Millions Miss Out on Antibiotics in Echo of Vaccine Inequity

(Bloomberg) -- Efforts to widen access to antibiotics and reduce the threat of superbugs are running into the same problems that have kept Covid vaccines out of reach in many lower-income nations, a report shows.

Only a third of vital antibiotics and antifungals have strategies or licensing agreements to expand their availability, according to the Access to Medicine Foundation, based in Amsterdam. That’s limiting supplies in regions where the risk of drug-resistant infections is highest.

Drug-resistance already kills hundreds of thousands of people each year, putting health systems all over the world at risk, and health officials warn the death toll could explode to millions a year without any action. The threat is seen as a “silent pandemic” that could create a bigger health crisis than Covid. 

“We’re going to repeat this inequity problem we had in Covid in this space,” Jayasree Iyer, executive director of the foundation, said in an interview. “So what are we really doing to stop the next pandemic?”

Pharma companies launched a $1 billion fund in 2020 to develop antibiotics, a field many retreated from in recent years. Drugmakers are also making some progress as they advance with vaccines for drug-resistant gonorrhea and E. coli, among other products, according to the 2021 Antimicrobial Resistance Benchmark, which evaluated 17 of the world’s largest drugmakers. 

Pfizer Inc. has made the biggest recent gains, expanding its research and development pipeline even as it focuses on Covid vaccines.

The overall industry pipeline remains small, however. The report identified 92 projects at eight large pharma companies targeting infections caused by bacteria and fungi that pose the biggest risk of drug resistance, with GlaxoSmithKline Plc leading the way. That’s up from 77 projects in 2020.

Some companies are making strides in other ways, transferring technology to manufacturing sites in countries including Pakistan, Brazil and Nigeria, according to the foundation. The industry is also getting better at curbing the release of antibiotic waste into the environment, in some cases by enforcing standards with ingredient suppliers, it said.

The report underscores the need for companies to increase efforts to boost access in lower-income regions, the foundation said. Possible steps include registering products in local markets, tiered pricing, voluntary licensing agreements and public-private partnerships.

“Unavailability of suitable antibiotics has a huge toll on those directly affected, but is also a hazard for the world because doctors often resort to suboptimal treatments when the right medicines are unavailable,” the report said. “This gives pathogens an opportunity to develop resistance.”

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