By Raj Topiwala
Alexander Fleming’s discovery of Penicillin in 1928 is undoubtedly one of history’s crowning achievements in medicine. In the 89 years that have since followed, antibiotics have saved countless lives and reduced once fatal maladies to easily treatable diseases. However, with the list of antimicrobial resistant pathogens growing at an alarming rate, we risk soon encountering diseases that are resistant to every available method of treatment, regressing us back into the pre-antibiotic age (and its diminished life outcomes).
With that in mind, one would expect research and development (R&D) into antimicrobial resistance (AMR) to be a major objective in the pharmaceutical industry. However, it turns out that AMR innovation is a rather unattractive option for pharmaceutical firms. Because patents for new pharmaceuticals expire quickly, there is a narrow window of time for firms to make up the massive costs of R&D and turn a profit, a near-impossible task for new antibiotics. With the plethora of inexpensive generics already on the market, why would a consumer choose the new expensive antibiotic when they could get a generic for nearly free? To offset this lack of profitability, a prize-system that rewards new AMR innovation has been proposed. In searching for a way to fund the prize, I propose we focus our gaze on what is arguably the biggest contributor to AMR there is: the agriculture industry.
The largest consumer – and waster – of antibiotics is the agriculture industry. More drugs are used for animals that produce food than the people that eat them (CDC, 2013) and an estimated 75-90% of antibiotics used in feed is excreted from livestock completely unmetabolized (O’neil 2016). The industry is routinely exposing pathogens to antibiotics without killing them – directly fostering the development of drug resistance. Taxing this practice presents a win-win scenario for the health sector. If the industry opts to continue using antibiotics at such
a dangerous rate, the tax revenue generated would be more than sufficient to fund the prize. If instead, the industry responds to the tax by decreasing antibiotic use in feed, then an entirely different, but equally beneficial, victory in reducing the dangerous practice will have been achieved. On some level, it is fitting to have the very practices that are creating AMR enable to solving of it. Though the agriculture industry is clearly unequipped to “clean up their own mess” in this case, having them pay for the AMR prize comes in at a close second – one that is both feasible and effective.
CDC: Centers for Disease Control and Prevention. (2013). Antibiotic / Antimicrobial Resistance. Retrieved November 19, 2017, from https://www.cdc.gov/drugresistance/threat-report-2013/index.html
O’Neil, J. (May 2016). Tackling Drug-Resistant Infections Globally: Final Report and Recommendations. The Review on Antimicrobial Resistance.