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: http://amr.solutions/blog/

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:

Share

Leaky pipe(line)s, Part 2 / CARB-X reboot / WHO 2021 pipeline review

Dear All, We have a 3-part discussion today on the theme of “I want a new drug … so how do I find it?” Off we go! First, the 14 June 2022 newsletter entitled “Leaky Pipe(lines) / When Is A Molecule A Drug” generated further discussions that are worth sharing: It was noted the microdosing

Antibiotic procurement models for LMICs / G7 Leaders call for Pull!

Dear All, Two stops on our tour today: (i) an excellent survey of incentive models and (ii) a final communique from the recent G7 meetings. First up, CGD (Center for Global Development) have released a report (link) entitled “Leveraging Purchasing Systems to Ensure Access, Stewardship, and Innovation: A Landscape Review of Current and Potential Market Structures

Leaky pipe(lines) / When is a molecule a drug? (Part 1 of 2)

Dear All, I was fascinated by this recent paper in AAC: Neha K. Prasad, Ian B. Seiple, Ryan T. Cirz, and Oren S. Rosenberg. Leaks in the Pipeline: a Failure Analysis of Gram-Negative Antibiotic Development from 2010 to 2020. Antimicrob Agents Chemother. 2022 May 17;66(5):e0005422. doi:10.1128/aac.00054-22. (Addendum: This newsletter has a follow-up newsletter.) In brief,

FDA/CVM: Antimicrobial use in companion animals

Dear All, Post-newsletter addendum: I’ve learned that USDA will host a 10 Aug 2022 (virtual, 10a-4.30p ET) workshop on AMR in food agriculture. See the meetings calendar for more details; go here to register. I’ll confess to having missed entirely the request back in February 2022 from FDA’s Center for Veterinary Medicine (CVM) for comments on antimicrobial

Scroll to Top