It’s rare that I call for government intervention, but because government already raises the cost of drug development to such stratospheric heights, if they don’t do something to encourage new antimicrobial drugs to be developed, we’re going to be very very screwed. By the time this rises to the level of a real crisis (e.g. when there are enough sick people dying of diseases that haven’t been lethal for years) it’ll already be too late, and you’ll be waiting a decade or more before any effort started at the point of a crisis come to fruition.
The problem is this: new antibiotics are difficult to find, and any new antibiotic that would hit the market is practically guaranteed to be held in reserve for infections that can’t be treated by current antibiotics. The market will tend to be small. Because of these market realities, there have only been two novel classes of antibiotics produced in the past 40 years.
I would suggest a prize of sufficient size to guarantee a hefty return on investment to any research team or company that can successfully bring a new class of antibiotic to market, and that has a reasonable safety and pharmacological profile. For libertarians that are uncomfortable with government involvement with the market, you can justify it with the fact that antimicrobials are a critical component of our war fighting capacity as a nation. There’s definitely a military justification to spawn new development. The fact is that without some kind of incentive, new antibiotics just are not going to be developed, and I don’t think you’ll have any luck convincing the American people to drop the FDA requirements that raise the barriers for new drugs entering the market. A prize is the most efficient way to deal with this kind of problem.