Imagine if scientists had seen Covid-19 coming years in advance yet did little to prepare. Unthinkable, right?
Yet that’s exactly what’s happening with another infectious disease crisis — the one caused by antibiotic-resistant bacteria and fungi. So-called superbugs already kill more than 700,000 people each year. And the World Health Organization warns that by 2050 the annual death toll could reach 10 million if we don’t use the time to get prepared.
The antibiotics and other antimicrobial drugs needed to prevent such a calamity don’t yet exist — and they’re years away from patients. The problem isn’t a lack of willing scientists, but rather a broken marketplace that has…
The bill, known as the PASTEUR (Pioneering Antimicrobial Subscriptions to End Upsurging Resistance) Act, would create a subscription-style payment model in which the federal government would pay up front for access to Food and Drug Administration (FDA)-approved antibiotics that target drug-resistant pathogens and meet critical, unmet health needs.
The aim of the bill, which would delink companies' profits from the volume of antibiotics sold, is to help solve the market challenges that have led many pharmaceutical companies to abandon antibiotic development and contributed to the weak pipeline for new, innovative antibiotics.
The main “objective” of an antimicrobial product is to inhibit or kill other microorganisms. If we don’t dive deeper into specifics, antibiotics are just a subset of this antimicrobial definition.
Many of the antimicrobials in common use are true antibiotics, being isolated from bacteria and fungi, but some are not. For example, penicillin is made by a number of fungi in the genus Penicillium and vancomycin by a bacterium known as Amycolatopsis orientalis, and both are therefore true antibiotics, while ciprofloxacin and linezolid are synthetic products and so are technically antimicrobials.
Antimicrobials refer to a group of agents that share the common aim of reducing the possibility of infection and sepsis. Antibiotics are often derived from moulds or are made synthetically and are absorbed into the body with the aim of killing bacteria (bactericidal) or preventing their multiplication (bacteriostatic).
In a world challenged by microbes resistant to antibiotics, many medical interventions that rely on these medicines to ward off infection — chemotherapy, organ transplants, C-sections, and hip replacements, to name a few — will continue to become riskier than they already are.
Many factors contribute to this bleak scenario. These include poor infection control, misdiagnosis, misuse and overuse of antibiotics, and the use of substandard or falsified medicines. Another key contributor is the presence of antibiotics in the environment. These can come from agricultural applications (animal and crops) and run off, from human and animal waste, and from wastewater emitted by antibiotic manufacturing plants.
As the number of infections resistant to antimicrobial drugs continues to rise around the world, and with it their huge human and financial toll, we urgently need new ways to preserve the effectiveness of existing antibiotics and to develop much-needed new ones.
Creating state-run or publicly owned pharmaceutical companies, an idea recently floated by British economist Jim O’Neill, isn’t the way to proceed.
In the not-too-distant future that we could be facing — one with rampant, uncontrollable, multidrug-resistant microbes — a seemingly inconsequential infection could have the power to kill. Being admitted to a hospital may do more harm than good, as hospital-acquired infections become incurable. Modern medical procedures, such as organ transplants, chemotherapy, and even surgery, might no longer be possible.
For many patients and physicians, this future is already a reality.
Antimicrobial definitions can vary widely depending on use, function, production, regulation, benefits and more. However, according to Merriam Webster, antimicrobial is defined as, “destroying or inhibiting the growth of microorganisms and especially pathogenic microorganisms.” Many antimicrobials come from nature, including those found in plants, molds and essential oils. For instance, ancient Egyptians utilized several mold strains and botanical extracts to treat infections. Centuries later, modern antibiotics were developed, which are just one type of antimicrobial.
Almost everywhere you look, you can find microorganisms, or microbes, living organisms too small to be seen with the naked eye. While some microbes are good and important to many ecosystems, others can cause serious illnesses. That’s why we rely on the “good chemistry” of substances known as antimicrobials.
Unless lawmakers take steps to jump-start antimicrobial innovation, the world will soon find itself unprepared for a global health emergency as deadly as Covid-19.
We aim to demonstrate the rich social-material worlds that antimicrobials inhabit and travel within, and in doing so offer policy-makers, scientists, and funders new ways to conceptualise and act upon AMR.