We’ve successfully made Covid vaccines. Now, India must focus on drug development

Source: Indian Express

Relevance: Issues related to the development and production of new antibiotics

Synopsis: Efforts should be initiated to consolidate existing strengths in pharmaceuticals and support the country’s antibiotic needs

Challenges posed by AMR

• India has one of the highest levels of antibiotic resistance. It complicates not only the treatment of life-threatening infections, but also endangers outcomes in routine hospital procedures.
• Moreover, the benefits gained through medical advances are nullified when patients contract drug-resistant bacterial infections.
• The pandemic, had further complicated the situation. Around 3-4% COVID patients are acquiring secondary bacterial infections. A recent ICMR study reported high mortality rate of 56% among Covid patients infected with resistant bacterial infections.

Issues in development of new antibiotics

• Poor return on investment,
• The complexity of discovering novel antibiotics for multidrug-resistant pathogens,
• The high cost of bringing a novel antibiotic to the market,
• Irrational use that renders drugs ineffective and contributes to their short market-life. Therefore, required level of attention and resources are not channelled in to this.

This has impacted new drug development and research has stagnated with all major pharma companies exiting the arena.

Worse, antibiotics, recently discovered and developed in the West, do not find their way to India in a timely manner. For instance, Antibiotics such as imipenem/relebactam, and meropenem/vaborbactam, available in the US and EU for more than two years now, are yet to be introduced in India.

Suggestions

1. Timely infusion of funds: The development of the Covid vaccine in India was made possible by the timely infusion of funds as a result of advance purchase payments to companies involved in production. The Covid vaccine story needs to be replicated to support the country’s antibiotic needs.
2. Plan to develop new anti-microbials: India needs to put together a plan for developing new anti-microbials. As a first step, the government needs to recognize the deficiencies in the production pipeline.
3. Efforts should be initiated to consolidate the country’s existing strengths in pharmaceuticals by engaging relevant actors.
4. Independent studies demonstrating the therapeutic value of novel drugs could contribute to identifying drugs whose development can be undertaken.

Conclusion

Despite constraints, the antibiotic space in India has seen a few successes. For instance, The novel combination cefepime-zidebactam discovered in the country is  found to be highly effective against multidrug-resistant pathogens.

It is time that such valuable leads from Indian laboratories mature into ready-to-use drugs for the country’s patients. That will provide a strong impetus to making the country atmanirbhar in healthcare.