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California’s growing AMR challenges demand a federal response | Guest Commentary

October 29, 2022
The Sentinel
By Guest Commentary


An epidemic is taking shape in California and effective treatments to stop it are getting harder to find.

In 2020, the CDC reported that antibiotic resistant infections and related deaths increased by 15%. A portion of this was due to the COVID-19 pandemic, but what too many people don’t know is that antimicrobial resistance (AMR) is an increasingly urgent threat throughout the country, and it takes many forms in California.

While people living with chronic conditions are at an increased risk, there is another growing threat in California that is putting antimicrobials to the test. Valley fever is caused by a fungus found naturally in parts of the state, most notably Kern County at the southern end of the Central Valley.

Symptoms are usually flu-like, though at its most serious, Valley fever can be long-lasting and even lead to death.

With the fungus long present in the southwest, California and Arizona account for the vast majority of the roughly 20,000 annual U.S. cases. But it would be a mistake to treat this as a strictly local matter. The rise of Valley fever is part of a larger global health crisis known as antimicrobial resistance, or AMR.

Doctors typically treat Valley fever with a 3-to-6-month course of anti-fungal medication. But the more we expose microbes like fungi and bacteria to medicines designed to kill them, the more some become immune. The medical community calls these drug-resistant microbes “superbugs.”

Drug resistant superbugs already kill about 35,000 Americans each year and about 1.27 million people worldwide. Without a large-scale effort to develop better medicines, this superbug threat is growing even more deadly.

The declining effectiveness of antimicrobials has several causes. For one, these medicines have been vastly overprescribed for years. Excess and incorrect use breeds more resistant microorganisms.

Here, Valley fever provides a telling illustration. Since Valley Fever resembles many bacterial infections, it’s common for doctors to mistakenly prescribe antibiotics to patients who have the disease. When antibiotics are used inappropriately, it accelerates the process by which bacteria become immune. This is also happening in the world of fungi.

A dramatic reduction in types of pharmaceutical development is also to blame for the AMR crisis. In fact, scientists haven’t successfully brought a new class of antibiotics to market since 1984.

The reasons are largely economic; according to a Cambridge University study, it costs about $1.5 billion to develop a new antibiotic. Since antimicrobials are supposed to be prescribed as little as possible, companies have little chance of earning a return on this kind of investment.

As long as these market barriers persist, so will the antimicrobial resistant infections and related deaths.

Fortunately, legislative solutions are in the works. One, the PASTEUR Act, would create a model in which the government pays for effective new antimicrobials on a subscription basis, providing developers with a source of income regardless of quantity used.

Another promising proposal, the FORWARD Act, takes a more targeted approach, directing funds to the development of new treatments for fungal infections including Valley fever specifically.

Together, these two bills could mark a turning point in the U.S. fight against antimicrobial resistance — and address a public health crisis that is putting Californians at increased risk.


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