Two health trends are converging and the result is likely to be bad news. More and more infectious diseases are showing up in the population. At the same time, pharmaceutical companies are producing fewer antibiotics to fight them.
Part of the problem is that antibiotics, discovered in the early 20th century, have been overused. Over the years bacteria have come along that have acquired an immunity and are nearly impervious to them.
These “superbugs” have emerged as a serious threat. In 2012, for example, there were about 450,000 new cases of multidrug-resistant tuberculosis worldwide, according to the World Health Organization.
In September, President Obama issued an Executive Order committing the U.S. government to “detecting, preventing, and controlling antibiotic resistance,” placing the issue on the front burner. In the order Obama cited statistics from the Centers for Disease Control and Prevention (CDC) showing at that of the 2 million Americans sickened each year from antibiotic resistant infections, 23,000 die.
For Michael Kinch, associate vice chancellor and director of the Center for Research Innovation in Business, it's personal. A few years ago his 12-year-old son nearly died after his appendix burst. Only 2 of the 6 antibiotics he received had any effect, and they happened to be the 2 oldest drugs.
“It’s not that my son had had extensive exposure to antibiotics,” Kinch said. “We’re all just colonized by resistant bacteria now.”
So doctors now are more careful about prescribing antibiotics – which may be a good thing. But perhaps as a result, drug companies are making fewer of them. After all, they are in business to make drugs that get prescribed.
Kinch says there are other factors at work. He notes that the number of antibiotics available for clinical use has dwindled to 96 from a peak of 113 in 2000.
That number will probably continue to decline. Kinch says the rate of withdrawals – antibiotics removed from the market – is double the rate of new introductions.
The reasons for the withdrawals vary. Some drugs just don't work anymore. Some are now considered too toxic or have been replaced by new versions of the same drug.
But Kinch says the trend is unmistakable. Antibiotics are declining because pharmaceutical companies are leaving the business of antibiotic discovery and development.
Getting out of the business
For example, Pfizer or its predecessors developed 40 of the 155 antibiotics ever sold in this country. Kinch says that today, Pfizer doesn't sell an antibiotic. He says Eli Lilly, AstraZeneca and Bristol-Myers Squibb have all left the field.
Government health officials have already noted the shortage of new antibiotics that can be effective against these new multi-drug resistant bacteria and are concerned.
“There is an urgent need to address the lack of effective treatments to meet the increasing public health burden caused by multidrug-resistant bacteria,” a 2011 National Institutes of Health (NIH) study warned.