Cultures of development and innovation

In 1967, William Stewart, the Surgeon General of the United States of America, famously stated that the “time has come to close the book on infectious diseases”. Stewart’s comments reflected a dominant cultural view of the world where nature was thought to be under control and the dangers to health of microbial life forms could be managed through a combination of human ingenuity and increasing scientific knowledge. At that time, many scientists believed that, at least in high- and upper-middle-income countries, infectious diseases were largely under control. 

From the late 1960s, beliefs in the capacity of scientific medicine to control, or eradicate, infectious diseases contributed in part to a move away from the development of antibiotic medicines. Companies focused instead on developing antibiotic analogues, and on the production of more lucrative patent-protected medicines used over prolonged periods of time. Antibiotic analogue development was a low-risk innovation strategy compared to the development of new antibiotic classes, which were not only deemed more and more unnecessary but were also subject to expensive and increasingly regulated clinical trial processes. In this climate, antibiotic development laboratories and research programmes were shut down, which led to a loss of scientific and technological infrastructure and skills.

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