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Medicine Businesses The Almighty Buck United Kingdom

'Without Action on Antibiotics, Medicine Will Return To the Dark Ages' (theguardian.com) 321

Four years ago professor Sally Davies, England's chief medical officer, gave the world a sombre warning of the growing threat posed by bacteria evolving resistance to life-saving antibiotics. If this were left unaddressed, she argued, it would lead to the erosion of modern medicine as we know it. Doctors and scientists had long warned of the problem, but few outside medicine were taking real heed. Consumption of antibiotics rose 36% between 2000 and 2010, writes Ed Whiting, director of policy and chief of staff at Wellcome, a biomedical research charity based in London. He notes that much of the progress in the field is yet to be made: We urgently need new antibiotics. No new classes of antibiotics have been approved since the early 1980s. Between 1940 and 1962 about 20 classes were produced, but industry backing has decreased significantly since that golden age. The pipeline of new treatments is all but dry, the void fast exploited by resistant bacteria. A concerning number are now resistant to drugs reserved as the last line of defence, and the most vulnerable are in greatest danger -- the young, old and critically ill. Blood infections caused by drug-resistant microbes kill more than 200,000 newborn babies each year. The reason for the lack of interest from the pharmaceutical industry is simple: the economics don't add up. Developing new antibiotics is scientifically challenging, time-consuming and costly. The medicines we so badly need cannot be allowed to be sold in volume; they must be conserved for real need, with fair access guaranteed. This limits their retail value. Many early-stage projects will fail, making them a risky bet. Even those that are successful will take at least a decade to produce medicines that are safe for human use.
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'Without Action on Antibiotics, Medicine Will Return To the Dark Ages'

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  • Please (Score:3, Insightful)

    by no-body ( 127863 ) on Friday May 19, 2017 @02:02PM (#54449887)

    help the POTUS to understand this!!!!

  • My dad has an infection in his arm which is only being moderately helped by intravenous Cipro and Vancomycin. They've sent a culture to Mayo to see if they can find a better treatment option but at this point I'm more than a little concerned. This stuff is already happening. They really need to get their heads out of the sand.
    • other therapies (Score:5, Insightful)

      by DrYak ( 748999 ) on Friday May 19, 2017 @02:27PM (#54450087) Homepage

      The worst part is, if a new antibiotics is discovered, it might help you right now, but after a couple of year, because of over use(*), the bacteria will eventually evolve some resistance against it. So the next patient with the same kind of infection will be again in the same situation...

      Maybe time to dust off alternative therapies, like phage therapy [wikipedia.org] ? (**)
      Cue in citation of your favorite strategist (Churchill, Sun-Tzu, Machiavelli, etc.) commenting about the millennia-old proverb that the enemy of your enemy is your friend.


      (*) : over-prescription, industrial/agricultural use, etc.

      (**) : phage are like viruses but specialize in infecting bacteria. So phage therapy is basically curing your sickness, by making your sickness itself sick, with its own sickness, in a kind of pathogen-ception.

      • It depends. It's pretty rare for a bug to be resistant to all available antibiotics. There are a few notable exceptions, but proper management of antibiotic use reduces the threat significantly. A few extra options to choose from also helps. The problem is that making your money back on new antibiotic development is hard, for a variety of reasons.

        Maybe time to dust off alternative therapies, like phage therapy [wikipedia.org] ? (**)

        Cool idea, but still very much in the basic research stage. There are a few once-off success stories, but turning it into a large-scale therapeutic is very challen

        • Re:other therapies (Score:5, Insightful)

          by Wootery ( 1087023 ) on Friday May 19, 2017 @04:57PM (#54451201)

          It depends. It's pretty rare for a bug to be resistant to all available antibiotics.

          Give it time.

          proper management of antibiotic use reduces the threat significantly.

          We don't have proper management. Hence the article, no?

          • by Holi ( 250190 )
            Laws need to be changed yes, but changing the laws now and not finding new antibiotics doesn't really solve the immediate problem.
      • Phage therapy already receives renewed interest and bacterias will also evolve resistance against it.
        IMO the real problems are (as you said) overuse but also lack of incentive (commercial) to develop new antibiotics.
    • Re: (Score:2, Insightful)

      by Anonymous Coward

      Get the FDA out of the way, and dozens if not hundreds of new treatments will explode onto the scene in a jiffy.

      You should have your dad make a trip to Lubbock, TX and visit one of the world's foremost wound care doctors: http://southwestwoundcare.com/

      I used to work with him--he is very willing to use experimental treatments (that he has confirmed to work). Saved lots and lots of limbs.

    • by jedidiah ( 1196 )

      Vanco can destroy your kidneys. You have to stay on top of that stuff. Stuff like Vanco is no long term solution.

    • At what point is amputation a viable treatment?
      I presume the doctors have already broached the possibility and the need to do so before he doesn't' even have a stump to work with left.

    • Dale Girbble says bee stings will cure him.

  • Markets... (Score:5, Insightful)

    by beheaderaswp ( 549877 ) * on Friday May 19, 2017 @02:08PM (#54449939)

    Oh... you mean markets cannot solve every problem on the planet?

    Maybe if we spent a bunch of government grant money on the problem we could make it better?

    Naw... the market always works... right? It's not like penicillin was discovered at St Mary's Hospital using government money.

    Wait.... It was.

    • Re:Markets... (Score:5, Insightful)

      by interkin3tic ( 1469267 ) on Friday May 19, 2017 @02:19PM (#54450031)
      We could take a huge chunk of the threat out by intelligently regulating antibiotic use in farm animals. [scientificamerican.com] But I've been accused of being an evil socialist elitist bent on destroying all american jobs. Why do I hate jobs and love big government so much? Why can't I just accept that jobs heal all sickness, we don't need laws, just jobs jobs jobs jobs?
    • If you think about it, the microbiological market is sorting this out.

      The microorganisms are allowed to fully develop without any government interference or constraints. Market forces at work :) It is an upside for microorganisms, but the downside is that we can never go to the hospital or have elective surgery without risk of being consumed by microbiological market forces.

      What we really need are living antibiotics that evolve with the microorganisms. Bacteriophages [wikipedia.org] seem like a good weapon of choice.

    • Government grant money wouldn't have averted this problem, and would only be a band-aid now. The reason we reached this point is because the prices of the current crop of antibiotics externalized their true cost (i.e., the cost of developing new drugs due to the overuse and thus the increasing ineffectiveness of the existing ones). Just another act in the tragedy of the commons [wikipedia.org].

      Without addressing the overuse problem, government grant money is at best only going to create the next generation of increasingl

  • by Spy Handler ( 822350 ) on Friday May 19, 2017 @02:13PM (#54449983) Homepage Journal

    We still know about germ theory, so we would still be sterilizing scalpels and tongs with heat or alcohol or whatever. And we have xray machines and anesthesia and all that other good stuff, so it's still gonna be way better than medicine in the dark ages.

    Making new stronger antibiotics is only a temporary solution, bacteria will probably develop resistance to that too.

    What's probably gonna happen is that surgery will become risky and very expensive. Everything in the surgery room will need to be sterilized extremely thoroughly, and you would need super air filtration systems like a CPU manufacturing clean room. Even then risk of infection will always be there. So you would only want surgery in life-threatening situations. No more nose job or tummy tuck or a hip replacement. If you have a bum hip, you're gonna be walking around on a cane or in a wheelchair like our ancestors did.

    • by Punko ( 784684 )
      And we'd see the first reductions in life expectancy once these resistant bugs become widespread. Its not that we'd return to the Dark Ages, but lifespans would be reduced to the levels currently seen in sub-Saharan Africa.
      • lifespans would be reduced to the levels currently seen in sub-Saharan Africa.

        Nah. What was the life expectancy in the USA in the 1920's? I'll bet it was well over 60. Life wasn't all that terrible back in the day when people were driving around in Ford Model T's.

    • Or perhaps antibiotics can be completely abandoned when we have figured out how to augment,stimulate and guide a person's own immune system.
  • Profit (Score:2, Insightful)

    by rsilvergun ( 571051 )
    new antibiotics aren't going to be profitable. For one thing the drug companies make plenty on the existing ones. For another they're too essential for life, so they're prone to price controls. We could make them profitable enough but only by allowing business practices similar to what Epipen's Pharma Bro did.

    This is what "Austerity" and rampant non-stop tax cuts gets you. This is something the government needs to step in and do. The days of one bright guy with a petri dish making a major breakthrough a
    • by DaHat ( 247651 )

      new antibiotics aren't going to be profitable.


      For one thing the drug companies make plenty on the existing ones.

      Currently. Do you think they are blissfully unaware of the possibility of a future where their current products are ineffective? Given likely know the time required to get such a thing approved (after the similarly long time to do the research), don't you think they'd be looking at future opportunities?

      For another they're too essential for life, so they're prone to price controls.

      Odd t

      • and existed before the complex games companies play to keep things in patent control.

        And yes, they were massively funding research. Not into new antibiotics, because that's a fairly recent issue (last 20 years tops). But the cancer drugs that kept my kid alive were invented by the government (or Europe, research into childhood diseases isn't profitable enough to do it here in the States and, well, aforementioned tax cuts).
    • Re:Profit (Score:5, Informative)

      by lgw ( 121541 ) on Friday May 19, 2017 @02:52PM (#54450291) Journal

      You've misunderstood "austerity". Austerity works as follows:

      * We don't have the tax revenues to pay for half the programs the government wants to fund.
      * We had been borrowing money for the other half.
      * No one will lend us any more money, because we're clearly never going to pay our debt off given our spending history.
      * We're stuck, no possible/I. way to keep spending at current rates

      But, hey, maybe if we show lenders some evidence we're capable of spending less, cutting some programs we like, maybe they'll lends us at least a little. That's better than cutting half the programs to get back to tax revenue, right?

      Austerity isn't some weird tickle-down economic theory or anything. It's what you do because you must, as for one reason or another, you can't print money to make up the shortfall.

      • The Keynesian method, which nobody seems to practice, is to have some austerity going in good times and forget about it in bad. Too many countries seem to forget about trying to save in good times (the Clinton administration is an exception). Austerity in bad times generally makes them worse. It's cost the Greek economy dearly.

    • by tomhath ( 637240 )

      For anything more important than a twinkie you need an organized response, i.e. the government.

      And yet we keep hearing about how wonderful socialized medicine is in countries that have it.

      Why do those countries expect private pharmaceutical companies to develop drugs instead of funding the development themselves? And why do people in those countries expect to get the drugs at deep discounts compared to what the drugs sell for in the US? It's time for other countries around the world to open their wallets and pay for some of the R&D.

  • by nimbius ( 983462 ) on Friday May 19, 2017 @02:18PM (#54450025) Homepage
    fun fact: many of these antibiotics are developed through public private partnership with your local schools and universities under nondisclosure agreements which prevent any of the research from being made public. these NDAs often have expiration dates as far far as 80 years into the future.

    the fact remains that if and when the cloistered elite need access to lifesaving medicine en-masse, these drugs will be quickly made available. If the cure for Hepatitis C was any indication, you'll certainly gain access to these advanced new antibiotics as well...at $30,000 a bottle.
    • Got a reference? Not doubting you, just would like to read up on it.

    • by Guppy ( 12314 )

      you'll certainly gain access to these advanced new antibiotics as well...at $30,000 a bottle.

      One of the last major antibiotic innovations though the pipeline was daptomycin, approved in the 1980's. Not sure what it costs now, but a few years ago a course of IV daptomycin was $28k.

  • by Anonymous Coward
    If a college receives any public funds, than any research should be owned by the public. Any derivatives as well. Therefore, and/all penicillin based antibiotics should be profit-and-prescription free.
    • Federal copyright law supports public institutions (non-federal) owning and profiting from intellectual property.

  • by bugs2squash ( 1132591 ) on Friday May 19, 2017 @02:30PM (#54450115)
    Whenever I read a statistic like Consumption of antibiotics rose 36% between 2000 and 2010 I wonder what they had to do to boil it all down to one number. For all I know this is accounted for mostly by a single drug being administered to farm animals ? It sounds like a shocking number but it means very little to me. Even a little more information would have been really helpful and help me feel like it wasn't a statistic created for wanton shock value.
  • Two small comments (Score:4, Insightful)

    by bradley13 ( 1118935 ) on Friday May 19, 2017 @02:32PM (#54450123) Homepage

    First, get antibiotics out of agriculture, where they're given _all_ _the_ _time_ as a preventative measure. Stupid.

    Second, why exactly should access be "fair"? TFA complains on moment that there's no economic incentive, and then promptly demands fairness. Get real. Life isn't fair. But what the rich can buy today will be available to the rest of us tomorrow.

    • by DaHat ( 247651 )

      But what the rich can buy today will be available to the rest of us tomorrow.

      If I had any mod points they would be yours, 100x over.

      Take something as simple as Teflon, which is rather important in different areas modern medicine... saw it's earliest commercial value in air-conditioning on cars... for the very very rich.

      Back in the 60's when dialysis was a pretty new technology (dependent on Teflon btw), we saw the 'God Committee' decide ones 'social worth' of patients when choosing who would get it... fast

    • by tomhath ( 637240 )
      The antibiotics used in agriculture are not the problem. Antibiotics used on humans without proper testing and stewardship are the problem, especially in Third World countries
  • by sexconker ( 1179573 ) on Friday May 19, 2017 @02:43PM (#54450215)

    What we urgently need to do is to learn to let people die.

    On a global scale, the use of antibiotics is more of a problem than the shit we use them against.

  • by JoeyRox ( 2711699 ) on Friday May 19, 2017 @02:44PM (#54450231)
    Humans are just a phase.
  • Good thing we have the for profit industry in the US. With all those dollars guiding them we should have a solution by next week. Of course, only the 1% may be able to afford it anyway, but citizens in single payer countries will be ok.
    • Good thing we have the for profit industry in the US. With all those dollars guiding them we should have a solution by next week. Of course, only the 1% may be able to afford it anyway, but citizens in single payer countries will be ok.

      So the money from single payer countries will have a solution by next week?

  • by Gravis Zero ( 934156 ) on Friday May 19, 2017 @02:56PM (#54450335)

    While this will be a tragic turn of events for millions or even billions of people, ultimately we will be forced to seek a new path of technology to sustain our bad behavior. As they say, "necessity is the mother of invention". It will be a long hard road but we will reach the end and develop something akin to synthetic microbes that do exactly what they are programmed to do. Frankly, with the last few centuries so focused on killing each other, humanity could use the diversion to actually work on protecting ourselves from the ever-present invisible enemies that are microbes.

    It's a hard road we face but after much death and suffering we will come out stronger as a species.

  • Phage Therapy (Score:2, Insightful)

    by Anonymous Coward

    Geezus, I keep posting this. Antibiotics are great and all, and limiting nonessential use is great and all, but we really need a Plan B. A serious alternative way of treating drug resistant infections.

    And we already have it!

    It is called phage therapy and it is completely different. Viruses have been attacking and eating bacteria for literally billions of years. This predates multicellular organisms and so we already know how effectively bacteria can develop immunity to viruses (hot tip: they can't! If

  • What ridiculously hyperbolic garbage.

    If we weren't so focused on the failing strategy of "look for MOAR antibiotics", we could have had the superbug problem licked already with alternatives like phage therapy (which you can only get right now if you fly to Georgia).

    What does it tell you when the famed "merkan innovation" can't even out innovate a tiny former soviet republic using 90yr old tech?

    Yeah, thought so.

  • Between climate change and overpopulation isn't this just a way to cull the herd? People survived before antibiotics, and the genetically strong will survive the loss of antibiotics. It won't be pretty though.

  • Drug companies that do research into antibiotics get access to government grants, Those that don't and stick to only profitable drugs obviously don't need the lep so they are denied access.

Karl's version of Parkinson's Law: Work expands to exceed the time alloted it.