You have probably heard about the problem of anti- biotic resistance.  This resistance is at last crumbling, but there is another problem – of economics.

The issue is that pharma firms must recoup their investment in developing drugs, but antibiotics are the antithesis of a bestseller. They are taken for days or a few weeks, whereas diabetes or heart drugs are highly profitable because patients can use them for life. Plus, new antibiotics can’t compete with older, cheaper drugs that still work and are no longer patented.

By the time resistance to the old antibiotics builds up and doctors must prescribe new, expensive ones, their patented life may be almost over, leaving little time for their owner to turn a profit. Novel drugs must also be kept in reserve or used sparingly, to stop bacteria building a resistance to them, too.  As a result,  US sales of all antibiotics still under patent totalled just $700 million in 2017 – less than what a single new cancer drug makes in a year. This is having a dire effect on the field. Big companies have  reduced their programmes and are not launching new studies. Now, most drug discovery is done by small, struggling biotech firms. Bad profit prospects meant those working on antibiotics lost some 50 to 75 per cent of their stock value in 2018.  There are only about 800 experienced researchers left working on antibiotics.

A recent study showed that only 56 experimental antibiotics worldwide have passed animal tests and human trials. Typically, only 14 will prove viable and about 5  work in novel ways. That is a concern, because drugs that operate in the same way as existing ones may not be able to defeat resistance.

It is estimated that the loss of antibiotics would cost society trillions of dollars. Tomorrow I will continue by reporting what is being done.  (Based on article in the New Scientist but heavily edited for length,  Jan 19-25, 2019)