Pharmaceutical companies are in a tough position; they are highly regulated, trials are expensive, new products fail most of the time, and if they are successful, everyone complains the cost is too high while the company tries to make money before it goes generic.

In the UK, the company with the best antibiotic pipeline in the world, AstraZeneca, is trying to sell that business, because they don't think they will ever make money at it given current restrictions.

Government is not ready to fill in the gap, it will be far too expensive for academics, who are not used to having to produce products and endure trials. In The Lancet Infectious Diseases, it's noted that less than 1% of research funding awarded by public and charitable bodies to UK researchers in 2008 was awarded for research on antibiotics, the first detailed assessment of public and charitable funding to UK researchers focusing on bacteriology and antibiotic research.

Credit: Life Sciences Foundation

According to lead author Professor Laura Piddock, of the University of Birmingham, "The message that antibacterial (i.e. antibiotic) drug resistance has become a world health crisis has been brought to global attention by WHO, the European Union (EU), the World Economic Forum, and, most recently, the UK Chief Medical Officer. As a world leader in biomedical research, UK research has an important part to play in tackling this crisis. However, our study clearly shows that the proportion of public and charitable funding for research into new antibiotics, understanding resistance mechanisms and ways of tackling resistance are inadequate for the size of the task."

Piddock and colleague analyzed funding databases for the UK's main research funding organizations, finding that of £13.8 billion total available research funding, £269 million (1.9%) was awarded to bacteriology projects, and around a third of this (£95 million or 0.7% of total funding) was awarded for research on antibiotics. Additionally, £181 million in EU funding was awarded to antibiotic research consortia including researchers based within the UK, including two EU Innovative Medicines Initiative awards, totaling £85 million.

While this article focused exclusively on research funding for antibiotics, previous studies have shown that funding for other antimicrobials (antifungals and antivirals) is similarly low as a proportion of total funding.

As well as demonstrating that the proportion of research funding given for UK antibiotic research will need to increase, the authors suggest that publicly available, subject-specific, funding databases will allow investment in priority areas to be tracked in future.  

"Since 2011, most new EU funding has focused on public–private partnerships with industry," adds Piddock. "However, an increased understanding about antibiotic resistance is needed, not least to inform strategies to both minimize and prevent antibiotic-resistant bacteria arising when new treatments become available."

In a linked Comment, Dr Michael G Head from the Farr Institute, University College London, UK, said "The private sector needs to be more transparent about how much they invest in areas related to antibiotics (generation of new therapeutics being an obvious and particularly important area), so that their data can be similarly analyzed in detail. Efforts to document the investments of other countries regarding antibiotic resistance research would be beneficial and would allow funders and policymakers to chart the optimum future direction of research money. Metrics to establish the true burden of antibiotic resistance and methods also to assess the likely effect of other types of research are needed; for example, preventive research such as vaccine development will affect future burdens of bacterial infections and resistance."