Development of Antibiotics is Not Profitable, Universities Play a Crucial Role

The pharmaceutical and life sciences sector is a central pillar of the Swiss economy, accounting for nearly 40 percent of Swiss exports and involving significant investments in research and development. The long road to the approval of a new drug always begins with a scientific breakthrough, followed by long-term investments, human resources, and coordinated strategies. The results benefit patients, society, and the economy alike.

In an interview with the SNSF, Michael Lobritz explains why new drugs to combat antibiotic resistance are urgently needed—and why basic research is essential in this endeavour.

Michael Lobritz, you are the Head of the Infectious Diseases Department at Roche Pharma Research and Early Development. Before this, you worked as a physician and researcher in the field of infectious diseases. What role does fundamental research play in the development of new drugs?

Fundamental research is the foundation of everything. There are sometimes misconceptions about the difference between the work of companies like Roche and the academic world. Academic research is about discoveries and exploring unknown biological mechanisms. Pharmaceutical research, on the other hand, involves creating something new—we make the next step by translating scientific insights into actual treatments. The two worlds complement each other, and I often refer to them together as 'applied fundamental research,' bridging the gap between discovery and product development.

Can you give a concrete example?

The most well-known case is the discovery and development of penicillin. Many know the story of English researcher Alexander Fleming, who in 1929 observed that mould on a forgotten petri dish had killed nearby bacteria. That was an astonishing discovery, but not yet a medicine. Penicillin only reached the market in the mid-1940s.

What happened in the meantime?

More than a decade passed before Howard Florey and his team in Oxford could prove that the purified substance was effective, and before suitable purification and production methods enabled safe and effective use. This demonstrates how fundamental and pharmaceutical research complement each other: First, relevant mechanisms are identified, and later, actual treatments are developed.

The example of penicillin also illustrates the importance of long- term support for basic research. Institutions like the Swiss National Science Foundation play a crucial role in promoting this early-stage research, which lays the foundation for subsequent medical breakthroughs.

Is a solid scientific foundation particularly important in infectious diseases?

This foundation is central in all areas, but infectious diseases have particular characteristics. New pathogens regularly emerge, and familiar ones appear in resistant forms. The constant change means we must always be innovative.

Is there a lack of innovation in certain infectious diseases?

Yes. When there is insufficient investment in basic research for certain pathogens, gaps in urgently needed medications arise. Covid-19 showed us how decades of research can suddenly become vital: The rapid development of mRNA vaccines was only possible because years of research had already been conducted in this area.

This shows how fundamental research lays the foundation for future innovations. Since developing a new technology can take up to 15 years, we need to think about the medical needs of 2040 today.

How important are antibiotics for modern medicine?

Their importance cannot be overestimated—nor can the basic research that precedes them. Antibiotics are so deeply embedded in healthcare that they are almost invisible. However, without them, much of modern medicine would be unthinkable. On any given day, up to half of all hospital patients receive antibiotics; in intensive care units, it's sometimes over 90 percent. Antibiotics were among the first drugs to fundamentally change healthcare, and all subsequent progress has been built upon them because they keep sick people alive who would otherwise be more vulnerable to serious infections due to various treatments, from cancer therapy to transplantation. Without antibiotics, the entirety of medical care would be at risk. Society would cease to function.

Are we heading towards a major health crisis if antibiotic resistance isn't resolved?

Even today, there are cases where patients can no longer be cured because of resistance. Without constant innovation, we risk returning to a time when even common infections or minor surgeries could end up being lethal. Imagine being unable to cure a simple infection because no antibiotic works—that scenario must be prevented. Antibiotics are not just a nice-to-have, but enormously important for healthcare.

At the same time, we see less innovation in antibiotics than in other therapeutic areas. Few companies are heavily investing in early-stage antibiotic research, and the barriers are not scientific but economic.

What is needed for basic research to continue producing effective treatments?

In this field, certain rules must be followed: Every antibiotic has a life cycle. The goal is for a new antibiotic to remain effective for decades and protect public health. Unlike other drugs, new antibiotics should therefore be reserved for serious cases and used sparingly. This, however, means that development is not profitable.

Here, academic research plays a crucial role: Universities and public research institutions are not profit-driven. They can develop new insights into the mechanisms of antibiotics, providing the basis for future treatments.

Government financial incentives are also important. There are two types: push incentives aim to share the cost and risk of research and development, supporting both successes and failures. Pull incentives reward successful innovations after approval—for example, through premiums when a drug comes to market or by purchase guarantees.

What steps do you take to develop an antibiotic from research findings? Where do you start?

The starting point is our scientific foundation and our long experience with treatments against infections, starting with the first drug against tuberculosis. Collaboration with the academic world is essential.

For our new antibiotic candidate, Zosurabalpin, Phase III trials are upcoming, which means extensive studies to confirm safety and efficacy before approval. We knew that it could kill bacteria but not how. By collaborating with a Harvard lab that researches bacterial memory mechanisms, we were able to understand the functioning of the active substance in detail and identify an entirely novel target molecule. This shows how fundamental research and industrial development together produce completely new treatments.

Editor's note: Image rights belong to the respective publisher. Image rights: SNF