Can't answer this particular question. But I remember hearing that developing new antibiotics is not very profitable - To minimize resistance building against new antibiotics, old antibiotics will be used until they are no longer working. So new antibiotics just won't sell that much for now.
About 1/8 of global deaths are due to some sort of bacterial infection, pretty close behind cancer ( 1/6 ).
However for children the number that die of infection in the UK is double that of cancer deaths - ( ~15% versus ~7% ) - and that's in an advanced economy.
Infection is a big problem.
In terms of barriers to making treatments - yes in part there is a problem with the right financial incentives - but it's not the only problem - finding molecules that simultaneously kill bacteria, won't be rapidly evolved around, and are safe to take isn't that easy. Then you have the problem of selectivity between bacteria - how many different sorts will it work with - 'good' verus 'bad' bacteria etc. Then you have the problem of being able to make the molecule at scale etc.
The good news is there is a constant bacteria on bacteria, fungus on bacteria chemical war going on - hence the paper.
> ( ~15% versus ~7% ) - and that's in an advanced economy.
There were 1,507 infection related child deaths between 1 April 2019 and 31 March 2022 (3 years); an overall rate of 4.20 deaths per 100,000 children per year. This was the equivalent of 15% of all child deaths in this period.
Overall, in 90% of the infection related deaths the child had an underlying health condition, including 68% who had a life-limiting condition (e.g., cerebral palsy), and 22% who had another underlying health condition (including prematurity). 10% had no underlying health condition.
In children where infection provided a complete and sufficient explanation of death, nearly a quarter (24%) had no underlying health condition.
We could definitely do more - one of the challenges here is that some bacteria are quite picky about where they grow - ie there a lots that don't grow on a petri dish. So not always so easy to grow side by side.
Note from the paper - they stored the soil samples for a year on growth media before testing ( to allow any compunds to build up presumably ). That doesn't sound like a fast process.
Our knowledge of what's out there is quite biased by what grows well in the lab - probably less than 1% of all bacteria will grow on an agar plate.
It’s because antibiotic resistance is a misunderstood issue. If one antibiotic doesn’t work, you move on to the next. Maintaining antibiotic resistance is energetically costly to the bacteria. If you aren’t actively selecting with that antibiotic, its resistance will be lost before long as mutants with deficient antibiotic resistance are now more fit and outcompete those with functional antibiotic resistance.
I read a fascinating paper around a decade ago that proposed, roughly speaking, to cycle through the limited set of different antibiotics that we have available in some careful order, so that as far as possible, only 1-2 are in use at any one time, ideally around the world. As soon as resistance against the incumbent antibiotic grows past a certain level, it is "benched" and replaced with the next in the sequence, with the goal being that, by the time that all other antibiotics in the sequence have been used and it's time to revisit the original one, the stresses placed on the bacterial population by the other antibiotics in the meantime have been sufficient to completely eliminate resistance to the original. This would mean that resistance to the original antibiotic the second time around would have to develop "the hard way", i.e., via novel mutations (rather than reactivation of alleles still present in the population), thus maximising the period for which it will remain effective.
Massive practical coordination problems, but I find the idea of consciously exploiting this "time dimension" really interesting.
Same goes for chemo therapy. There are many chemo therapies from 60s still being used due to the fact their patent is still owned by certain oligarchy.
> their patent is still owned by certain oligarchy.
I don’t know that it’s helpful to have such a blunt and un-nuanced take.
Theres no “certain oligarchy” that holds a single patent on "chemotherapy" as a broad concept, as it encompasses various chemical treatments for cancer. specific chemotherapy drugs and methods are patented by pharmaceutical companies and research institutions, for example:
- NanOlogy LLC: holds a patent for a method involving injecting large surface area microparticle taxanes directly into the tumor, combined with systemic delivery of immunotherapeutic agents.
- Johns Hopkins University: assigned patent rights for a method related to cancer treatment to Becton-Dickinson & Company, which then sublicensed them to Baxter.
- University of Cincinnati Clermont College: has a patent for breakthrough chemotherapy technology involving nanocarriers.
- Northeastern University: reports a patented molecule, WYC-209, that eliminates cancer cells.
It's like the claim that pharma had tripled the price of a 100 year old drug(insulin) that the inventors had sold for only $1 and were now charging $450 a month for it.
Then you dig into the claims and you find out that, the original insulin is still available, it's new formulations that have the higher cost.
>Until now, the only so-called “Walmart insulin” you could get for a lower price (roughly $25 to $35 per vial) was the older, human versions of insulin — R (or Regular) insulin, N (which is Novolin, aka NPH insulin); and a 70/30 mix of the two other types. Those formulations have been around since the early 1980s, but they work much differently and are seen as much less reliable than the analog insulins that first started appearing in the later 1990s.
https://www.healthline.com/diabetesmine/walmart-relion-novol...
But the new stuff works better, is faster acting and allows a freer lifestyle.
I agree that there is a problem with the pharma industry but lying about the problem to try and get change is not going to help the cause.
Outright "communist" states like Cuba and Venezuela no longer have sponsors, and are sanctioned by the US, so they're exempt from having to prove that their economies could conceivably generate any innovation.
Right-wing "post-democratic" states like Russia and Hungary are, by some definition, capitalist, but you see no innovation there either. Presumably someone if not you could blame America for them being unable to innovate. One could equally say that their markets aren't free, because they're fully captured and manipulated by their respective mafia/oligarchies.
Ahem. Just like the so-called communist countries are.
Then of course there's China. Where capitalism is also a plaything of the governing power. Similarly, no major drug developments have come out of there. Although we did have a fantastic example recently of how not to manage a biolab doing gain of function research.
Pray tell, which countries without free markets do anything at all? I'm not holding my breath for North Korea to cure cancer, no matter how much of their GDP is spent trying to keep their Dear Leader alive.
Blaming difficulty of problems on capitalism alone is disingenuous. There are huge scientific projects that are not profitable and still done because there is a somehow clearer path forward (ex: UKBioBank, CERN, ITER).
When I hear "{x} is not very profitable" I think people mean "we are not sure if we succeed doing {x} and it requires us to divert lots of resources from other things that we think would be more useful".
Pharma companies invest already huge amounts in drugs and many fail anyhow. Quote: "It takes 10 to 15 years and around US$1 billion to develop one successful drug. Despite these significant investments in time and money, 90% of drug candidates in clinical trials fail." (https://www.asbmb.org/asbmb-today/opinions/031222/90-of-drug...)
That quote itself seems to be disingenuous, conflating "one successful drug" which costs $1B with "drug candidates in clinical trials." Even more so when taken from context, as the next sentence in the article is
> Whether because they don’t adequately treat the condition they’re meant to target or the side effects are too strong, many drug candidates never advance to the approval stage.
And that doesn't sound "successful" at all. How much money is sunk into R&D at the point of failure is the much more relevant statistic to consider. If the pharmaceutical industry wasn't wildly profitable, they'd be investing those billions elsewhere, leaving drugs to a slow-cooking niche.
There is no claim that each drug costs 1$ billion. If you stop after 1-2 years of development you might have wasted some millions, if you stop after 3-4 years you wasted tens of millions and so on. The 10% success is still very low, because you can still fail after 10 years (potentially investing a lot)
If you are interested in the topic, for example for oncology: https://jamanetwork.com/journals/jamanetworkopen/fullarticle... , to quote "Failed drug development in oncology incurs substantial expense. At an industry level, an estimated $50 billion to $60 billion is spent annually on failed oncology trials."
There is no "oracle" that says invest 50 million (or 100 million or 1 billion) in X or Y and it will succeed (in pharma or other domains). And this is not exclusively because of capitalism, it is because doing some things is hard.
