GHonorable a old pain The book of Leviticus mentions an infectious condition involving the continuous emission of semen and a painful erection. Only 2,500 years later, in the mid-20th century, the discovery of antibiotics brought relief.
But not, perhaps, for long. Decades of exposure to antibiotics N. Gonorrhea, bacteria that cause disease, develop resistance. With some new antibiotics on the market, the bug is on the rise again. Treatment failures are reported in many countries. It is now designated a “priority” pathogen by the World Health Organization.
News on 1 November that zoliflodacin, a new antibiotic, had been successful in a clinical trial was therefore welcomed. The drug inhibits an enzyme called type II topoisomerase, which is essential for the reproduction of bacteria, among other things. Even more interesting than how zoliflodacin works, though, is how it was made. Most of the drugs are manufactured by private companies. Zoliflodacin was developed with support from the US government and the Global Antibiotic Research and Development Partnership (GARDP), a non-profit organization funded by various organizations including the Wellcome Trust, a major charity, and the Swiss Canton of Geneva.
GARDP Worked with American pharmaceutical company Inoviva Specialty Therapeutics. The company conducts early development, and is shepherding the drug through registration with the Food and Drug Administration. The National Institute of Allergy and Infectious Diseases has guided this through its Phase 2 trials, which test whether a new drug works. GARDP Next, support the drug through much larger Phase 3 trials, the final stage before a drug is approved for use. Its support allows those trials to be tailored to public health goals – such as trials including high-risk patients such as women, adolescents and the elderly. HIV. GARDP It is also handling licensing, which it hopes will make zoliflodazine cheaper and more widely available.
Duncan Graham-Roe, a spokesman for GARDPSuch partnerships could increase the supply of new antibiotics, he said. (Another non-profit, CARB–X, doing similar work.) The dearth of new drugs in recent decades mainly reflects weak incentives. To delay the development of resistance, new antibiotics should be held in reserve until they are really needed. But a drug that spends years on the shelf is not commercially attractive.
Governments have tried to address that problem with concepts such as guaranteed prices and annual payments even if the drugs are not used. State-run pharmaceutical companies have also been contested. It will take more than zoliflodacin to show that GARDP Found a winning formula. But the signs are good: It’s developing four more antibiotics, including one for complicated urinary tract infections, and more are on the way■
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