I recently listened to a podcast featuring Dr Matt McCarthy, who is an infection diseases physician and ethics professor and who authored the book Superbugs[1].
He did a good job (to a layperson such as myself anyway) of explaining why big pharma don't have much incentive to develop new antibiotics, possible financial interventions that may makes sense, and the alternative treatments that are being developed.
I haven't read the book, but he's done quite a bit of press around it on podcasts, youtube etc. Definitely worth a listen to learn more about the topic.
The simple reason is pharma wants to develop chronic use drugs or cancer drugs, and why would they want to make antibiotics that are carefully rationed, if profits are lower? Seems to me, we may need a socialized, international effort, an ISS of antibiotic development.
I suspect the parent was referring to the lack of incentives for big pharma to develop new antibiotics, which is of course very relevant in a discussion around resistance to existing drugs.
I don't believe this to be a contentious issue. It is well understood that the current model and associated costs of drug development provide little incentive for research and development of novel antibiotics.
In the words of the infectious diseases physician I referenced in another comment:
For the past 75 years, we've relied on a partnership between the federal government and big pharma to bring new antibiotics to market. And what we're seeing is that that partnership is dissolving, and it's dissolving for the simple reason that pharmaceutical companies increasingly are having trouble making a profit off of antibiotics.
The reason for that is if you think about an antibiotic, they are prescribed in short courses. And doctors are very stingy about doling them out. And even the best new antibiotic may wear out its welcome when the bacteria become resistant. So what we're finding is that these companies say, why would we want to make a product that doctors don't want to prescribe?
Now to address this, there are a number of policy proposals on the table. They're called push and pull incentives, which can entice these companies to stay in the antibiotic business. A push incentive might be something where you go to a company that's making billions of dollars and say we'll cut your corporate tax rate if you promise to invest some of those profits into new antibiotics. This is a sure-fire way to get more money into the pipeline. However, many people recoil at the idea of giving a tax break to a multi-billion dollar company.
My explanation is the problem lies in the food source, not antibiotics. We can't rely on the continuous increase in the use of antibiotics to prevent a food cataclysm.
Presumably any newly developed antibiotic would be sold for prices similar to existing ones, if not for a premium. If this results in decreasing profits, then we must conclude development costs are rising, which suggests finding new antibiotics is increasingly harder. Sure, we can throw taxpayer money at it to have more drugs developed and introduced in the near-to-mid term, but if finding new antibiotics is indeed continuously harder, at some point it will also be too expensive for public money to finance R&D
We have to aim to solve the root cause, not just mindlessly continue to throw money at it
