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Taking up the superbug challenge Taking up the superbug challenge
(7 months later)
The threat posed to human health by antibiotic-resistant bacteria, highlighted by the UK's chief medical officer, makes for grim reading (New wave of 'superbugs' poses dire threat, says medical chief, 11 March). That the country which discovered penicillin has seen its antibiotic discovery research programmes in universities and large pharmaceutical companies shrink over the past 20 years is to be regretted. We will be reaping the effects of this for years to come.The threat posed to human health by antibiotic-resistant bacteria, highlighted by the UK's chief medical officer, makes for grim reading (New wave of 'superbugs' poses dire threat, says medical chief, 11 March). That the country which discovered penicillin has seen its antibiotic discovery research programmes in universities and large pharmaceutical companies shrink over the past 20 years is to be regretted. We will be reaping the effects of this for years to come.
The pace of antibiotic discovery research needs to be quickened now. To this end a new group of academic researchers, Antibiotic Discovery UK, was formed in autumn 2012. Several small pharma companies have also become involved. The group has developed a roadmap to: 1) rebuild antibiotic discovery research in UK universities; 2) work with industry to develop new drugs using novel approaches, targets and chemistry; 3) encourage the UK government to provide more funds for antibiotic discovery; 4) promote education in antibiotic discovery and antibiotic use and 5) research new approaches such as in the TB arena of multiple combination therapy.The pace of antibiotic discovery research needs to be quickened now. To this end a new group of academic researchers, Antibiotic Discovery UK, was formed in autumn 2012. Several small pharma companies have also become involved. The group has developed a roadmap to: 1) rebuild antibiotic discovery research in UK universities; 2) work with industry to develop new drugs using novel approaches, targets and chemistry; 3) encourage the UK government to provide more funds for antibiotic discovery; 4) promote education in antibiotic discovery and antibiotic use and 5) research new approaches such as in the TB arena of multiple combination therapy.
To encourage large pharmaceutical companies to reinvest in antibiotic discovery, financial incentives need to be put in place similar to that in paediatric drug development, where companies can obtain a patent life extension of up to six months. As profits from sales of new antibiotics are relatively small compared with drugs for chronic conditions such as heart disease or cancer, companies that invest in them should receive a "wild card" allowing them to extend the patent life of a more profitable drug in their portfolio. Perhaps the length of the patent extension could be linked to how much money the company is investing in antibiotic drug discovery research. If these approaches are quickly adopted, we might be able to prevent the catastrophe that the chief medical officer foresees.
Professor Colin Garner
Honorary clinical professor, Hull York Medical School, University of York
To encourage large pharmaceutical companies to reinvest in antibiotic discovery, financial incentives need to be put in place similar to that in paediatric drug development, where companies can obtain a patent life extension of up to six months. As profits from sales of new antibiotics are relatively small compared with drugs for chronic conditions such as heart disease or cancer, companies that invest in them should receive a "wild card" allowing them to extend the patent life of a more profitable drug in their portfolio. Perhaps the length of the patent extension could be linked to how much money the company is investing in antibiotic drug discovery research. If these approaches are quickly adopted, we might be able to prevent the catastrophe that the chief medical officer foresees.
Professor Colin Garner
Honorary clinical professor, Hull York Medical School, University of York
• In your article, growing antibiotic resistance is described as a future peril. At Médecins Sans Frontières/Doctors Without Borders (MSF) we view multi-drug resistant TB (MDR-TB) as a catastrophe today: rates are the highest ever recorded. Yet the treatment remains woefully inadequate. MDR-TB patients have to take up to 20 pills a day for two years and endure eight months of painful injections, with excruciating side-effects including nausea, permanent deafness and psychosis. Even then, only half are cured.• In your article, growing antibiotic resistance is described as a future peril. At Médecins Sans Frontières/Doctors Without Borders (MSF) we view multi-drug resistant TB (MDR-TB) as a catastrophe today: rates are the highest ever recorded. Yet the treatment remains woefully inadequate. MDR-TB patients have to take up to 20 pills a day for two years and endure eight months of painful injections, with excruciating side-effects including nausea, permanent deafness and psychosis. Even then, only half are cured.
There is a desperate need for increased research into new antibiotics. But on the positive side, the pipeline for TB drugs is the best it has been for 50 years. There are 10 drugs in clinical testing, one new anti-TB antibiotic with no reported resistance available now, and another expected soon. We have a rare chance to use these new drugs wisely, and to develop a short, less toxic, affordable treatment regimen for MDR-TB. This is one superbug we can do something about now, if the research community and governments worldwide wake up and seize the opportunity.
Dr Bern-Thomas Nyang'wa
TB specialist, MSF
There is a desperate need for increased research into new antibiotics. But on the positive side, the pipeline for TB drugs is the best it has been for 50 years. There are 10 drugs in clinical testing, one new anti-TB antibiotic with no reported resistance available now, and another expected soon. We have a rare chance to use these new drugs wisely, and to develop a short, less toxic, affordable treatment regimen for MDR-TB. This is one superbug we can do something about now, if the research community and governments worldwide wake up and seize the opportunity.
Dr Bern-Thomas Nyang'wa
TB specialist, MSF
• To prevent the "catastrophic threat" of antibiotic resistance, the chief medical officer need look no further than the dinner plate. Factory-farmed animals are disease-ridden as a result of being crammed into filthy sheds – a breeding ground for new strains of bacteria and viruses – and are fed a diet of drugs to keep them alive in these unsanitary conditions, increasing the chance that drug-resistant superbugs will develop. Hans-Gerhard Wagner of the UN's Food and Agriculture Organisation called the intensive farming of livestock an "opportunity for emerging disease". Last month, researchers at Michigan State University restated the well-known fact that the overuse of antibiotics in farm animals increases the likelihood that "superbugs" will cause harm to humans. They found antibiotic-resistant genes on farms at levels up to 28,000 times higher than normal. Choosing to eat vegan helps to decrease the danger of mutating bacteria.
Ben Williamson
People for the Ethical Treatment of Animals
• To prevent the "catastrophic threat" of antibiotic resistance, the chief medical officer need look no further than the dinner plate. Factory-farmed animals are disease-ridden as a result of being crammed into filthy sheds – a breeding ground for new strains of bacteria and viruses – and are fed a diet of drugs to keep them alive in these unsanitary conditions, increasing the chance that drug-resistant superbugs will develop. Hans-Gerhard Wagner of the UN's Food and Agriculture Organisation called the intensive farming of livestock an "opportunity for emerging disease". Last month, researchers at Michigan State University restated the well-known fact that the overuse of antibiotics in farm animals increases the likelihood that "superbugs" will cause harm to humans. They found antibiotic-resistant genes on farms at levels up to 28,000 times higher than normal. Choosing to eat vegan helps to decrease the danger of mutating bacteria.
Ben Williamson
People for the Ethical Treatment of Animals
• So, the lack of antibiotic development over the past 25 years is in part ascribed to market failure. As government lets privatisation and market forces rip throughout our public services, how many other catastrophic events lie round the corner?
Nick Pearce
Ilkley, West Yorkshire
• So, the lack of antibiotic development over the past 25 years is in part ascribed to market failure. As government lets privatisation and market forces rip throughout our public services, how many other catastrophic events lie round the corner?
Nick Pearce
Ilkley, West Yorkshire
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