From magic bullets to friendly fire

I was just asked to serve on the Medical Alumni Council for the University of Pennsylvania, representing the nation’s oldest medical school (1765).  While I was there recently I had the pleasure of seeing one of the senior alumni whom I had first encountered as a medical student in 1974. 

After a full medical career, he has gone on to serve for the past 17 years of “retirement” as a senior advisor to the Food and Drug Administration (FDA) on new drugs for hepatitis and others. Part of this role includes organizing special advisory processes for this problem and others.

I had been aware that there is an “arms race” underway among biotech and drug companies to develop and test new treatments for hepatitis (caused by viruses). But I had no idea just how extensive the race has become. I marveled to learn that he now has to help the FDA sort through over 50 new drugs in various stages of development.

We also marveled that back during the 1970’s as medical students we were counseled not to go into infectious diseases as a career. Because we pretty well “had that problem licked now” with the new miracle drugs of antibiotics. Instead, we were advised to enlist in the new “War on Cancer” signed into law by President Nixon in 1972.  This was before HIV/AIDS, atypical strains of TB, MRSA, Ebola, West Nile virus, Eastern Equine Encephalitis, Hanta virus, etc.  

In 1998, when I was in Philadelphia running the College of Physicians, I led the creation of a popular new educational exhibit called “Emerging Infectious Diseases: Ancient Scourge and Modern Menace.”  

Due to the widespread use of the antibiotic “miracle drugs,” we predicted the rise of dangerous antibiotic-resistant bacteria, saying that these “Magic bullets were turning into friendly fire.”  

At the exhibit opening, during the opening address, one of the local distinguished professors who had remained in the field of infectious diseases stated it was about time someone was drawing attention back to these emerging problems. 

Indeed, the medical industry and the FDA have been letting things slide when it comes to treating infectious diseases. That’s according to the new U.S. Congressional FDA Safety and Innovation Act of last July. 

And it turns out the development of new drugs for infectious disease has been in serious decline for decades. And the number of actual new FDA-approved drugs for infectious diseases has been falling steadily since the 1980’s. Of course, this is all during the widespread, persistent, and indiscriminate use of antibiotics, which has led to the development of more deadly antibiotic-resistant bacteria.

Today, it’s estimated that over two-thirds of infections in the hospital are caused by these dangerous resistant bacteria, with around 2 million cases and 100,000 deaths per year.

But don’t worry! They’ve formed a new committee to study the problem!

Of course, that’s just the typical response from lifelong career bureaucrats when they’re caught asleep at the switch. They simply form a “committee” to deflect responsibility and create the illusion of action. 

But at least we can now hope that something good will finally come out of all this inaction. These committees also typically include experts from outside the government, who—needless to say—are a bit more motivated. So there should be more tools to work with to initiate some special advisory processes and results. Just as has happened with my former professor from Penn.


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