Antibiotics at the crossroads

This paper explores what can be done about the declining level of antibiotic research and development which has long been insufficient to meet the needs of most populations, particularly in poorer but also in wealthier countries.

Causes of this decline in research are identified as:

• economic pressures: the demand for profit-making drugs pressures companies to focus on long-term treatment of chronic conditions in preference to brief treatments for bacterial infections
• regulatory obstacles: with the current system geared to generic standards of safety and efficacy, the development of new antibiotics is prevented
• stalled science: industrial research and development has mainly produced variants of older antibiotics, when new drugs are sorely needed.

In order to find a more constructive approach the paper makes the following recommendations:

• what is needed is a not-for-profit drug company; encouraged by tax incentives for example, industry could give sabbaticals to its scientists and executives to work at such a not-for-profit firm in rotation
• smarter regulatory requirements and patent incentives should be revised to encourage the pharmaceutical industry to develop new antibiotics
• a fresh approach to research is needed, focusing on new microbial targets.