A stealthy public health threat looms and California Isn’t ready

Although the COVID-19 pandemic was, for many, a wake-up call about the spread of infectious disease and the threat of related bacterial infections, California’s infectious disease doctors, scientists, and other health care professionals were all too aware of the potentially fatal consequences.

Unfortunately, even as we navigate out of COVID, an under-the-radar but urgent threat looms: the declining efficacy of the antibiotics we use to treat a broad range of infections.

Antimicrobial resistance occurs when bacteria defeat the very drugs developed to kill them, which allows the germs to grow stronger and spread. When bacteria become resistant to multiple antibiotics, they are often called “superbugs.” Superbugs and other infections that become resistant to antibiotics can be difficult – or even impossible – to treat and control. The high use of antibiotics during COVID-19 has only made matters worse.

The CDC estimated that the cost of antimicrobial resistance is $55 billion every year in the United States.

According to the U.S. Centers for Disease Control and Prevention (CDC), antimicrobial resistance is an “urgent global public health threat” responsible for more than 2.8 million infections and more than 35,000 deaths in the U.S. every year.

Among Californians, this translates to roughly 360,000 illnesses and nearly 4,500 deaths. The CDC estimated that the cost of antimicrobial resistance is $55 billion every year in the United States, including a loss of $20 billion in health care-related costs and about $35 billion in productivity losses.

One barrier that stands in the way of effectively combating antimicrobial resistance is the nature of the antibiotics market. Most antibiotics are older generic drugs, which makes them more affordable and accessible to those who need them, but which also means that fewer manufacturers invest in making them. As these antibiotics become weaker over time, there aren’t sufficient new antibiotics coming to market to supplement our defenses.

Novel antibiotics are needed to target pathogens that are resistant to current antibiotics. But without additional incentives for manufacturers to invest in research and development of new antibiotics, companies – including many of the small and invocative life sciences companies based here in California – will lack the capital necessary to bring new products to market.

The PASTEUR Act would, in effect, create a situation where developers wouldn’t have to wait for market demand to create new antibiotics.

Fortunately, there is a solution that California’s lawmakers can prioritize right now to help address the growing threat of antimicrobial resistance.

The Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act is bipartisan legislation which aims to incentivize drug makers to develop new antibiotics. The legislation would set up a reimbursement pathway through which antibiotic developers are paid upfront for use of their drugs, as opposed to the current pay-per-use model.

The PASTEUR Act would, in effect, create a situation where developers wouldn’t have to wait for market demand to create new antibiotics. The bill would also require the U.S. Department of Health and Human Services (HHS) to create antimicrobial development advisory committees and establish an antibiotic use program at hospitals and health care facilities.

It is critical that we learn lessons from COVID-19 to help prepare for the next pandemic and for tomorrow’s public health threats. I urge California’s lawmakers to support – and for Congress to immediately pass – the PASTEUR Act to help increase the tools we have at our disposal to combat these threats.
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Editor’s Note: Larry Bottorff, MBA, BSN, RN, CIC is executive director of the Infectious Disease Association of California. He resides in Orange County, Calif.