Thursday, May 01, 2014

Where's The Next Alexander Fleming*? Or Why Corporations Don't Have Incentives to Create New Antibiotics.

The recent predictions that we are entering a post-antibiotics age, an age where a small scratch can, once again, mean death, must be added to those archives where the environmental end of the world, all those wars based on religion and greed for power etc. also live and procreate.  The "eat, drink and be merry for tomorrow we shall die" archives.

One part of me has that very reaction.  The wiser (or more optimistic) part notes that apocalyptic news and fears are not exactly uncommon in human history and that the proper reaction to such news is to invest resources in combating whatever the direst threats are.

So what are the resources we need to combat the threat that antibiotics will no longer work because of their overuse in "meat production" and in the treatment of human illnesses? 

Research into new antibiotics and into antibiotic resistance.  Here's the problem with the corporate model of such research: 

There have been no new classes of antibiotics for 25 years, he said.
Pharmaceutical companies cannot cover the costs of research and development because new antibiotics have to be used sparingly, for fear of resistance developing – and when that begins, they have a short lifespan. "New antibiotics coming on to the market are not really new," he said. "They are variations of those we already have." That means that bacteria are likely to develop resistance to them that much sooner.

Translated to everyday language:  Governments should put a lot of money into this research**.  The benefits are wide-spread but cannot be captured by profit-making units. 

*Alexander Fleming is credited with the formal introduction of penicillin into our medical cupboards.

**Another reason for governments to address this market of pharmaceuticals is that the use of antibiotics has strong external effects which the market hasn't internalized: My consumption of antibiotics has a direct effect on whatever condition I'm treated for but it also has an indirect effect:  to increase the likelihood that the same antibiotics won't work on some future condition you might develop.  Yet that side-effect does not enter my calculations or the calculations of animal farmers, which means that the use of antibiotics has been higher than would have been socially optimal.

This is similar to the anti-vaccination decisions where parents, say, refuse to vaccinate a child because any side-effects from the vaccination will fall on the child but the protection the vaccine gives to the rest of the society doesn't enter the family's calculations.