In Washington, Republicans and Democrats are typically at loggerheads when it comes to healthcare policy. Just consider the recent Inflation Reduction Act, which made extensive changes to Medicare and also extended Affordable Care Act subsidies. Every single congressional Democrat voted for the legislation, while every single member of the GOP voted against it.
But occasionally, a bill is such an obviously good idea, and so desperately needed, that it commands significant bipartisan support. The PASTEUR Act, co-sponsored by 31 Democrats and 31 Republicans in the House and two members of each party in the Senate, is just such a bill. It would help tackle one of the most terrifying public health threats of our time — the increasing prevalence of drug-resistant bacteria, viruses, fungi, and parasites.
These “superbugs” already kill tens of thousands of Americans a year, of all races, occupations, and political persuasions. Superbugs can turn routine surgeries and minor injuries into life-threatening events, since an untreatable infection can quickly prove lethal. They make medical advances such as organ transplantation and immune suppression drugs for cancer and autoimmune disease extremely risky. And they pose a massive barrier to healthy aging for all, including and especially older adults at high risk, even as we celebrate the UN Decade of Healthy Ageing.
Left unchecked, superbugs could effectively end modern medicine as we know it.
The PASTEUR Act seeks to prevent such a catastrophe by strengthening antibiotic stewardship programs and jumpstarting antibiotic discovery.
Strong antibiotic stewardship programs can help reduce inappropriate antibiotic use and thus slow the development of drug-resistant pathogens. As a recent CDCreport shows, many such programs were stretched to the limit during the pandemic, as members of stewardship teams were reassigned to emergency COVID response roles or outright furloughed.
With insufficient staffing and oversight, many institutions experienced greater antibiotic use due to COVID-19. From March 2020 to October 2020, nearly 80% of patients hospitalized for the coronavirus received antibiotics, even though very few had concurrent bacterial infections. And overall, the first year of the pandemic led to a 15% increase in hospital-onset AMR infections and deaths.
The increasing overuse of antibiotics gives bacteria more chances to mutate into drug-resistant strains, thus accelerating the spread of superbugs.
Yet despite the urgent need for more and better antibiotics, the market incentives to invent these new drugs simply do not exist. No new class of antibiotics has been approved in 35 years. It should not be surprising that with these powerful and visible signals, private investors are not to taking on the immense costs of making the investments that average well over $1 billion for a single medication.
In the first-ever AMR Preparedness Index, a data-driven assessment of the top 11 economies in the world released by our organizations, the United States ranked second. But this relatively rosy ranking obscures the fact that none of our peers are well-prepared on AMR: we earned the number two spot with barely a passing a grade, earning 68 out of 100 points across a robust lineup of metrics. In the category of Innovation, the United States performed even worse, at just 52 out of 100.
The result has already been deadly. And will only get worse. AMR kills at least 35,000 Americans each year and generates more than $4.6 billion in health care costs. According to a recent report from Lancet, the global AMR toll is 1.27 million deaths annually. By 2050, it’s projected AMR could claim as many as 10 million lives each year worldwide, far outpacing the human impact of the COVID-19 pandemic — with a cost to global prosperity equivalent every year to that of the 2008 financial crisis.
Thankfully, we know how to beat AMR. We just need the political will and global cooperation. The U.S. can take the lead with the PASTEUR Act.
First, the legislation would help to reduce unnecessary use of antibiotics. By doing so, we can extend the life-saving value of the antibiotics we already have and buy time to produce new ones. The PASTEUR Act would establish a grant system for hospital antibiotic stewardship. These hospital programs will not only help fight AMR now, but also establish the human infrastructure necessary to tackle the next pandemic.
Second, the bill would create an antibiotic “subscription” financing model, with an upfront payment for new antibiotics, rather than linking reimbursement to the total volume of drug sales. This novel approach is necessary because antibiotics must be used judiciously to preserve their effectiveness. Revenue linked to sales volume fails to provide sufficient return on investment. A subscription model would harness the innovative power of the U.S. biopharmaceutical industry.
Third, passing the PASTEUR Act will itself raise the profile of AMR as a critical public health priority. We need a society-wide effort — indeed, a global effort — to improve surveillance, expand training for providers and increase support for education and awareness campaigns — exactly as President Biden has proposed in his 2023 budget request to Congress.
We have seen that American innovation and U.S. leadership can drive rapid progress on even the toughest challenges. It’s time to direct these strengths to AMR by passing the PASTEUR Act.
Dr. Emily Spivak is a Fellow of the Infectious Diseases Society of America (IDSA) and serves as Chair of the IDSA Antimicrobial Resistance Committee. She established and serves as Co-Director of the Antimicrobial Stewardship Programs at University of Utah Health and the Salt Lake City Veterans Affairs Healthcare System. Michael Hodin, Ph.D. is CEO of the Global Coalition on Aging.
Source: International Business Times