The industrial development of antibiotics is often presented as one of the last great contributions of capitalism to human development. It was so, but fraught with contradictions from the very beginning. Antibiotics were industrialized for war and were the basis on which the great global pharmaceutical monopolies were built. All in all a breakthrough for the species. But the triumph against bacterial infections is a race against the clock and is being lost. The reason? Developing up-to-date antibiotics is not attractive enough for big capital.
Antibiotics, war and the first global pharmaceutical monopolies
The history of antibiotics in a graphic
In school we are often taught that antibiotics were discovered by a Scottish researcher, Dr. Fleming, in 1928. This is a half-truth. Although he isolated the mold Penicillium notatum and demonstrated its therapeutic possibilities, the real revolution was its industrialization, which did not begin until a decade later.
And it was actually research by IG Farben, the great monopoly linked to the war effort, and hard core of German state capitalism what first put an antibiotic into production: sulfonamide. Originally intended as a veterinary product for the military - in World War I, eight million horses had died- its use in humans was soon discovered. Sulfonamide consisted of those little sachets with a white powder poured into soldiers' wounds by field paramedics.
The U.S., which wanted something similar to prepare its military for a war, showed interest after the successful use of penicillin to prevent infections associated with skin grafts after a famous fire in Chicago. The promise of orders set capital in motion, Oxford's best researchers set to work on its industrialization, and when the US entered the war in 1942, the industry could begin supplying US troops and field hospitals.
In 1944, when Fleming was awarded the Nobel in Medicine, shared with Chain and Florey - the two Oxonian researchers responsible for industrialization - penicillin was still a monopoly of the occupying armies of the US and Britain (as lovers of "The Third Man" will recall). But in 1945, when the Allied armies begin to reduce their orders, antibiotics were introduced on a large scale in hospitals. The "Golden Age of laboratories" begins, in which most of the classes of antibiotics still in use today were discovered.
The economic profits of penicillin and the first large families of antibiotics were the driving force behind the concentration of the British and American big pharma industry. It can be said that "Big Pharma" is the child of the extension of penicillin and war capitalism.
In the rest of the industrialized world, states funded research, provided subsidies and mobilized private capital. The US used the "wonder drug" as a way of securing its new sphere of influence. As a mixture of all these things is how, for instance, antibiotics reached the Mediterranean countries. They reached Spain in 1948, in one of the first "gestures" towards Franco.
The industrialization of antibiotic production put an end to the most frequent causes of death at the time and reduced hospital mortality drastically. So it's true, antibiotics were a contribution of capitalism to human development... although one need only look at the context -- world war, state capitalism, hyper-concentration of capital, in a word, imperialism to realize that they were already in their origin the fruit of a system in decline.
Antibiotics and human development under decadent capitalism
For the contribution to human development made by antibiotics to have a real impact, research must be ongoing. Bacteria evolve and adapt, and with them the industry must keep its finger on the pulse of research and production. It's a race, not a milestone beaten once and forever.
Decadence in the end means that the logic of the system, the demands of accumulation, come more and more frequently, violently and constantly into contradiction with human needs. And that is exactly what has happened with antibiotics.
Imagine a world in which routine surgery or chemotherapy is considered too dangerous because there are no drugs to prevent or treat bacterial infections. Unless researchers develop new antibiotics and therapies, the annihilation of modern medicine will soon become a reality.
The post-antibiotic era is here. Science, July 30, 2021
The antibiotic crisis in two charts: new developments since 1980 and antibiotics "abandoned" due to proprietary company bankruptcy in the last decade (5 of 15)
The cause is that big pharma has dropped out of the race against bacteria. As the cited Science article asserted, "It is no secret that the main problem is the private sector's lack of interest in pursuing the development of new antimicrobial therapeutics."
In a bitter paradox, antibiotics fueled the growth of the most profitable pharmaceutical companies of the 20th century and are one of the classes of drugs most needed by society. Yet the market for them is broken.
For nearly two decades, the large corporations that once dominated antibiotic discovery have been running away from the business, saying the prices they can charge for these life-saving drugs are too low to support the cost of developing them. Most of the companies now working on antibiotics are small biotech companies, many of them operating on credit, and many are failing.
In the past two years alone, four such companies filed for bankruptcy or put themselves up for sale, despite having survived the perilous decade-long development and testing process to get a new drug approved. When they collapsed, Achaogen, Aradigm, Melinta Therapeutics and Tetraphase Pharmaceuticals took out of circulation, or drastically reduced the availability of, 5 of the 15 antibiotics approved by the U.S. Food and Drug Administration ').
The Antibiotic Paradox. Nature, August 19, 2020
Expected returns on investment in antibiotics
Actually, as the chart shows, antibiotics are profitable within patent terms...but not profitable enough for capital to reward large placements to the companies involved in them.
Under capitalism, research is part of the productive process and this is subordinated to the accumulation of capital. And during decadence, moreover, the hyperconcentration of capital deforms the productive fabric and the overabundance of [fictitious capital](http://dictionary.marxismo.school/Fictitious capital/) dedicated to speculation offers placement alternatives that are often more profitable... and capital does not care whether this leaves basic human needs unattended or not.
Is there no solution?
The traditional way to "incentivize" in state capitalism would be to further lengthen the patent. The problem is that the big laboratories are no longer convinced even by the possibility of increasing the terms of legal monopoly on their discoveries. Antibiotics, they say, take too long to be profitable.
As we saw with microprocessors, with quantum technologies, with the heavy industry, with the climate change and with so much else, including the gratuitous killing during the current pandemic and the growing contradiction between health and capitalism, capital accumulation increasingly comes into contradiction with the most basic social needs. That is why there is no true human development even despite all the technological and scientific conditions being in place.
It is true that proposals have appeared for the creation of a global macro-regulator to ensure "incentives" with mechanisms similar to the "Green Deal" to large pharmaceutical companies that resume research on antibiotics. In other words, state-orchestrated transfers of income from workers to capital invested in pharmaceuticals. It is no coincidence that the proposals made so far would guarantee prices that would possibly make commonly used antibiotics inaccessible to a good part of the global population, as is already happening in the USA where the consumption of veterinary antibiotics by people has increased due to health costs.
When capital and its states tell us they want to fix some of the barbarities produced by their own system, they do not subordinate accumulation to the social objective, they simply, as we can see every day with the Green Deal, design a way to accelerate accumulation at the expense of basic needs and call us to a "sacrifice to save Humanity" which in reality is a sacrifice for the profitability of capital. On top of that they expect us to be grateful to them for exploiting us more "in exchange" for destroying less.
Their way of dealing with the growing contradiction between capitalism and human needs is... to deny even more universal human needs. There is no problem to solve using capitalism, capitalism is the problem, and the solution is to confront it and put an end to it.