How to Address a Problem like Superbugs

Given the virulency of these superbugs and the threat they represent to humanity as a whole, should a market-based approach to creating new antibiotics still be considered at all?

Anyone paying attention to the media in the last few years has probably heard of the rise of Superbugs. No, these are not a new group of superheros uniting to save the world and create a mega million dollar box office hit…these are bacteria that are resistant to three or more types of antibiotics. While that may not sound like a big deal, it really is because we have a limited selection of antibiotics to choose from. If you get infected with one of these superbugs, you essentially revert back to life 1700’s style: you treat the symptoms of a disease and have to hope your immune system can shake it on its own.  If not, it’s a trip to the graveyard.

Bloodletting

Anyone want to go back to bloodletting as a cure for basic diseases?

The rise of Superbugs has many different causes, which I explored in depth in a previous post titled What Will We Do Without Antibiotics?  All of these are serious issues that need to be addressed.  In the short term, one way to solve this problem is to expand the types of antibiotics we have available so that we minimize the chances of a bug becoming resistant to it.  This seems logical (and indeed it is logical to do so), but this is also entangled with economics, and anything that is touched by economics ceases to be logical.

As Steven Ross Johnson points out in his article Current Market Model Doesn’t Work for Antibiotics: Here’s Why, the main reason for the lack of variety in antibiotics is a direct result of the market-based supply and demand model: Antibiotics, like all drugs, are expensive to develop and thanks to testing and FDA bureaucracy may take up to 10 years to make it from lab to market.  In order to make that profitable to the company, the drugs would need to be insanely expensive and used for a long period of time so the company can recoup costs.  But antibiotics are generally only taken for short periods of time…two weeks or less, making it near impossible to wring any profit out of them. Remember, the sole reason businesses exist is to make profit, so drug companies haven’t been investing in this area because there is nothing in it for them.

How to solve this dilemma? Johnson showcases several different ideas, including public-private partnerships and government initiatives to incentivize the drug companies to do the research and develop these new drugs. But my question is this: you are still using market-based thinking in many of these cases, often you are just putting your money on one side of the equation to take some of the risk out.  In an attempt to preserve profit, there were always be artificial constraints on the development of the new drugs, no matter how much you try to weight the scale.  The superbugs aren’t waiting to strike, and they don’t care what type of economy its victims prize.  Therefore, it seems foolish to risk the lives of humanity across the planet for the pursuit of profit.  As we saw with the Ebola outbreak in Africa, these bugs cannot be contained to a single area, even with the best tools and highest standards to prevent transmission.

Maybe it’s the Millennial half of me, but it seems that using the same market based approach to try and solve an issue created by a market based approach is the equivalent of throwing good money after bad.

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