In the US, antibiotic innovation has skidded to a halt. The last novel class approved by the FDA debuted in 1984.
A piece of legislation lined up for a vote in Congress, called the Pasteur Act (named both for the 19th-century microbiologist and to stand for Pioneering Antimicrobial Subscriptions to End Upsurging Resistance), could repopulate that empty landscape by guaranteeing government funds to help a small number of new antibiotics make it to market. The proposal has bipartisan support in both the House and Senate, is backed by the Department of Health and Human Services (HHS), was implicitly endorsed in the last White House budget, and resembles programs already implemented in other countries.
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That patients might run out of effective antibiotics is a jarring thought. The Centers for Disease Control and Prevention estimates that antibiotic-resistant infections already kill more than 48,000 Americans each year and sicken 2.8 million. A January study in The Lancet estimated the annual global death toll at 1.27 million. Antibiotic resistance got worse during the pandemic as health care workers tried to protect Covid patients from bacterial infections, not just in individual outbreaks in hospitals but across the US.