Antibiotic resistance requires new thinking — learn from Norwegian oil policy

Everyone wants new antibiotics, but no one wants to pay for them now. This is a typical market failure, where free markets don't give us the solutions we need.

Why should the pharmaceutical industry invest billions in developing new antibiotics now, before there is a market?

The rational thing is to wait until the need arises and the businesses know what terms they are getting. Unfortunately, this can cost society valuable time and many lives. Developing new drugs takes many years.

The fact that an industry takes less investment risk than society wants is a problem Norway has solved before. And we can do it again.

The Oil and Gas Exploration Refund Scheme has been crucial in stimulating new activity in the North Sea, and for companies to take the risk of looking for new fields. Now similar mechanisms are needed for the development of new antibiotics.

The solution is to change mindsets about what we as a society should pay for. Today we pay the pharmaceutical industry for our use, but we should rather pay for access.

We can look to Sweden, Germany and the United States for inspiration. They have introduced so-called pull incentives, such as payment guarantees for access on new antibiotics. This is how industry can make money developing a product, regardless of its use.

If more countries join forces, such schemes will have a greater effect. Norway has strong research environments, a solid economy and a long tradition of contributing to global health. We should therefore take our share of responsibility for establishing new mechanisms. Only in this way can we keep antibiotic resistance in check. And it's urgent.

Already, more than twice as many Norwegians die from resistant bacteria as in traffic. Worldwide, more than a million people die each year. This comes to light in a note from the thinkforge Long term, which proposes a funding mechanism as described here.

It will get worse. Last week FHI came up with ominous numerals: the number of Norwegians infected by the most resistant bacteria has grown by a total of 70 percent in the last two years. Antibiotic resistance not only costs many lives, it also threatens modern medicine.

When antibiotics no longer work, all forms of surgery become more dangerous. Cancer treatment is becoming more risky. Even routine interventions such as caesarean sections can become life-threatening, if they are followed by infections we are unable to treat.

Before antibiotics were developed and adopted in the 1940s, bacterial infections such as pneumonia, blood poisoning and tuberculosis were among the most common causes of death in Norway. Pneumonia could also hit young people hard. Many died because there were no effective medicines. This, in turn, could become reality.

Norway is among the countries in the world that use the least antibiotics, both in health care and in agriculture. This is good, but not enough. That we contribute little to the problem does not give us protection in return.

Without antibiotics that work, much of the health care system as we know it today changes. Therefore, we should learn from what has worked before, including on the Norwegian continental shelf. In order for businesses to make necessary investments, they need to get paid for what society needs. For antibiotics, it's all about preparedness, not use.