antibiotics research. Even small biotechs were
starting to give up. A lot of people think it’s just
an issue about incentivising, and therefore, paying
the big pharma. Why should governments do that? But what they ignore is the link
between the chain all the way down to the earliest stage. Because the genuine
risk-takers that are coming through the
so-called biotech world, that are backing these very
visionary, and creative, and highly risky
start-ups, unless there is a takeout for them
they’re going to stop too. To develop a new medicine
takes 10 to 12 years and considerable investment. But importantly, it
also takes expertise. You need experts
continuously working on this. And that needs to be
sustainable for companies. And we know there’s market
failure for companies researching in antibiotics. And we’ve seen
companies not being able to carry on research
into antibiotics. The UK, at least,
is making progress. Since 2014, it
has cut the amount of antibiotics it uses
by more than 7 per cent. And sales for use in
food producing animals have dropped by 40 per cent. The UK has unveiled a plan
to control AMR by 2040. But O’Neill says
policymakers could do more. They need to fix the
broken antibiotics market by developing what he
calls a market entry reward. Provide something
in the vicinity of a billion dollars
for the right producer of a new urgently needed drug. A second alternative is you
just take it completely away from pharmaceutical companies
and have a utility type entity or government backed entities
that just do it themselves, and just say, OK,
if you guys just want to live in the
profit world, its none of your responsibility anymore. After penicillin was discovered
in 1928, deaths from infections plummeted and operations
became routine. But Sir Alexander
Fleming himself warned about the risk
of microorganisms developing resistance. Ninety years on, the world is
on the brink of falling back into the medical dark ages. A future where you
die from a cut finger sounds like something you might
see in a science fiction film. But the scientists here know
they’re in a race against time. And unless we wake up,
that dystopian future will become a
reality all too soon.

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