Small biotech the ‘true engine’ of antibiotic innovation, as pharma ‘spews nonsense’ on its R&D: Jim O'Neill

Health experts have rounded on pharma companies as having “endless talk and no action” when it comes to antibiotic R&D, as governments around the world continue to sound alarm bells over a potential antimicrobial resistance “apocalypse”.

Speaking at a Wellcome Trust meeting in the U.K., Jim O’Neil, a Lord and chair of the Chatham House think-tank, and the man tasked with heading up a British government global review of antimicrobial resistance back in 2016, accused the bigger players in the industry as “spewing out nonsense” about the problem.

He said they are all talk and no action.

“If they produced one-tenth of the commitment in their words, we would be getting somewhere,” he said.

The issue for pharma is that there is little to no ROI for antibiotic R&D, given that one of the key things you’d do with these drugs is not give them out readily.

Cancer and rare drug R&D, while costly, will always see a much greater return, so those have become the mainstay focus of most Big Pharma, with only a handful involved in antibiotic work.

This could be overcome, says Lord O’Neil, also a former Goldman Sachs chief economist, by using a so-called “play or pay” system, with levy on all drug sales being slapped on those that do not have antibiotic development programs.

And for those who do “play," they could get a bonus payment of between $1 billion and $1.5 billion for any successful new antibiotic drug, incentivizing them financially.

One of the other more radical ideas being put forward, and one that has been spoken of over the years, is to nationalize antibiotic R&D, although this would remove any competitive element, and require large sums of taxpayer money.

Lord O’Neill himself said the solution may be to “just take it away from them and take it over”.

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Tim Jinks, head of Wellcome’s drug-resistant infections program, added: “Science can’t solve this problem on its own. We need to overhaul the economics to fix the broken antibiotic market.”

Jinks went on: “Small biotech companies are becoming the innovation engine for antibiotics,” but they suffer from a lack of resources that pharma has, but aren’t using, he argued.

There hasn’t been a new antibiotic on the market since the 1980s, and antimicrobial resistance, whereby bacteria are evolving to not be killed by older antibiotics, could leave open the possibility that once easily treated infections once again become a deadly scourge, should new antibiotics not be made.

Lord O'Neill's review found that the threat of antimicrobial resistance (AMR) could kill an extra 10 million people a year by the middle of the century.