Comprehensive Policy for Infection: There Has Never Been a Better Time

Ankit Mahadevia, CEO, Spero Therapeutics

The suffering from COVID-19 can be measured in multiple, sobering ways:

Life expectancy in the US has fallen by a full year, according to the CDC.

The economic cost – measured in reduced gross domestic product, premature death, and long-term disability – has been estimated at $16 trillion by economists David Cutler and Larry Summers at Harvard University.

This week, the US passed the grim milestone of half a million deaths from COVID-19.

The pandemic has shaken the foundations of our society. It has forced people to question assumptions about scientific priorities to better prepare for pandemics an interconnected world.  Further, multi-drug resistant bacterial infections pose one of the major threats to global health and prosperity, and these troublesome bugs haven’t gone away.

Even so, there is reason for optimism: there has never been a better time to muster the will, resources and expertise to reduce the threat from infectious disease.   

New Opportunities in Washington

We applaud the work underway at the World Health Organization and international governments. The US, under a new Administration, is well positioned to extend its global leadership in science with short-term and long-term investments.

Scientists with knowledge of the infectious threats are in a better position to help shape policy than ever before. President Biden, in his letter to his new science advisor Eric Lander, asked him to think broadly about pandemic preparedness. That call specifically included antibiotic resistance. Lander’s work in this area will not be marginalized – he is the first science advisor to be elevated to the Cabinet.

Within Congress, a change in party leadership and a focus on broad solutions for everything from COVID-19 to immigration creates an opportunity.  Well thought-out solutions are being crafted. The PASTEUR Act, with bipartisan co-sponsorship, is one. 

PASTEUR would commit transformational, multi-hundred-million-dollar investments to support drug development against key microbial threats that are not prevalent today, but would be deadly without effective medicines. The bill changes the incentives for antibiotic developers — allowing for investment returns that aren’t based on maximizing prescribing volumes. This would be a powerful incentive for industry to develop these critical defenses, while avoiding overprescribing that undermines effectiveness over time.

Expanded Support for Innovators

New and existing organizations have stepped up to provide support for new weapons against infection. The government-supported efforts are being supplemented by the Bill & Melinda Gates Foundation, the NOVO Repair Fund, and CARB-X – as well as traditional biotech investors.

The Biomedical Advanced Research and Development Authority (BARDA) continues to support R&D for diagnostics and therapeutics for existing and emerging threats. We applaud the agency’s timely response to the COVID-19 challenge; along with continued support for defense against drug-resistant bacteria.

The AMR Action Fund is the latest player on the scene. It’s a global organization established in 2020 by more than 20 pharmaceutical companies to fund development of innovative medicines against infectious threats.

The fund recently added Henry Skinner, a former Novartis Ventures investor, as CEO. The stated plan is to begin investing this year. The pharma companies and nonprofit groups backing the AMR Action Fund agreed last week to contribute another $140 million to the more than $1 billion it had already raised for R&D against multi-drug resistant bacteria. 

Bold Strategies Are Needed…and They Already Exist     

As Operation Warp Speed has taught us, we need bold, wide-ranging strategies against fast-moving and far-reaching pathogens. Incremental policy incentives, such as targeted changes to reimbursement for therapeutics, are necessary but not sufficient.

Fortunately, more ambitious plans do exist. The PASTEUR Act is one such example. Another is the Bipartisan Commission on Biodefense’s Apollo Program.

Founded in 2014 and co-chaired by former US Sen. Joe Lieberman and former Secretary of Homeland Security Tom Ridge, the Bipartisan Commission has proposed ~$10 billion a year for a comprehensive approach to testing, tracing, and treating future pathogenic threats. Former BIO president Jim Greenwood serves on the commission, so this group at least has some industry input.

What Next?

It has been some time since the conditions were so favorable for infectious disease. The time is now to work together.

Drug developers in infectious disease continue to have a duty to choose sustainable programs that marry clinical need with commercial benefit. This creates a stable base of R&D and expertise that can respond to future threats. 

The biotech industry at large can make its priorities clear.

  1. Bold, transformative solutions that give our industry what it needs for pandemic defense.
  2. Advocate for policies that prioritize treatments against infection. We can do this through our representative organizations such as BIO.

As private citizens, we can make clear to our elected officials that we want bold solutions to make sure we don’t have another COVID-19. 

We have the technology, talented drug developers, clinicians, and public health professionals. What we need is leadership, long-term focus, and coordinated efforts against a problem that’s bigger than any one company, or any one country. If we act together behind a comprehensive plan, we’ll be in position to prevent future pandemics.

Special thanks to Aleks Engel of the NOVO Repair Fund, Tim Hunt, and the Spero team for their contributions

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