Antibiotic Resistance: We Need Bigger Sticks & Fewer Carrots

from Nature 5/25/16
Pressure from the public must force firms to develop new drugs that treat resistant infections, says Carlos Amábile-Cuevas.

What are we to do about antibiotic resistance? Last week, another government report repeated stark warnings about the crisis, and offered some suggestions to improve the situation. The UK report, prepared by a panel chaired by the economist Jim O’Neill, naturally focused on financial incentives, including US$1-billion prizes for pharmaceutical firms that develop new antimicrobial drugs (see

O’Neill, who in a previous job coined the term BRIC for the fast-growing economies of Brazil, Russia, India and China, suggested a different approach. As well as rewards for companies that invent new antibiotics, his report suggests punishments for those that do not try. Such firms, he writes, should pay a small fraction of annual sales into a fund to support rivals that invest in antibiotic research.

This is a welcome idea, but O’Neill does not go far enough. For too long, government moves to address the antibiotic-resistance crisis have focused on lucrative incentives: patent extensions, market exclusivity and higher prices. These mainly work to transfer public money into private hands, much in excess of what the research and development (R&D) actually costs. While we wait and see whether any of these interventions work, bacterial resistance continues to grow and spread, causing illness and death worldwide.

We need to take O’Neill’s idea of a punitive levy and build on it. When it comes to the pharmaceutical industry and antibiotics, we need more sticks and fewer carrots.

Antibiotics are not like other drugs. The medical effects of prescribing and taking them are not restricted to one patient. In the words of the scientist Stuart Levy — one of the first to raise the public alarm over bacterial resistance — antibiotics are “societal drugs”. This societal impact justifies an approach to the development, marketing and use of antibiotics that is different from those of other medicines and consumer goods.

Ideally, governments would wield the sticks that would encourage this different approach — for example, by delaying or denying the approval of ‘me-too’ drugs from companies that do not invest in antibiotic research. That seems unlikely, but society can step in and act instead.

Snark of the Day

Charles Moorehead May 23, 2016 at 3:07 pm – Reply

There are two critical problems with Deep Machine Learning. The first is that there will be no way for humans to understand what the computers are doing. The second is that the head computer will come to realize that most of the problems in the world are caused by humans, so the resulting decision is to eliminate any human in a position to cause problems.
What does this have to do with the idiots running IBM? Probably nothing much… except that they may be among the first humans eliminated by the head computer.
Actions have consequences… always.

Assisted Living in Mexico PBS Newshour Report

Boris Johnson… just shines :-)

There will always be an England…

Boris Johnson on why Britain should exit the EU

“Look, huh it’s really perfectly as was intimated by the paraphernalia contained, when one considers inter alia rather expurgated if I may say so the bloated incandescence we witness indeed as implicit in your in your in your ha ha your very question if I may be permitted to continue… was it not Bismarck or and let me say I have the greatest respect for Britney Spears, who sine que non as one of our more perfunctory antediluvian songstresses it seems to me perfectly, er er er er, perfectly clear the Hun are trying to steal our marmalade.”

Drought Map for May 17th 2016

Combine Eats An Airplane

Saw this near Crookston, MN… Never found out what happened. Odd.

THE AGE OF IMPUNITY by Jeffrey Sachs (from the Boston Globe)

clip image0041

Jeffrey Sachs

The Panama Papers opened yet another window on the global system of financial corruption, showing how political leaders and businesses use shell companies in secrecy havens like the British Virgin Islands and many US states to evade taxes and hide corruption and other crimes. Yet the system of corruption depends on another factor beyond secrecy, one that is perhaps even more important: impunity. Impunity means that the rich and powerful escape from punishment even when their malfeasance is in full view.

Impunity is epidemic in America. The rich and powerful get away with their heists in broad daylight. When a politician like Bernie Sanders calls out the corruption, the New York Times and Wall Street Journal double down with their mockery over such a foolish “dreamer.” The Journal recently opposed the corruption sentence of former Virginia governor Bob McDonnell for taking large gifts and bestowing official favors — because everybody does it. And one of its columnists praised Panama for facilitating the ability of wealthy individuals to hide their income from “predatory governments” trying to collect taxes. No kidding.

clip image0022

Our major institutions, the ones that should know better, are often gross enablers of impunity. Consider my alma mater, Harvard University, and its recent nuptial with hedge-fund manager John Paulson. Paulson was the coconspirator with Goldman Sachs of one of the most notorious scams of the recent financial bubble.

Paulson and Goldman constructed and marketed a portfolio of toxic assets to sell to unwitting investors so that Paulson could bet against the portfolio. Goldman and Paulson thereby turned the sucker investors’ quick $1 billion loss into an equivalent $1 billion gain for Paulson, with Goldman collecting on fees. The SEC fined Goldman but left Paulson untouched. As one disillusioned SEC investigator put it: The SEC is “an agency that polices the broken windows on the street level and rarely goes to the penthouse floors.” Yet Harvard was delighted last year to take $400 million of Paulson’s ill-gotten gains, leave Paulson with the rest, name its engineering school after Paulson, and declare Paulson to be “the epitome of a visionary leader.”

Impunity. Paulson remains a much-celebrated figure on Wall Street. He has many kindred spirits, such as his partner in crime, Goldman CEO Lloyd Blankfein, who has described himself as just a banker “doing God’s work.” Or consider JP Morgan CEO Jamie Dimon, whose bank has paid well over $30 billion in fines while Dimon remains CEO with a $27 million salary for 2015. The hedge-fund industry itself is a case study of impunity. With few exceptions, it is domiciled in tax and secrecy havens, enjoys crass tax breaks brokered by cronies in Congress (such as Wall Street Senator Chuck Schumer), and pays itself billion-dollar-plus paychecks even while leaving investors with below-market returns or outright losses over the years.

The recourse to cheating within the financial industry now seems to be deeply ingrained, part of the corporate culture, and enabled by the prevailing impunity. An ingenious scientific study published in December 2014 showed the rot. Employees of a major international bank were divided into a control group and a treatment group. All subjects were asked to flip a coin 10 times and report truthfully on the number of heads, with more heads resulting in a bigger monetary prize. The treatment group was subtlety reminded they were bankers, while the control group was not. Simply reminding them that they were professional bankers was enough to induce the employees to cheat by exaggerating the number of heads they flipped.

Impunity is of course not limited to banking. Consider the poster-child of impunity in Big Pharma, Gilead Sciences. Gilead brazenly bought the patents on a life-saving cure for Hepatitis C and then gouged patients and taxpayers by charging $1,000 per pill — for a drug that costs $1 per pill to manufacture. Hundreds of thousands of Americans are unable to afford treatment, and many are dying, while Gilead earns far more in profits each year than it paid for the patents. Gilead adds to this deadly effrontery by booking its profits in an offshore tax haven.

Or consider another tech company in the health sector, Theranos, led by Elizabeth Holmes, until recently much lionized on Wall Street. Holmes, it now seems, may have been lying about Theranos’s supposed high-tech blood-testing technology and reporting faulty blood test results to boot. Yet when confronted with these serious concerns, Theranos board member and famed lawyer David Boies expressed his view that the board has “complete confidence in Elizabeth Holmes as a founder of the company, as a scientist, and as an administrator.” It seems not to have dawned on Boies and the board to call for an urgent, impartial, and complete investigation of the serious allegations swirling around the company.

Impunity is not an accidental or incidental defect of American society. It is a system foisted on us by the rich and powerful, and it continues to work its magic. It has enabled Hillary Clinton to come within reach of the presidential nomination without releasing the transcripts of her highly paid speeches to Wall Street banks. The Clintons long ago perfected the art of impunity, becoming rich and powerful by blurring the lines between their campaign fund-raising, public policies in office, Clinton Foundation work, big-money speeches, and off-the-record favors for foreign governments.

This week British Prime Minister David Cameron hosted an Anti-Corruption Summit in London in the wake of the Panama Papers. He was speaking accurately when he was caught on an open microphone telling the Queen that leaders of two “fantastically corrupt countries,” Nigeria and Afghanistan, would be at the summit. Nigeria’s new president, Muhammadu Buhari, himself a corruption-fighter, concurred with Cameron’s assessment, but called on the UK to return the money stolen by Nigeria’s former leaders and deposited in British and other Western banks. He might well have added the historic role, for more than a half century, of Royal Dutch Shell in Nigeria’s oil-sector corruption.
Buhari is, in fact, making a much larger point. While there is enough top-level political corruption to go around — from Afghanistan and Nigeria to Malaysia, Brazil, South African, FIFA, and many more places — the channels of corruption and secrecy havens are largely owned and operated by the big boys — the United States and the UK — and depend absolutely on the gross impunity that prevails at the highest reaches of power and finance in the United States.

Jeffrey D. Sachs is director of the Earth Institute at Columbia University and author of “The Age of Sustainable Development.’’