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What will it take for Congress to up the ante for antibiotics?

The Hill logo The Hill 6/23/2022 Mary Dwight, opinion contributor
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This month marks one year since the reintroduction of The Pioneering Antimicrobial Subscriptions To End Upsurging Resistance (PASTEUR) Act which fills a critical gap in our national and global healthecosystem by providing a mechanism to encourage biotech companies big and small to return to the long-abandoned business of antibiotic development. We are pleased to see growing support from both Democrats and Republicans for its innovative subscription model approach of paying for novel antibiotics based on value rather than volume. Yet, we don’t have time to wait for action. The very real threat of increasing antibiotic resistance makes the PASTEUR Act “must pass” legislation this year. Congress needs to up the ante and pass the PASTEUR Act

While most of us are fortunate enough to be able to treat infections with a quick course of oral antibiotics, the stakes could not be higher for individuals dealing with antibiotic resistance; this includes immunocompromised individuals, young children, athletes, individuals who recently gave birth, and those who live in hospital or nursing home environments. An increasing number of bacteria are resistant to antibiotics, potentially placing us on course for another pandemic that, unlike the current one we live in, is preventable if we prioritize rebuilding the antibiotics pipeline.    

People with cystic fibrosis (CF) face a heightened vulnerability to infections because of the persistent mucus in their lungs, which requires routine use of antibiotics as part of their CF care. And, as a result of this medically necessary treatment, many people with CF find themselves battling difficult-to-treat infections for which existing antibiotics are not effective.  One example of this is MRSA, a dangerous type of infection that is increasingly resistant to antibiotics which will affect one quarter of people living with CF in the United States each year (the median age of infection being 11 years old).   

One 19-year-old woman living with CF in New Jersey today has cultured MRSA as long as she can remember, however she can only count two antibiotics that have made a difference against this dangerous infection. As a child, she routinely took these antibiotics, which usually were enough to rebound her back to her baseline lung function before the infection. But with the routine use of these drugs came waning effectiveness. When she turned 16, those final two antibiotics no longer worked. She got very sick, leading to an elongated hospital stay that caused her to miss school. With no remaining treatments, the MRSA continues to threaten her health and her future. The PASTEUR Act can change this.  

Antibiotics are a hallmark of modern medicine, ensuring our safety in activities ranging from surgeries to having a baby, or playing high school sports. Yet we are watching their efficacy fade rapidly in real time because Congress won’t prioritize revitalizing this essential tool for all of our health by passing the PASTEUR Act.  

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At the Cystic Fibrosis Foundation, we invest in research to accelerate the development of new antibiotics. Our Infection Research Initiative is a comprehensive approach to improve outcomes associated with infection, including enhancing detection, diagnosis, prevention, and treatment that also has the potential to benefit the broader public. Three of the seven most common infections in people with CF — caused by Aspergillus, MRSA, and Pseudomonas — are part of the Center of Disease Control’s Watch List.   

The Foundation represents less than 1 percent of the American population, and we have spent $109 million in three years to address this issue. However, this crisis will not be solved with one organization’s funding. We are doing our part to develop new tools to combat infections, but research investment alone will not solve these challenges — we need Congress to do its part. 

CF is a rare disease, but in the case of antibiotic-resistant infections, people with CF face challenges today that a larger population is at risk for facing tomorrow if we do not continue to manage this issue and develop new antibiotics. Products in the antibiotics pipeline need to be supported by a robust ecosystem of incentives to combat the low market, high societal value of these goods. That’s where the PASTEUR Act comes in. We know just how high the stakes are if the PASTEUR Act does not pass.   

This week, nearly 70 teens who have CF or love someone with the disease are meeting with their members of Congress to urge action, especially on passing the PASTEUR Act. These teens are well-versed in what life is like when there is an increased risk of antibiotic-resistant infections.  

The question they are asking Congress, what we are all asking is this: Will Congress up the ante for antibiotics? 

Mary Dwight is senior vice president, chief policy and advocacy officer at the Cystic Fibrosis Foundation.  

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