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The antimicrobial resistance crisis needs action now

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Re: The antimicrobial resistance crisis needs action now

#101

Post by taeric »

epicureanideal wrote: post #98
hourago wrote: post #81

Earlier quoted context omitted.

> The problem is that cost and risk of development and trials is too large for the current rewards, This kind of invesment has been traditionally done by governments. But with a reduction of taxation governments do not have animore money to do this. And for private companies it makes more sense to spend that kind of money in advertisment than in developing new products. > ensuring good prices or bounties for successf…

> But with a reduction of taxation I’m pretty sure government tax revenue is still at or near all time highs. As the population grows there’s more and more taxes to spend for this purpose. It’s just a matter of priorities.

This feels like a misdirection, though. Revenue may be high, but the same forces that drive this being a trivial statement also mean that expenses are at an all time high.

Re: The antimicrobial resistance crisis needs action now

#102

Post by clnq »

nextos wrote: post #8

We need more research in bacteriophages. They can be engineered to avoid any resistance, and they can replace antibiotics in all use cases. Besides, they are much more selective. Getting antibiotics when needed is OK, but they can lead to other health complications down the road.

Phage therapy is already used in Eastern Europe and Russia. I received phage therapy there myself against an antibiotic-resistant GI infection about 15 years ago. It has been effective. Of course, this is a sample size of 1.

I genuinely believe that ideological and political stigma still stands in the way of phage research and use in the West as it did in the cold war when phages were considered "Soviet". More thoughts on this - https://www.theguardian.com/science/2019/may/09/cold-war-pol....

Soviets, Russian and Georgian scientists did a lot of good work; I'm ashamed to see it shunned in Western medicine when I know it can already be effective and save lives if an industry developed around the medical use of phages. Lives lost to antibiotic resistance in the West will be the price of politicizing science.

More on the normality of clinical phage use in the Soviet Union and Eastern Europe - https://www.tandfonline.com/doi/pdf/10.1586/14789072.2.6.815.

Re: The antimicrobial resistance crisis needs action now

#103

Post by rdedev »

krisoft wrote: post #86
rdedev wrote: post #40

Earlier quoted context omitted.

The problem with phages is that our immune system can recognize them easily and flush them out of the body. It doesn't stick around long enough to do the work. It could work if the dose is massive or if the infection is localized to one specific area. Btw this is what I learnt from reading a blog from someone who has worked with this stuff. I'm not a biologist and it's been a long time since I read that article so I…

> The problem with phages is that our immune system can recognize them easily and flush them out of the body. The problem with phages is that they are finicky to administer. There is no "get this phage and it will kill all bacteria in and around you" treatment. They are specific. This of course has its own benefits too, but makes the process of administering harder. With antibiotics the doctor comes to the conclusion…

The reason I explained in my previous comment deals with the interaction between our body and the phage. A lot of drugs fail in this phase. What works in a cell culture need not work in the body. Even if you find the right phase for your infection it still might not work. All this might be solved with genetic engineering. But there a lot of work to do.

Also as an aside, physics is easier than biology. Once you figure out a solution that works, it always works in the future. The moon is not actively changing its orbit to survive. Bacteria or cancer for that matter always end up finding a way to overcome

Re: The antimicrobial resistance crisis needs action now

#104

Post by unity1001 »

zosima wrote: post #15

I am quite sure, that if a sufficient bounty was given out for developing new kinds of antimicrobials, they'd be developed in no time. The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed. There are very many promising leads though, and either making development cheaper (by requiring smaller or fewer clinica…

> The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed

If that is so, then that research should be done by the state. The well-being of entire human race cannot be tied to monetary incentives of profiteering.

Re: The antimicrobial resistance crisis needs action now

#105

Post by ChrisMarshallNY »

hourago wrote: post #81
zosima wrote: post #15

I am quite sure, that if a sufficient bounty was given out for developing new kinds of antimicrobials, they'd be developed in no time. The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed. There are very many promising leads though, and either making development cheaper (by requiring smaller or fewer clinica…

> The problem is that cost and risk of development and trials is too large for the current rewards, This kind of invesment has been traditionally done by governments. But with a reduction of taxation governments do not have animore money to do this. And for private companies it makes more sense to spend that kind of money in advertisment than in developing new products. > ensuring good prices or bounties for successf…

> Give passionate CEOs money and you get the next big scam.

This has been the case for decades, yet we still seem to have not learned this.

This is my observation, from having seen this happen in a couple of industries, and hearing of it happening in others.

There seems to be a "sweet spot," in new money-making stuff, where real value is produced, rewards are reaped, and scamming is low.

The industry starts off with small-scale passion projects, and relatively low rewards. Virtually no scamming, but also modest financial gains, as the passion-players start to establish the infrastructure.

Then it starts to "catch on," and a more professional approach is applied. The industry starts to scale, and the first folks on the upswing start to make some good money.

Then, after that, the scale goes up exponentially, the quality of the work nosedives, the rewards pile up, and the scamming becomes more prevalent. Many of the originators fall down, because they can't adapt to the new darwinian order.

Eventually, the whole thing becomes so corrupted, that it collapses under its own weight.

Rinse and repeat.

Re: The antimicrobial resistance crisis needs action now

#106

Post by version_five »

unity1001 wrote: post #104
zosima wrote: post #15

I am quite sure, that if a sufficient bounty was given out for developing new kinds of antimicrobials, they'd be developed in no time. The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed. There are very many promising leads though, and either making development cheaper (by requiring smaller or fewer clinica…

> The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed If that is so, then that research should be done by the state. The well-being of entire human race cannot be tied to monetary incentives of profiteering.

What are examples of the state actually achieving a research objective better than free enterprise?

Re: The antimicrobial resistance crisis needs action now

#107

Post by PeterisP »

version_five wrote: post #106
unity1001 wrote: post #104

Earlier quoted context omitted.

> The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed If that is so, then that research should be done by the state. The well-being of entire human race cannot be tied to monetary incentives of profiteering.

What are examples of the state actually achieving a research objective better than free enterprise?

The majority of research advances in medicine have been done with NIH grants and the free enterprise only afterwards did the "productization" of it.

Re: The antimicrobial resistance crisis needs action now

#108

Post by dap »

version_five wrote: post #106
unity1001 wrote: post #104

Earlier quoted context omitted.

> The problem is that cost and risk of development and trials is too large for the current rewards, and hence there is very little new antimicrobials being developed If that is so, then that research should be done by the state. The well-being of entire human race cannot be tied to monetary incentives of profiteering.

What are examples of the state actually achieving a research objective better than free enterprise?

I’m not sure, but what about the space program in the 1960s?

Re: The antimicrobial resistance crisis needs action now

#109

Post by version_five »

dap wrote: post #108
version_five wrote: post #106

Earlier quoted context omitted.

What are examples of the state actually achieving a research objective better than free enterprise?

I’m not sure, but what about the space program in the 1960s?

I thought of that too. I don't know enough about it to know if it's a legit counterpoint. My view is that real competition is necessary to efficiently and effectively get to a solution, versus focusing on the bureaucratic mechanics of running the machine that's supposed to be building the solution, which is what happens when government takes things on.

But the space program, and maybe the Manhattan project, actually had real, credible competition, even if it wasn't economic, so maybe were able to escape the bureaucratic trap. Something less urgent (even if it is on paper) like antibiotic resistance, I'm not convinced presents the kind of competition that would actually substitute for a competitive market.

Re: The antimicrobial resistance crisis needs action now

#110

Post by tormeh »

azinman2 wrote: post #75
lofatdairy wrote: post #17

Earlier quoted context omitted.

This is actually completely right. I believe there's some policy in the works in the US after talking to a friend who's doing some consulting work to help align the Cost-Benefit side of antimicrobial development. I can't say if there's a plethora of drugs just waiting to be released after CT requirements are lowered, but definitely there is less of an R&D incentive currently because pts who take antimicrobials only t…

There’s also pharma world wide. Seems the system is broken if only massive economic upside in the US is what leads to drug discovery and successful clinical trials.

Testing requirements are as high in other rich countries. And existing antibiotics work fine atm. Nobody’s gonna pay to use new ones unless there’s no alternative, both for cost and resistance reasons. So why bother? Might as well postpone development until there’s a real market, right?

I actually think this is good since it means we postpone usage of, and thereby resistance to, any new antibiotics.

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