GUEST VIEW: Superbugs need their own moonshot initiative

By Dr. Cynthia L. Sears and Dr. Fyza Yusuf Shaikh

As two physicians who have devoted our lives to studying cancer, we’re thrilled with President Biden’s “Cancer Moonshot” initiative to halve the disease’s death rate within 25 years. But it won’t achieve that goal unless we act on a lesser-known health crisis.

For many cancer patients who die, their tumors aren’t solely responsible. Superbugs sicken these patients, who can’t fight off infections due to weakened immune systems — even with the help of antibiotics.

Reducing deaths from cancer requires an equally aggressive strategy for defeating drug-resistant infections.

It does not make sense to treat these two crises as separate. It’s already estimated that infections are a primary or associated cause of death in roughly 50% of cancer patients.

Without an effort to neutralize the threat posed by superbugs, these deadly infections will disrupt any progress we make in the fight against cancer.

Superbugs are bacteria and fungi that have developed antimicrobial resistance — a naturally occurring defense against the drugs used to kill them.

We’ve seen firsthand how cancer patients are vulnerable to these deadly infections. Time and again, we’ve watched as patients fighting cancer developed bacterial infections that were highly resistant to antibiotics.

Superbugs can prove fatal for our patients. The risk of someone with cancer dying from an infection is three times higher than the risk for an individual without cancer.

A drug-resistant infection may also force a cancer patient to halt their treatment. A young woman with a drug-resistant abdominal infection might not get the bone marrow transplant she needs to cure her leukemia. For patients undergoing chemotherapy, an infection can delay their treatment while the cancer continues to grow, leading to complications and worse health outcomes.

In short, for cancer patients, the superbug crisis isn’t some far-off threat — it’s a present mortal danger.

Unfortunately, the pipeline for new antibiotics is nowhere near what is needed. At present, there are 64 therapies in clinical development. To put that in perspective, there are more than 1,000 drugs in development for cancer.

Because antibiotics are meant to be used judiciously to preserve their effectiveness, it’s essentially impossible for companies to earn back the money they’ve invested in researching and developing those medicines using typical sales.

It’s for this reason that antibiotic startups have declared bankruptcy or left the industry in recent years.

This market failure demands reforms. The PASTEUR Act would create a system in which the government purchases a “subscription” for access to new antibiotics, instead of paying per dose. PASTEUR would pay for the value of these medicines rather than their volume, giving companies the return on investment they depend on.

The fight against cancer is poised to make enormous strides in the coming years. Yet without an equally energetic effort to beat back superbugs, too many cancer patients will still lose their lives.

Cynthia L. Sears is an infectious diseases physician and professor of medicine at the Johns Hopkins School of Medicine. Fyza Yusuf Shaikh is an oncologist and assistant professor of oncology at the Johns Hopkins School of Medicine. This piece originally ran in the Baltimore Sun.