Fighting the next health crisis

The next health scourge to hit Canada may not be another viral pandemic, but outbreaks of antibiotic-resistant bacteria. For this reason, Health Minister Jean-Yves Duclos recently announced a $300,000 contribution to international efforts to fight antimicrobial resistance (AMR). AMR costs Canada $1.4-billion every year and is associated with more global deaths than HIV/AIDS, malaria, or breast cancer. Given the scale of the risk, Canada needs to do much more. The problem is that developing new antibiotics is not only scientifically challenging, but is almost impossible from a business perspective. Clinicians are reticent to use the newest antibiotics to reduce the chance of resistance emerging. Paradoxically, the better the product, the less it is used, and the less profit companies will earn. The last small- and medium-sized enterprises that successfully had their antibiotics approved went bankrupt immediately after that success. It is no surprise that pharmaceutical firms are closing their antibiotic discovery labs, small antibiotic companies are having difficulty getting private investment, and the few companies with promising antibiotics are folding. E. Richard Gold is a professor at McGill University and director at VIMI. Photograph courtesy of E. Richard Gold We are both experts in pharmaceutical innovation, and one of us founded a Canadian company that developed one of the few truly novel antibiotics in the global clinical pipeline. That experience tells us that the best way for Canada to contribute to developing new antibiotics is for the government to play a major role in aligning firms and universities, and to fund research—at a fraction of the cost of an actual AMR crisis. Here are our conclusions. First, we need to realize that existing pharmaceutical policies, which assume that market forces will encourage the private sector to invest, do not work for antibiotics. The risk of scientific failure is great, but the risk of market failure is greater. Second, Canada needs to be realistic about its capacity to contribute. Given the relatively small size of Canada's research budget compared to global spending, it must form partnerships to have any impact. The most efficient strategy would be contributing to existing international drug discovery non-profits, such as CARB-X and the Global Antibiotic Research & Development Partnership. Third, Canada must target internal investments in industries that have the potential to up-end the antibiotic drug discovery process. Canada's computational and AI drug discovery companies, in particular, offer the potential to really change how antibiotics are discovered. Aled Edwards is the founder and chief executive of the Structural Genomics Consortium. Photograph courtesy of Aled Edwards Finally, Canada must create a nimble mechanism to organize and prioritize its investments in AMR. Together with a team stretched across Canada, we are building a platform to accomplish this: Viral Interruption Medicines Initiative. VIMI is a Canadian non-profit representing Canada's interests in international antibiotic and antiviral drug discovery consortia. For decades, VIMI's founding team has brokered drug discovery partnerships among industry, governments, universities, and funders, including the main funders of the global AMR drug discovery efforts. VIMI's approach is novel, focusing on four things: reducing the costs of getting things done, leveraging Canada's funding, streamlining the regulatory process, and helping Canadian companies fill the gaps in drug discovery science. VIMI reduces costs and needless scientific duplication by sharing results openly. VIMI leverages Canada's funding by co-investing in global projects of greatest priority for Canadians. VIMI is streamlining the regulatory system by creating new forms of market exclusivity that allow open sharing of drugs and data while maintaining commercial control of the antibiotic. VIMI fills gaps by strategically investing in the science of the future, such as computational drug discovery. It is already hosting competitions where pharmaceutical and computational drug firms pay university labs to test their AI predictions and agree to place the drug hits in the public domain. Canada needs to target investments in nimble, globally-connected, organizations such as CARB-X, GARD-P, and VIMI, which have track records of aligning the private sector, universities, and regulators. Doing so is Canada's best bet to ensure that new antibiotics will be invented and that Canadians can quickly access them when the crunch comes. E. Richard Gold is a professor at McGill University and director at Viral Interruption Medicines Initiative. Aled Edwards is the founder and chief executive of the Structural Genomics Consortium, and a professor at the University of Toronto. He is also the president of VIMI. The Hill Times

Fighting the next health crisis

The best way for Canada to contribute to the development of new antibiotics is for the government to play a major role in aligning firms and universities, and to fund research.

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Fighting the next health crisis

The best way for Canada to contribute to the development of new antibiotics is for the government to play a major role in aligning firms and universities, and to fund research.

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