Antibiotics don't make much money but we desperately need new ones. That means transforming pharma companies into public goods producers

WHATEVER you think of free markets, it’s hard to deny that they create powerful forces for innovation. Profit encourages investment in new technologies and products, while competition ensures that they keep coming.

But not always. Consider antibiotics. A successful antibiotic drives its own obsolescence: the more of it you sell, the more bacteria resist it. You can’t improve sales through marketing, for fear of encouraging overuse, which also promotes resistance.

The market forces that proved so effective at coming up with a remedy for male impotence have let us down when it comes to antibiotic resistance. That’s alarming. As New Scientist has reported for two decades, the abuse of antibiotics has led to the emergence of resistant bacteria and hard-to-treat infections. And since antibiotics are poor earners, there’s little new in the drug-delivery pipeline.

After years of mounting concern, the now desperate global healthcare community is finally taking steps outside the normal market-driven drug development process. The broad idea is to de-link the payment a company receives for developing a drug from its subsequent sales. That should give companies confidence that they will make money, although as yet there’s no consensus on exactly how to do it (see “Superbug crisis: Global push to save antibiotics begins“).


Fortunately, we have plenty of ideas. Our society already makes things that aren’t driven by profits from sales: taxpayer-funded public goods like roads, schools or basic research. Fixing the market failure in antibiotics production means transforming pharma companies – or parts of them – into public goods producers, with public interest rather than profit driving R&D and marketing.

Fixing the market failure in antibiotics production means transforming pharma companies

The industry has little to lose: it isn’t making much money on antibiotics anyway. But the stakes are high for everyone else. Turning shareholder-owned pharma firms into socially motivated medicine-makers will not be easy. And the challenge isn’t just finding new drugs – it also involves conserving the efficacy of old ones.

The furore over the attempted takeover of the UK’s AstraZeneca by US-based Pfizer showed how contentious state involvement in the pharma industry can be. But now the door to non-market solutions is open, governments should press on: and not just the health ministers who discussed the idea in Geneva this week.

Antibiotic resistance is a huge, implacable and evolving threat. It demands a weighty, determined and flexible response.

This article appeared in print under the headline “Anti-resistance movement”