The next pandemic? It may already be upon us

‘Antimicrobial resistance (AMR) won’t race across the world like Covid-19, but its effects will be devastating. Thankfully, we already know what we need to do to defeat it...

‘Reining in the inappropriate use of antibiotics, in humans and in farmed animals, is key to staying ahead of AMR, but we also need novel anti-infectives coming down the pipeline – new last resorts. The thing holding up that pipeline to date has been the same thing that meant we had no coronavirus vaccines at the start of this pandemic: the economic incentives are few. Because antibiotics tend to be needed in relatively small quantities at a time, there are no economies of scale to be had either.

‘That’s the bad news; now for the good. Efforts are afoot to stimulate the development of novel anti-infectives. Outterson is the founder and executive director of CARB-X, which is funded by the British and German governments, the Wellcome Trust, the Bill & Melinda Gates Foundation and several arms of the US government, and which promotes the early stages of R&D – technically, the preclinical and phase 1 clinical phases. Meanwhile, last July the International Federation of Pharmaceutical Manufacturers and Associations launched a $1bn initiative, the AMR Action Fund, to finance the much more expensive phase 2 and 3 clinical trials that bring a drug – the few that get that far – to the threshold of regulatory approval. And the UK is experimenting with a new subscription-style payment model that pays drug companies upfront for access to novel antibiotics, so decoupling profit from volume sold.’

Read here (The Guardian, Feb 15, 2021)

When a virus is the cure

‘As bacteria grow more resistant to antibiotics, bacteriophage therapy is making a comeback...

‘Phages, or bacteriophages, are viruses that infect only bacteria. Each kingdom of life—plants, animals, bacteria, and so on—has its own distinct complement of viruses. Animal and plant viruses have always received most of our scientific attention, because they pose a direct threat to our health, and that of our livestock and crops. The well-being of bacteria has, understandably, been of less concern, yet the battle between viruses and bacteria is brutal: scientists estimate that phages cause a trillion trillion infections per second, destroying half the world’s bacteria every forty-eight hours. As we are now all too aware, animal-specific viruses can mutate enough to infect a different animal species. But they will not attack bacteria, and bacteriophage viruses are similarly harmless to animals, humans included. Phage therapy operates on the principle that the enemy of our enemy could be our friend.’

Read here (The New Yorker, Dec 14, 2020)