Hidden pandemic of AMR poses challenge for modern medicine

There is more focus on R&D for cancer drugs compared to antibiotics
| Photo Credit: Getty Images/iStockphoto

A simmering silent pandemic of superbugs that is going on for decades, is causing more havoc than most people realise. “While this is a global story, India is at its epicentre,” Anirban Mahapatra, Scientist, Editorial Director at American Society of Microbiology, whose book “When the drugs don’t work – The hidden pandemic that could end modern medicine” was released earlier this year told The Hindu. “Quarter of antibiotics consumed in the world are in India, and there are annually 300,000 direct deaths attributable to AMR, and superbugs are a factor in 10 lakh additional deaths each year.”

Mr. Mahapatra says that even a single scar can get dangerous as it can develop into a deadly wound if the body does not respond to antibiotics. “We haven’t had any innovative antibiotics developed since the last few decades and we are finding more and more patients with seemingly minor infections going for complicated treatments and surgery; even new born babies are facing infections at a very high rate for which there is no cure,” he says. 

So how did we reach this situation? A lot of early antibiotics were easier to isolate from soil and they have already been found. Also largely, populations have become resistant to these antibiotics. Also, pharmaceutical companies are now investing more in research and development related to anti-cancer medication as compared to antibiotics. 

“There are only 27 drug candidates in clinical development for priority bacteria across the world meant for tackling AMR. Most of these will fail along the way and not get approved in comparison to 1,600 in cancer treatment. Also there are only 3,000 active researchers who focus on AMR resistance worldwide while there are 46,000 dedicated to cancer research,” Mr. Mahapatra explains. 

There is a complete market distortion with how antibiotics are developed and how we value them. “That’s why the pipeline is dry. The government can do more to provide incentives as there is going to be a public benefit to have more of these drugs,” he suggests. 

There is more focus on R&D for cancer drugs compared to antibiotics because as a society we put less value on antibiotics as drugs, even if they are expensive and save your life compared to cancer which might just likely extend your life by a few months. 

This is because, he explains, if a pharma company invests a lot of money in antibiotics — say, it takes 10 years to develop that antibiotic — they normally have a set amount of time before it falls off the patent cliff. Then generics are available as an alternative so they have to recoup R&D expenses within a decade. “So, the problem is that you have to price it very high and it is available for limited people, and the economics of it does not make sense at all,” Mr. Mahapatra adds. 

Even when people suffer from a small sniffle, they prescribe antibiotics themselves, or have a neighbourhood doctor to write a prescription and there should be more stringent enforcement by the government to restrict this. During COVID for instance, seven out of 10 people were given Azithromycin without basis even when they did not have a bacterial co-infection, he says.