Billionaires invest in anti-aging. Cool, but who will invest in antibiotics?
In January 2022, biotech start-up Altos Labs came out of stealth mode and publicly affirmed its existence. Altos raised $3 billion in seed capital, which is believed to be the highest amount a biotech company has ever raised in a single round. The company’s goal is “cellular rejuvenation therapy,” or the reversal of the aging process. With a star-studded board full of Nobel laureates and reported investments from Jeff Bezos and Yuri Milner, it’s obvious billionaires are betting big on science to treat aging.
There’s nothing inherently wrong with studying anti-aging – in fact, it represents a fascinating and potentially rewarding trajectory of research. But Altos Labs is emblematic of a more troubling misalignment of research and development funding with the public good. Rather than the public deciding how and for what purpose pharmaceutical development should be funded, we find ourselves increasingly at the mercy of billionaires, who can afford to buy their own research programs.
Biotechnology companies backed by billionaires and endowed with colossal funds are capable of carrying out innovative research without being profitable. Thanks to the massive consolidation of wealth under capitalism, companies like Altos Labs are shielded from the market forces that impact so hard on pharmaceutical development and innovation in other areas of research. If we want to be able to do pharmaceutical development that benefits the public, we must similarly isolate companies that are pursuing research that is of interest to people who are not ultra-rich.
Antibiotic innovation is an area of research that has suffered significantly due to market failures – and one that billionaires seem to find far less compelling than anti-aging.
The development of antibiotic resistance is a critical threat for which we are totally unprepared. A recent study in the Lancet reports that more than 1.2 million people died in 2019 from antibiotic-resistant infections. Another United Nations report projects that by 2050, 10 million deaths a year will be caused by drug-resistant bacterial infections, and that by 2030 antibiotic resistance could plunge up to 24 million people into poverty. In the face of this crisis, we desperately need to develop new antibiotics, in addition to funding public health campaigns to enable more responsible use of existing antibiotics.
However, R&D for new antibiotics has been largely abandoned by pharmaceutical companies. Due to the strict regulation of antibiotic use and the potential for resistance development (which would render specific drugs obsolete for a large number of infections), antibiotic development is not a profitable industry. In fact, antibiotic companies suffered a net loss of $100 million from 2014 to 2016, a figure that would scare off any big venture capitalist looking to invest. In 2019, two companies developing antibiotic candidates, Achaogen and Melinta Therapeutics, filed for bankruptcy. These companies had in fact marketed drug candidates and received FDA approval; for Achaogen, the development of their drug candidate took fifteen years and $1 billion. Because of this high level of risk and lack of profitability, 95% of research into new antibiotics is conducted by small biotechnology companies.
We cannot rely on benevolent billionaires to invest in antibiotic R&D for us. The subject just doesn’t interest them the way anti-aging does. Because much of the burden of antibiotic resistance falls on countries in the Global South, and even in wealthy countries the wealthy can find ways to protect themselves from the threat, billionaires can reasonably assume that they will personally be in safety, even in an era of widespread antibiotic resistance.
If we are to tackle this emerging health crisis, we must nationalize antibiotic R&D and attract the best scientific talent to focus on the problem. As Mariana Mazzucato writes, “nationalization is not just about fixing a failure in the private market; it is about unleashing an entrepreneurial state that has proven itself adept at developing transformative innovations. This “entrepreneurial state” will be able to democratize research funding decisions to align with the public good.
Importantly, a democratically-run antibiotic R&D state apparatus that disregards the need for short-term profits can also ensure fair product distribution. Superbugs do not care about borders, and simply providing commercial incentives and subsidies to the private sector without a mechanism for collective decision-making control will result in an inability to adequately tackle antibiotic resistance in the world. the world.
Calls to nationalize antibiotic production and innovation must be heard immediately. The bipartisan PASTEUR bill introduced in the Senate is a good start, as it would allow the federal government to pay drug developers contractually agreed amounts each year, with the amount of the payment and the length of the contract determined by the value of the drug. We need to pressure representatives to pass this legislation and ensure that the state plays a greater role in shaping administrative decision-making in antibiotic R&D and beyond.
Multi-billion dollar investments to extend human lifespans are good, but we need these kinds of investments for everyone, not just the wealthy few. Life expectancy between poor and rich in America is already vastly different, and science can help bridge that gap. But if driven by profit-hungry corporations and self-reliant billionaires, science will fall short of this potential.
In other words, if we do not pursue robust state intervention, we will find ourselves in a dystopian world infected with very dangerous superbugs and very wealthy capitalists.