In the twenty years too late is better than nothing department, the antibiotic crisis is squarely in the news today after President Obama issued an executive order that will establish a new inter-agency task force for the sole purpose of developing a national strategy to combat antibiotic-resistant bacteria.
ACSH s Dr. Josh Bloom, a former researcher in the antibiotic field says, This is just fine and dandy. Anything that addresses this terrible problem is welcome news. But what you are not reading is perhaps the most important reason that we are in this mess our own government. Specifically, the FDA.
Dr. Bloom has written numerous times about the folly of a change in the FDA s clinical trial requirements in the 1990s, which has perhaps contributed more than anything else to the crisis that we are now facing. His 2012 New York Post op-ed, entitled The Coming Gonorrhea Epidemic discusses how these new rules, which would require much larger clinical trials, resulted in drug companies dropping out of the area en masse, leaving a 20 year hole in the antibiotic pipeline.
Perhaps no one knows this better than ACSH advisor Dr. David Shlaes. Shlaes, the former head of infectious disease research at Wyeth, spent countless hours talking with and lobbying the FDA about what they were doing and the unforeseen consequences that would arise from their policy change. (We encourage you to watch today s interview with Dr. Shlaes.)
What is rather disturbing, says Dr. Bloom, is that the solutions to this problem mostly miss the mark.
This is perhaps best illustrated by Dr. Jesse Goodman, director of the Center on Medical Product Access at Georgetown University Medical Center, who says antibiotic resistance is one of the most pressing global public health threats.
Dr. Goodman says, "Success will require a sea change. Doctors, farmers and agribusiness, health systems and the public all need to think totally differently about antibiotics. They are precious resources and we must reduce their inappropriate use. Better diagnosis and stronger infection control practices can make a big difference right now.
To which Dr. Bloom says, Notice that he does not say ONE WORD about the only way out of this mess new drug discovery. Unfortunately, this mentality is pervasive. People think that if we use antibiotics more carefully or remove them from livestock feed that this problem will magically go away. I hate to break it to them and to you, since this threat may face any one of us at any time but this is like polishing the doorknobs on the Titanic. The bugs are already resistant, and no matter what safeguards are put in place, they will remain resistant. In the absence of new antibiotics this problem will continue to plague us.
For the guts of the story, we encourage you to read Dr. Shlaes blog Antibiotics, the Perfect Storm. In particular, see today s post entitled PCAST and Antibiotics - Show me the Money!, where he discusses the President s Council of Advisors on Science and Technology (PCAST) the gist of the Obama directive.