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Grassley's panel can help save humanity from superbugs

Des Moines Register logo Des Moines Register 1/16/2020 Patrick Schlievert, Iowa View contributor
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Imagine a loved one develops cancer. Doctors administer chemotherapy — and the tumors start shrinking. But then, she contracts a bacterial infection that even the latest antibiotics can't cure. Within days, she passes away.

Such drug-resistant infections pose a dire threat to cancer patients. They've already become the leading cause of death among leukemia patients in India, according to a recent report. Chemotherapy, which wipes out healthy cells in addition to tumors, makes these patients particularly vulnerable to bacterial and fungal bloodstream infections.

Just as in India, deadly bacteria are spreading to hospitals across America, despite doctors and nurses' best efforts to maintain sterile environments. Unless we develop new medicines capable of wiping out these drug-resistant "superbugs," they could kill millions of Americans.

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According to the Centers for Disease Control and Prevention, infections already result in the greatest health care costs in the United States, and superbugs would cause that price tag to skyrocket.

Creating those new medicines won't be easy. Most large drug companies have shut down their antibiotics research projects. Small biotech companies seeking to fill this space are struggling to stay in business. Developing new superbug treatments just isn't financially viable in today's economy.

If politicians don't intervene to spur additional research, superbugs will continue to threaten American lives. Fortunately, as chairman of the influential Senate Finance Committee, Iowa's Sen. Chuck Grassley is uniquely positioned to lead the fight against superbugs.

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The superbug threat is a problem of our own making. When we use antibiotics, a tiny fraction of bacteria may survive. Those survivors go on to replicate, evolve, and become impervious to previously effective antimicrobials.

Iowans often misuse antimicrobials. We fill more antibiotic prescriptions, on a per-person basis, than residents of all but a handful of states. According to the Centers for Disease Control and Prevention, 30% of antibiotic prescriptions aren't needed.

The overuse of antibiotics helps create ever-stronger superbugs — and if these bacteria and fungi become resistant to existing treatments, we'll revert back to the medical dark ages.

Common ailments like pneumonia would once again become a death sentence. Routine surgeries like hip replacements and cesarean sections would become too risky, since the incisions would inevitably get infected. And cancer-related mortality would soar, since chemotherapy would weaken patients' immune systems and leave them vulnerable to infections.

Researchers say Teixobactin is a promising new antibiotic able to kill some superbugs. © William Fowle, Northeastern University Researchers say Teixobactin is a promising new antibiotic able to kill some superbugs.

Even small cuts could prove fatal.

Despite the severity of this threat, scientists can't attract much funding to develop and commercialize new superbug treatments. Investors know that even if a biotech company creates a new treatment, hospitals will only purchase it in limited quantities, if at all, since doctors quite sensibly reserve the strongest antibiotics for rare emergencies.

Because of these low sales volumes, research companies typically fail to recover their development costs. For example, biotech firm Achaogen received FDA approval for a new antibiotic for resistant infections last year, but filed for bankruptcy this spring.

This dysfunctional market has deterred most investors from funding antibiotic research. Only one new class of antibiotics has been approved since the late 1980s. And as of December 2018, only 39 antibiotics were undergoing clinical trials.

It's up to Congress to correct this market failure.

Senator Grassley can bring the DISARM Act to his committee for a vote — a crucial step toward full Senate passage of this bipartisan bill. The legislation would remove financial barriers so hospitals can use innovative antibiotics when appropriate — thereby boosting patient access to these drugs and encouraging biotech companies to develop more of them. These incentives would only go to hospitals that implement stewardship programs, which guard against antibiotic overuse and overprescription.

Lawmakers could also offer "market entry rewards" to biotech firms. One expert panel created by the British government has proposed offering significant cash rewards to any firm that develops a new antibiotic that addresses an unmet medical need. Such rewards would offset companies' research costs and encourage them to invest in antibiotics.

That may seem like a lot to pay, but the price of inaction is far greater. The Organization for Economic Cooperation and Development estimates that superbugs could cost the U.S. health care system $65 billion annually by 2050.

Drug-resistant superbugs threaten our modern way of life. If lawmakers don't help scientists develop new treatments, millions of Americans could be at risk.

Patrick Schlievert, Ph.D., is a professor of microbiology and immunology and a professor of internal medicine at the University of Iowa's Carver College of Medicine. He is also co-founder and chief scientific officer of Hennepin Life Sciences.  

This article originally appeared on Des Moines Register: Grassley's panel can help save humanity from superbugs

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