“We have reached a tipping point where large and prominent drug-makers have retreated from the antibiotics field.” So says Jayasree K Iyer, the executive director of the charity Access to Medicine Foundation.
The organisation’s latest report shows that, despite growing need, fewer pharmaceutical companies are engaged in antibiotic research and development, as there is little money to be made. Global demand for antibiotics climbed by 65% between 2000 and 2015. But most of that demand was from poor countries – four of the six countries with the highest antibiotic consumption rates were low- or middle-income nations, so-called “access countries”.
Not only are pharmaceutical companies more reluctant to invest in research, they are also more reluctant to provide medicines to poorer countries. The report looked at 13 new antibiotics. Just three have been registered for use in 10 or more of the 102 access countries. A third of these new antibiotics don’t seem to be available in any access country. Of 24 older antibiotics still protected by patents, barely half (14) are available in even one access country. Doctors are often forced to delay treatment or use less effective drugs, increasing the likelihood of drug-resistant bacteria emerging.
It’s another example of how the market system is failing the world’s poor when it comes to medical R&D. There is, a report from Oxfam and Médecins Sans Frontières observed, “a great need for increased investment into not-for-profit R&D to meet the health needs of developing countries”. That was written a decade ago. It’s even truer now.
The possibility of a global coronavirus pandemic is focusing minds on how to develop a vaccine quickly. We should, however, not forget the broader, structural problems of the continued failure to produce and supply medicines to those who most need them.
• Kenan Malik is an Observer columnist
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