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By Dr. Nadine Rouphael

nroupha@emory.edu

As an infectious disease doctor at Emory University, the COVID-19 pandemic has commanded much of my attention the past two years. But that doesn’t mean I’ve forgotten about the threat that is rapidly becoming the next global health crisis: superbugs.

In mid-January, University of Georgia researchers studying local wastewater detected a gene that causes bacteria to become resistant to a “last resort” antibiotic.

The discovery is the latest evidence indicating how widespread antimicrobial resistance has become. AMR occurs when bacteria and fungi evolve to resist the medicines used to treat them. That should concern Georgians — and drive lawmakers to take action.

Drug-resistant superbugs render antibiotics ineffective and make previously treatable infections life-threatening. That’s already happening in Georgia. Cases of a drug-resistant bacterium known as MRSA increased by more than 15% between 2019 and 2020. A drug-resistant fungus that’s deadly in one-third of patients made headlines in 2019 after it appeared in the state.

Superbugs played a role in nearly 5 million deaths across the globe in 2019 and killed more than 1.2 million people. That’s nearly double previous estimates.

We need new antibiotics to reverse the course of this crisis. Unfortunately, we aren’t developing nearly enough. The U.S. Food and Drug Administration has approved just one antibiotic with a novel target in the last 35 years.

That’s mostly due to the unique nature of antibiotics. These medications are essential for treating common ailments like urinary tract infections and preventing infections after routine surgeries. But because antimicrobial medicines could speed up resistance each time they’re used, they must be used sparingly and only when critically needed.

These dynamics make funding antibiotic development particularly challenging since the drugs aren’t sold in a high enough quantity to deliver a sufficient return on investment. Large companies have exited the sector. Startups responsible for the lion’s share of antibacterial research raised funding well below industry averages over the last decade.

We must work on solutions. During the pandemic, public and private investors recognized the seriousness of the moment and poured in the necessary investments to facilitate record-breaking vaccine development.

Addressing the superbug crisis requires a similar level of support and investment.

Thankfully, members of Congress are working on providing it. Georgia’s own Rep. Drew Ferguson (R-GA) is a lead sponsor of the bipartisan, bicameral PASTEUR Act, which would institute a subscription-style model for certain antimicrobials. Just as Netflix subscribers pay a flat fee to stream as little or as much content as they want, the government would pay developers a set amount up front for access to novel antimicrobials. By providing a reasonable, guaranteed return on investment, it would enable antimicrobial makers to continue the development of new treatments.

Superbugs are already in Georgia hospitals and homes. Now is the time to recognize the seriousness of the threat they pose to our health — and advance policy solutions to support antimicrobial development.

Nadine Rouphael, MD, is an infectious diseases doctor, professor of medicine at Emory University School of Medicine and executive director of the Hope Clinic at Emory Vaccine Center. 

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