“Eine linsengrosse Menge genügt”

“A quantity the size of a lentil is sufficient,” the famous slogan on an old-fashioned German toothpaste that dates back to when toothpastes were sold as powders. A tiny dab from the small tube still suffices to brush your teeth.

The old problem of how to encourage the sale of small quantities appears pertinent to our failure to replace medicines that the germs have beaten.

The World Health Organization has said some of humanity’s most notorious germs can no longer be cured. Anyone who’s read the desperation and pain of the contagious life sentences we helplessly passed around to each other before the discovery of sulpha drugs and then antibiotics might wonder why the private sector doesn’t appear to be devoting the resources to antibiotic research that the problem appears to call for, and why governments don’t put more restrictions on the widespread use of antimicrobial substances. One plausible explanation I heard is that pharma companies are incentivized to find drugs that can be sold to the largest possible pool of customers who will consume them for as long as possible, to maximize the volume of sales of medicines as if they were any other widget. By that incentive, it might be less interesting to discover efficacious cures for the new superstrains of tuberculosis and gonorrhea, and more interesting to seek patents on therapies that can treat but not cure e.g a chronic condition in humans, chickens and cows (especially in rich cows). By this reckoning it might even look possible to earn more by switching from selling prescription drugs to nonprescription drugs. Or possibly beer.

Solving the problem of antimicrobial resistance would require spending money to find new treatments that work, yet selling the found drugs as sparingly as possible.

Harry Shearer said a W.H.O. official said one solution is to start thinking about effective antibiotics as global public goods. Good investment in vaccine research might eradicate these diseases while selling ~10 billion vaccine doses for each disease cured, even more if it works in chickens and cows. More dangerous solutions might include making the investments to find new therapies and then openly keeping the supply low and demand high for the precious new drugs to drive up their price; but this tactic would kill people whenever and wherever an economy or nomocracy hit a shaky patch. Finding new effective drugs but then keeping them secret, and thus available only to a small elite, would dangerously undertest the medicines, be more susceptible to fraud, and kneecap research.

(Eye na   LIN zen grow sah  MENG ah   geh NUE gt.)

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