Last month, a strain of bacteria resistant to “last-resort” antibiotics appeared in the United States for the first time. Luckily, doctors were able to kill the bacterium, but public health officials warned that one day a “superbug” resistant to all our antibiotics could emerge.
By 2050, a staggering ten million people around the world will die of such infections every year — one person every three seconds.
The issue of antibiotic resistance has been getting worse for quite some time. Today, well over five thousand Americans will acquire serious infections that are resistant to first-line antibiotics — think staph infection or tuberculosis. Second-line drugs will cost these patients between 50 and 200 times more than first-line drugs, not to mention the added cost of a hospital stay at about $2,000 per night. 63 Americans will die today from these infections. By year’s end, drug-resistant bacteria will have killed 23,000 — double the yearly number of firearm homicides.
In perhaps the most comprehensive report on the subject to date, economist Jim O’Neill predicted last month that by 2050, a staggering ten million people around the world will die of such infections every year — one person every three seconds.
That is, if we don’t act soon.
The problem of drug-resistant microbes is one we know how to fix, but the solution flies in the face of basic economics: Increase the supply of new antibiotics while decreasing demand. Here are three approaches for the United States, in light of O’Neill’s recommendations:
Pay companies to develop new antibiotics
Pharmaceutical companies are reluctant to develop new antibiotics because it’s not very profitable for them. Unlike lucrative disease therapies, antibiotics are prescribed for the short-term, if prescribed at all. Worse, if a drug company does society the biggest favor — developing a breakthrough antibiotic that kills drug-resistant bacteria — doctors will want to keep that drug on the shelves only as a last resort. So some companies choose instead to sell this special class of drugs to the food industry, at great cost to society.
Existing legislation tries to boost development of antibiotics by encouraging companies to sell as much as possible — tackling one part of the problem while making the other problem worse. Congress’ Generating Antibiotic Incentives Now (GAIN) Act of 2012 gives drug companies five more years of monopoly power over the antibiotics they develop.
A “market-entry rewards” approach, however, would take the incentive to sell out of the equation. The U.S. government, preferably in coordination with the G20 countries, could give about a billion dollars to a company that takes a new antibiotic to market in exchange for a fair degree of control over the drug’s use.
In other words, governments should pay companies to restrict sales of their antibiotic drug — or even to avoid selling the antibiotic at all.
Each billion-dollar payment would be a pittance compared to the trillions of dollars that the G20 countries spend on healthcare, O’Neill argues in the report. It’s not the money that poses the biggest barrier, but the willingness to work together.
“It is great to see this idea already being discussed by senior G20 officials,” O’Neill writes. “I hope this discussion will translate into tangible action during their Heads of States’ meeting in September.”
Pass legislation to curb antibiotic use in livestock
In the United States, 70 percent of antibiotics that are “medically important for humans,” according to the FDA, are also used for animal growth — reducing antibiotic effectiveness for patients who really need it.
The FDA has advised the food industry to curb the use of antibiotics in animals that are not sick, but these guidelines are voluntary. In order to give guidelines teeth, Congress should vote on The Preservation of Antibiotics for Medical Treatment Act, or a similar act that would set mandatory reduction targets for the industry.
The act currently has a 0 percent chance of being enacted, according to GovTrack — probably because the food lobby is one of the most powerful in Congress.
Prevent infections before they start
This recommendation does not require a bill in Congress — only action by regulators and public awareness about the need for hospital sanitation and vaccines. Events like last year’s superbug outbreak at the UCLA medical center remind us that improving hospital sanitation is of vital importance.
A new tool in the fight against MRSA: https://t.co/6ervUuvU3y
— Andrew Trzaska (@Trzaska) June 10, 2016
Just yesterday, a considerable breakthrough was made on this front. Scientists from the Center for Radiological Research at Columbia University Medical Center announced Thursday that they used a narrow wavelength of UV light to kill drug resistant bacteria in mice. Researchers predict that this type of UV light can be used in the operating room to sterilize surgical sites. Unlike conventional UV light, this narrow-wavelength light does not damage exposed skin, making it potentially safe for the operating room.
Vaccines also play a vital role in infection prevention, the O’Neill report emphasizes, as well as alternative lines of treatment like probiotics. We must continue to promote public awareness about the importance and safety of vaccines, especially in the face of persistent and unfounded controversy.
Cory Herro is an intern at ThinkProgress.