Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them by Brad Spellberg
Infectious Disease in the United States
The three top infectious causes of death in the United states are: sepsis, influenza and pneumonia. Each year, more Americans die of MRSA (Methicillin-resistant Staphylococcus aureus) infections than die of AIDS. MRSA was originally only a hospital-acquired infection, but now it is more often community acquired. Besides MRSA, there are also many other antibiotic-resistant bacteria: Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae.
Even if hospitals greatly improve their hygiene, and physicians stop over-prescribing antibiotics, there would still be many hospital acquired infections. The reason is that bugs crawl into patients on their catheters, plus their skin is broken during surgery. Also, chemotherapy weakens the immune system and makes patients more susceptible to infection.
Not Much Money in Antibiotics
Pharmaceutical companies are reluctant to spend money on a drug that the patient will take only for a couple weeks. In contrast, blood pressure medications and statins are taken every day for decades.
Don’t Look to Academia for Antibiotics
The author points out that it is not sufficient to fund academic laboratories conducting basic research, because no academic laboratory has ever developed an antibiotic. Only pharmaceutical companies have developed antibiotics. Many foreign drug companies sell their drugs for a ot less than American drug companies, because the foreign drug companies have only manufacturing costs, not research and development costs. Most foreign companies piggy back on American research. After the European Union instituted pharmaceutical price controls, European drug development declined.
The author gives details about Project Bioshield, where the government spent a large sum of money developing a new vaccine for smallpox, even though smallpox had already been eradicated from the face of the earth.
The Hollis-Eden pharmaceutical company was promised a large order for its radiation-poisoning steroid drug Neumune by the U.S. federal government, which reneged on the deal after the drug was developed.
Changing the Rules in the Middle of the Game
The author describes the case of the Oscient biotechnology company and its sinusitis drug gemifloxacin, where the FDA changed its rules for clinical trials in the middle of the game, that is, while the clinical trials are being run.
During the 2001 anthrax scare, the United States government threatened to revoke the German Bayer company’s patent on ciprofloxacin if it did not cut the price in half. Bayer was accused of profiting from people’s suffering. But, to my thinking, Bayer should be criticized only if it created the problem it is attempting to solve. Bayer did not give anyone anthrax.
Irrational Mistrust of Big Pharma
The author is critical of the widespread dislike of pharmaceutical companies for irrational, emotional reasons. Those of us on the political Right are willing to admit that the people running large corporations are motivated more by profits than by compassion. But politicians and government officials are no more moral. They just pretend to be.
Lessons from the Orphan Drug Act
The author suggests that for antibiotic development we pursue something similar to the Orphan Drug Act for rare diseases. For individuals, the author recommends lots of hand washing, avoiding being admitted to the hospital, and, if admitted, keeping your stay short.