The race to contain superbugs

Research!America

The serendipitous discovery of penicillin by Alexander Fleming in 1928 transformed the course of modern medicine. Penicillin, followed by a series of other antibiotics, seemed to promise a world free of infectious diseases that once killed millions of people worldwide. Medical breakthroughs such as organ transplants and chemotherapy would not have been possible without the development of antimicrobials. Fleming warned, however, that microbes have the ability to, and inevitably will, develop resistance to antibiotics. It did not take long to prove him right, with drug-resistant strains appearing just within years after the introduction of penicillin, as was the case for many subsequent antibiotics.

“Antimicrobial resistance is a serious global health threat that is undermining our ability to effectively detect, treat and prevent infections,” said National Institute of Allergy and Infectious Disease Director Anthony S. Fauci, M.D. Drug-resistant superbugs continue to emerge, requiring collaborations among governments, non-governmental organizations and industry to address the problem. Recently, scientists reported that a superbug strain of typhoid fever called H58, which is resistant to multiple types of antibiotics, is spreading globally. Typhoid affects about 30 million people each year and, if left untreated, could prove fatal in up to 20 percent of patients.

Drug-resistant pathogens are a significant public health concern, causing two million serious illnesses and 23,000 deaths each year in the United States alone, according to the Centers for Disease Control and Prevention. The economic costs are also significant with associated medical costs mounting to $20 billion annually and an additional $35 billion from loss of productivity. The public and private sector are working to prevent or slow the development and spread of antimicrobial resistant infections, strengthen surveillance, develop rapid diagnostic tools, and conduct clinical research to optimize the use of existing treatments.

Representatives from industry and academia will discuss investment incentives for combating antimicrobial resistance at a BIO International Convention Super Session on June 17 in Philadelphia. What factors have slowed the development of antibiotics?  What incentives are necessary to encourage industry R&D? Speakers include Helen Boucher, Director, Infectious Diseases Fellowship Program, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center; Julie Gerberding, EVP, Strategic Communications, Global Public Policy, and Population Health, Merck; Kenneth Hillan, Chief Executive Officer, Achaogen; Jim O’Neil, Honorary Chair of Economics, Manchester University; and Steve Solomon, Principal, Global Public Health Consulting. 

The experiences of the United Kingdom and Mexico in addressing this issue will be discussed in a panel at the BIO Convention titled “International Perspectives on Combating Antimicrobial Resistance” on June 17, featuring John Watson, the Deputy Chief Medical Officer for England, and Dávila Chávez, Director-General of International Affairs of Mexico’s Secretariat of Health. They will describe the challenges and opportunities in combating superbugs in their own countries and offer potential solutions.

Closer to home, President Obama included a request for $1.2 billion in his FY 2016 budget proposal to fight antimicrobial resistance, and the White House announced the President’s Executive Order and the National Strategy to Combat Antibiotic-Resistant Bacteria, urging federal agencies to take a more aggressive stance in this area. On June 2, the White House convened more than 150 representatives from the government and private sector for the “White House Forum on Antibiotic Stewardship” which focused on the development of rapid diagnostics to ensure proper treatments and avoid misuse or overuse of antibiotics as well as antibiotic stewardship programs for hospitals. The President also signed a memorandum directing federal departments to give preference to meat and poultry produced according to responsible antibiotic use.

Meanwhile, the 21st Century Cures Act, approved by the House Energy and Commerce Committee, would facilitate the development of certain new antibacterial or antifungal drugs for limited patient populations through a tailored FDA approval pathway and streamline the process by which FDA can clear or approve updates to antimicrobial susceptibility testing devices.

Fleming, who won the Nobel Prize for his discovery of penicillin, predicted that the misuse of antiobiotics could transform the bacterial population causing many antibiotics to lose their efficacy. But experts believe with the right response, the drugs might once again serve their purpose in saving lives.

For more information about the BIO International Convention, visit www.convention.bio.org.

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Without research, there is no hope.
The Honorable Paul G. Rogers