[...] A piece of legislation lined up for a vote in Congress, called the Pasteur Act (named both for the 19th-century microbiologist and to stand for Pioneering Antimicrobial Subscriptions to End Upsurging Resistance), could repopulate that empty landscape by guaranteeing government funds to help a small number of new antibiotics make it to market. The proposal has bipartisan support in both the House and Senate, is backed by the Department of Health and Human Services (HHS), was implicitly endorsed in the last White House budget, and resembles programs already implemented in other countries.
[...] "If this doesn't pass, or something like it doesn't get implemented, then I don't know what Plan B is," says Joe Larsen, a vice president at Locus Biosciences Inc. who launched an Obama–era program of antibiotic investment while serving in the US government's Biomedical Advanced Research Development Authority. "We need to re-envision the way we support antimicrobials in the US."
That patients might run out of effective antibiotics is a jarring thought. The Centers for Disease Control and Prevention estimates that antibiotic-resistant infections already kill more than 48,000 Americans each year and sicken 2.8 million. A January study in The Lancet estimated the annual global death toll at 1.27 million. Antibiotic resistance got worse during the pandemic as health care workers tried to protect Covid patients from bacterial infections, not just in individual outbreaks in hospitals but across the US.
[...] Lacking enough income to balance their expenditures, the big companies left the field to small biotechs. These new players believe in the mission, but typically don't have income from other product lines to buoy them while they wait for sales. Since 2010, the makers of five out of 15 new antibiotics approved by the FDA have folded or sold themselves at auction because they could not outlast the lag between approval and earnings. A sixth company backed off an antibiotic in Phase 3 trials in May and laid off three-fourths of its staff. A seventh reorganized itself just last month.