The next pandemic is already here. Covide can teach us how to stop.

In the first decades after the introduction of penicillin, bacterial adaptations and drug discoveries jumped into each other, while maintaining the ability of antibiotics to treat infections in the face of their ability to prevent pathogens. But in the 1970s, mid-century innovation exploded. Antibiotics are difficult to make: medications are not toxic to humans, but deadly bacteria, and they need to use mechanisms that have not yet developed defenses for dangerous bacteria. But switching from antibiotics produced in nature to synthesizing compounds in the laboratory was even harder.

The resistance, however, advanced. Excessive use in medicine, agriculture and aquaculture spread antibiotics to the environment and allowed microbes to adapt. Between 2000 and 2015, the use of antibiotics stored for the most deadly infections almost doubled worldwide. Levels of resistance vary by organism, medication, and location, but the most comprehensive report to date, Published June 2021 The WHO shows how quickly the situation has changed. Among the strains of bacteria that cause urinary tract infections, one of the most common health problems on the planet, some in some countries were resistant to a common antibiotic up to 90%; more than 65% of bacteria that cause bloodstream infections and more than 30% of bacteria that cause pneumonia also suffer from one or more treatments. If gonorrhea is left untreated when infertility is an easily curable infection, resistance to all the drugs used against it quickly develops.

At the same time, resistance factors – genes that control the ability of bacteria to protect themselves – are traveling around the world. In 2008, a man of Indian descent was diagnosed in a Swedish hospital with a set of bacteria carrying a set of genes to fight almost all antibiotics. In 2015, British and Chinese researchers identified a genetic element in pigs, pig markets, and patients in Chinese hospitals that allowed bacteria to dissolve a drug called colistin, known as a last-resort antibiotic, for its ability to fight the worst superheroes. These two elements, which hitchhike from one bacterium to another, have since spread around the world.

Faced with the difficult economy of drug development, antibiotic research has not continued on its own. In March, the Pew Charitable Trusts evaluated the global pipeline for new antibiotic compounds. The team found 43 somewhere in preclinical or clinical research, determined that only 13 were in Phase 3, that only two-thirds of them would be able to obtain licenses, and none had a molecular architecture to work against pathogens. are the most difficult to treat.

Warp speed lessons

So what would Operation Warp Speed ​​look like to achieve antibiotic resistance?

The antibiotic pipeline needs a boost in several key areas: basic research, test design, and post-approval incentives. Fortunately, the global response to the shields set a precedent for all three.

The first step would be to contribute to long-term basic research. Modern and Pfizer-BioNTech vaccines were ready to go less than a year after human infections were first recognized. This readiness has come from 10 years of basic research, regardless of specific disease. Once the shield appeared, Warp Speed ​​brought the Moderna vaccine to the finish line with additional funding for research. (Pfizer did not receive research support from Warp Speed, but both companies obtained funding for manufacturing and production).