Superb Book To Read & Share: “Superbugs, An Arms Race Against Bacteria”

Dear All:

I would like to draw your attention to a superb new book by William Hall, Anthony McDonnell, and Jim O’Neill. The names of the authors may be familiar as Jim O’Neill chaired the UK AMR Review and William Hall and Anthony McDonnell were two of the members of the core team who produced the Review’s seven excellent reports on AMR published during 2014-2016. 

Entitled Superbugs: An Arms Race Against Bacteria, and available on Amazon, the book features a foreword by Dame Sally Davies (Chief Medical Officer of the UK) followed by an introduction that crisply lays out both the problem of AMR and the goal of the book:

  • “At its heart, AMR is a problem of economic and political failure.
  • We need pharmaceutical companies to develop new antibiotics, but we must at the same time limit their use, which then makes it difficult for companies to recoup their investment.
  • The current rewards-based system does not work.
  • In this book, we combine economic policy ideas with our experience of global politics and global business investment to present workable solutions that policymakers can implement.”

The book’s survey of first the problem and then possible solutions (see below my signature for a summary of the chapter headings) is clearly written. Full of readily understood examples and supported by pithy quotes from current thought leaders, the book is perfect for a general audience. I thought the book did an especially good job of covering two key topics from a variety of perspectives:

Learning to think in economic terms. The book’s economic flavor brings together ideas in compelling ways. A great example of this is on pages 42-45 where the authors estimate the cost of AMR in several ways. Using the statistical value of a life (as estimated by the amount we routinely spend to prevent traffic fatalities!), the estimated cost is ~$900b/year. Using math grounded in health care costs and loss of productivity, the cost is $225b/year. Neither figure is perfect, but their scale is similar and the amounts needed to address AMR are a rounding error relative to the costs of AMR. For example, the final DRIVE-AB report calls for public sector push funding of $800m/year and pull funding of $1b/new antibiotic. Similarly, Superbugs itself recommends a global spend of about $4b/year to implement the full suite of approaches to tackling AMR.

Layout the options for solving the problem. Here the book drew heavily on both the UK AMR Review’s analyses + the ideas that were emerging in parallel from DRIVE-AB. The discussion of incentives for new agents builds on the need for public funding for research, collaboration by developers, and implementation of market entry rewards. The insightful discussion of prevention covers infrastructure, infection prevention, and behavior change. And the discussion of approaches to reducing use both in human medicine and food agriculture provide balanced perspectives on aspirations and reality in this space.

The book concludes by describing AMR as “a problem that can be solved.” I agree both with this and with the authors’ assertion that the challenge now is to find the political will to act. On this note, I am encouraged by the existence of ongoing conversations on both sides of the Atlantic. We’re not there yet, but at least we are talking.

Please consider reading and sharing this book as part of ensuring that this ongoing conversation continues! 

All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Expert-in-Residence, Wellcome Trust. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future:

Outline of Superbugs

  • Part 1: The problem
    • Ch. 1: When a scratch could kill
    • Ch. 2: The rise of resistance
    • Ch. 3: Failures in tackling drug-resistant infections
  • Part 2: Solutions
    • Ch. 4: Incentives for new drug development
    • Ch. 5: Prevention is better than cure
    • Ch. 6: Reducing unnecessary use of antibiotics in humans
    • Ch. 7: Agriculture and the environment
    • Ch 8: Next steps

Upcoming meetings of interest to the AMR community:


Fireside Chat with BARDA’s Branch Chief for Antimicrobials

Note: Be sure to take advantage of the BARDA Industry Day(s) event that occurs Monday-Tuesday of this coming week … see newsletter and forward calendar for details. Dear All, In what could be called Part 2 of Excellent 2023 ASM/ESCMID Talks (read the newsletter on Jen Cohen’s talk on how manufacturing underpins both access and

Japan Pulls for Pandemic Preparedness: Nikkei FT Conference

Dear All, As we discussed in the 5 Nov 2023 “Pulling for Pandemic Preparedness” newsletter, AMR is a global threat: resistance in one part of the world can suddenly appear in your hospital. As an example of that sort of threat, Jason Gale’s 30 Oct 2023 newsletter entitled “Untreatable Typhoid Should Make You Worry About Poop”

Pulling for Pandemic Preparedness

Dear All, This evening I’d like to bring together several relatively recent reports and note how all of them focus in one way or another on Pulling for Pandemic Preparedness … perhaps we can call this the Rule of 3 Ps. And as an aside, I’ll note that I learned the Rule of 4 Ps

PACE: A new £30m fund for AMR innovation

Dear All, Exciting additional news merits two newsletters in one day! I’ll keep it brief and quote directly from the website: “Innovate UK, LifeArc, and Medicines Discovery Catapult (MDC) have joined forces to create PACE (Pathways to Antimicrobial Clinical Efficacy), a £30 million initiative supporting early-stage innovation against antimicrobial resistance (AMR) to save lives. PACE has today (19 October 2023) announced

Scroll to Top