Congress aims to tackle antibiotics time bomb
Christine Queally
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The world’s population is becoming increasingly resistant to antibiotics, and healthcare institutions are sounding the alarm that inaction could result in a breakdown of healthcare systems worldwide within the next 30 years.
In 2021, the World Health Organization named antimicrobial resistance as one of the top 10 emerging threats to global health, but lawmakers in the United States have been unable to pass legislation to address the crisis.
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However, a bipartisan bill, the PASTEUR Act, was recently reintroduced by Sens. Todd Young (R-IN) and Michael Bennet (D-CO), and health professionals hope Congress can finally pull through.
“We can’t sit on our hands and wait for the next public health crisis to arrive. It’s time for Congress to pass the PASTEUR Act,” Young said.
Mary Dwight, chief policy and advocacy officer at the Cystic Fibrosis Foundation, explained why it is so vital to take action as soon as possible.
“We are currently in a crisis of enough effective antibiotics that are available to treat infections that occur every day all across America, all across the world. We really are in a current pandemic of ineffective antibiotics,” she said.
Clinicians say it is necessary to develop newer antibiotics to combat emerging, multi-drug resistant bacteria, but the marketplace for them is unfavorable due to the nature of antibiotics.
“The more we use an antibiotic, the more likely it is that the infections that we’re treating becomes resistant to the antibiotic. So, it’s important that we be good stewards of those drugs and that we not use the newer drugs as often when an older therapy works. You see how that could be a disincentive in the market,” Dwight said.
The newly reintroduced bill aims to make up for the lack of revenue generated by antibiotics. It would designate flat federal subsidies for companies that produce antibiotics, no matter how much of the antibiotic is actually purchased.
The bipartisan bill has been introduced before in the House and the Senate. Each time, the legislation never made it to a floor vote, in part due to the high price tag associated with it — a $6 billion down payment.
However, according to Dwight, the federal government is already spending nearly $4 billion a year to treat six of the most antibiotic-resistant infections. The CDC placed the estimate even higher, at $4.6 billion.
That cost will likely continue to grow as the catalog of antibiotic-resistant infections also increases.
In 2017, WHO published a list of bacteria for which new antibiotics are urgently needed. Included on that list were common infections like staph, salmonella, and gonorrhea.
Up to now, antibiotic resistance has largely only been regarded as an issue for people with chronic diseases, like cystic fibrosis or cancer.
However, assistant professor of infectious diseases at the Yale School of Medicine Scott Roberts said that perception is incorrect.
“We’re seeing over time that it is spreading outside of that select patient population and becoming more widespread,” he said.
“These infections can spread person to person and impact any one of us.”
According to Roberts, there are reports of gonorrhea that is only sensitive to what he described as “one of our last ditch antibiotics,” a class of drugs known as carbapenems.
The CDC also recently reported a major uptick in the number of multi-drug resistant strains of shigella, a common food-borne bacteria in the same family as salmonella.
Each year, over 2.8 million Americans acquire a serious infection that’s caused by antibiotic resistance, and 35,000 Americans die each year from those infections. The United Nations recently projected that antibiotic-resistant infections will account for 10 million global deaths a year by 2050.
“If you wait till something’s already a problem, you’re going to miss a huge catchment of patients who won’t benefit from that therapy until it’s too late,” Roberts said.
In an attempt to mitigate the impending crisis, lawmakers in the Senate recently held a hearing on antimicrobial resistance.
Witness Dr. Helen Boucher, dean and professor of medicine at Tufts University School of Medicine, clarified the urgent need for Congress to intervene before AMR becomes a full-fledged public health emergency.
“This is a game where there needs to be planning in advance for the threats we know and some we don’t know,” Boucher said.
Clinicians would like to see the development of more antibiotics for those emerging threats, but, as of now, the resources aren’t there.
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According to the Biotechnology Innovation Organization, of the 12 antibiotics companies that have gone public in the past 10 years, only five are still active today.
In 2019, two drug makers, Melinta Therapeutics and Achaogen, filed for bankruptcy within a year of releasing two of the most recent FDA-approved antibiotics, one of which was on the WHO Essential Medicines List.