The path of least resistance

A GROWING worry in medicine is bugs' increasing resistance to antibiotics. At AstraZeneca's research centre near Boston, scientists toil to find new weapons. Machines screen thousands of drugs each year, robotic arms nimbly handling plates of compounds to test their effect on bacteria. But progress is slow. “It is not our hottest area in terms of commercial return,” admits Martin Mackay, AstraZeneca's research and development chief.

Help is on the way. On May 8th the European Commission and Europe's pharmaceutical association gave details of a plan to boost antibiotics research by up to €590m ($760m). The same day in America, a congressional committee weighed measures with a similar goal. The attention is welcome. Its effect is less clear.

Drug-resistant bacteria cost Europe alone about €1.5 billion a year in health costs and lost productivity. But firms have been slow to create new antibiotics. First, the science is tricky. Some bacteria have evolved to pump out the drugs that infiltrate their walls; other, “Gram-negative” bugs have an impenetrable outer membrane. Second, clinical trials are arduous. Firms struggle to recruit enough patients with rare bacterial infections. Third, commercial prospects are grim. Patients take cholesterol drugs for life, but they usually take antibiotics for less than two weeks.

It is no wonder that Big Pharma has directed its attention elsewhere. AstraZeneca and GlaxoSmithKline (GSK) are now the only big drugmakers with substantial antibiotics programmes. Between 1983 and 1992 American regulators approved 30 new antibiotics. Since 2003 they have approved just seven.

Governments are keen to change this. In February Tetraphase, a small company near Boston, won a $67m contract from America's Biomedical Advanced Research and Development Authority (BARDA) for an antibiotic that might treat both anthrax outbreaks and serious infections in hospitals. GSK also has a contract with BARDA to test an antibiotic for Gram-negative bacteria. However, the company recently suspended enrolments to its trial because of complications in some patients. Seeking new ways to kill these vicious bugs is likely to be one of the main aims of the European Commission's new partnership.

To boost research in America, Congress needs to renew a deal under which drugmakers pay fees to regulators for reviewing new treatments. The mammoth bill now before congressmen also includes measures to encourage the search for new antibiotics. It would extend antibiotics' patents by five years, and let some treatments for life-threatening diseases be marketed before the final stage of clinical trials, thereby reducing their development costs. Kevin Outterson of Boston University says the government might provide an even bigger boost by paying more for new antibiotics—but politicians are strongly allergic to spending more on health.

It may be a decade before the European and American proposals produce an effective new antibiotic. In the meantime, says David Payne, a research chief at GSK, the best sign of progress will be if other firms rejoin the fight against killer bugs.