is being called on to pay for a $2bn
(£1.3bn) innovation fund to
revitalise research into antibiotics.
In return, there would be guaranteed
payments to companies who produced
vitally needed new antibiotics.
There are currently very few new
antibiotics in development amid a global
spread of resistant bacteria.
The proposals are in a report by a UK
government-appointed review team
headed by economist Jim O'Neill.
Mr O'Neill said: "We need to kick-start
drug development to make sure the world
has the drugs it needs, to treat infections
and to enable modern medicine and
surgery to continue as we know it."
He has previously warned that drug-
resistant microbes could kill 10 million
people a year worldwide by 2050 and cost
$100 trillion in lost economic output.
Resistant strains of bacteria are spreading
globally, threatening to make existing
drugs ineffective.
A global innovation fund of $2bn over five
years would be used to boost funding for
"blue-sky" research into drugs and
diagnostics - with much of the money
going to universities and small biotech
companies.
One promising area of research concerns
so-called "resistance breakers". These are
compounds that work to boost the
effectiveness of existing antibiotics - a far
less costly approach than attempting to
discover entirely new drugs.
Helperby Therapeutics, a spin-out
company founded by Prof Anthony Coates,
St George's, University of London, has
created a resistance breaker that acts
against the superbug MRSA.
The compound, known as HT61, will
shortly go into clinical trials in India,
where it is being developed under licence
by Cadila Pharmaceuticals India.
The review team said this kind of research
could benefit from the innovation fund
and could be the key to making existing
drugs last longer.
Mr O'Neill said the big pharmaceutical
companies should pay for the fund and
look beyond short-term assessments of
profit and loss.
Formerly chief economist with the
investment bank Goldman Sachs, Mr
O'Neill drew parallels between the
banking crisis and the looming
catastrophe of a world where antibiotics
no longer worked.
Innovation funding
He said big pharma needed to act with
"enlightened self-interest" because "if it
gets really bad, somebody is going to
come gunning for these guys just how
people came gunning for finance".
Mr O'Neill was speaking to the BBC's
Panorama programme, which has spent
six months following the work of the
review team, filming in India, the US and
UK.
Mr O'Neill was appointed last year by
Prime Minister David Cameron to head
the review into antimicrobial resistance -
which already claims an estimated 30,000
lives a year across Europe.
Many large companies have pulled out of
antibiotic research.
The report says this is partly due to the
uncertain commercial returns for new
antibiotics.
New drugs are often kept in reserve for
years, to preserve their potency, by which
time they may be nearing the end of their
patent.
After this expires, cheaper generic
versions are available.
In order to incentivise drug development,
the review team says, there should be
lump-sum payments to companies that
create proven new antibiotics.
This would break the link between the
profitability of a drug and its volume of
sales.
The review team predicts its proposals
could lead to 15 new antibiotics a decade,
of which at least four should be
"breakthrough products" targeting the
bacterial species of greatest concern.
It estimates the cost of guaranteed
payments for these drugs would be
$16-37bn over a decade but says this is a
small price to pay given that antibiotics
are essential to so many aspects of
healthcare, from common infections, to
surgery and cancer treatment.
US breakthrough
It is nearly 30 years since a new class of
antibiotics - meaning a group of drugs
with an entirely novel action - was
introduced.
But this decades-long drought could be
over as a result of a breakthrough recently
announced by US scientists.
A team at Northeastern University in
Boston, Massachusetts, has discovered 25
potential new antibiotics, all of them
derived from soil microbes.
One of them, teixobactin, is effective
against both tuberculosis and MRSA.
The drug is being developed by
NovoBiotic Pharmaceuticals and should
go into patient trials within two years.
Prof Kim Lewis, of Northeastern
University, who co-founded the company,
told Panorama: "We think there could be
thousands more antibiotics in the soil, yet
to be discovered."
There are still many uncertainties.
Teixobactin has yet to undergo patient
trials, and it is at this stage that many
promising drugs fail.
Nor is it effective against bacteria such as
E.coli and Klebsiella, which are
responsible for a huge proportion of
resistant infections.
But the Boston team's discoveries are the
type of innovative research many
scientists believe essential to ensure we
do not run out of effective antibiotics.
Prof Dame Sally Davies, chief medical
adviser to the UK government, said: "We
have to respond to the challenge of
antimicrobial resistance by making sure
we secure the necessary antibiotics for
generations to come, in order to save
millions of lives and billions of pounds."
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