The PASTEUR Act is not the way for the US government to address antimicrobial resistance
Antimicrobials are medicines, such as antibiotics, used to treat and prevent infections caused by bacteria, viruses, and fungi. When these microorganisms evolve to survive antimicrobial treatment, it is called antimicrobial resistance (AMR). AMR is a leading health threat and takes a huge toll on people’s wellbeing, particularly in low- and middle-income countries (LMICs), but is also a major concern in the US.
Neglect of antimicrobial research and development (R&D) has prompted the US government to experiment with “pull” incentive interventions to try to entice corporations to invest in this space, such as reimbursement reforms to support higher drug prices, extended monopolies, and other market-entry rewards and guarantees, including the proposed Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act.
However, this analysis by MSF shows that the PASTEUR Act is not the right way to spur antimicrobial innovation. The Act would: 1) drive up prices of PASTEUR-supported novel antimicrobials in all markets - negatively impacting access to the new products for people who need them; 2) compromise stewardship of resulting antimicrobials; and 3) be an inefficient means of incentivizing meaningful antimicrobial innovation.
The US government should prudently expand its role in encouraging antimicrobial R&D because new drugs are and will continue to be needed, and this type of innovation needs additional support. It should, however, use other means than the PASTEUR Act – particularly expanding investment in public and non-profit R&D – that would retain federal authority in the production and distribution of resulting products, better ensuring stewardship, equitable access, innovation of public health significance, and the kind of open science and collaboration that are badly needed to advance antimicrobial R&D.
