Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.


It usually doesn't take long for new parents to fill a prescription for amoxicillin — an antibiotic frequently wielded in fighting ear infections and other common childhood illnesses.

This year, however, a shortage of the child-friendly liquid form of the drug has providers and parents worried heading into the winter cold and flu season. Amoxicillin can treat the secondary bacterial infections these sicknesses can lead to.

The American Academy of Pediatrics recently warned that the supply issues could last "several months." It provided guidance about alternatives, such as crushing tablets or emptying capsules (which are not in short supply) and then mixing the contents with liquids easily swallowed by young kids.

Fortunately, as the doctors' group notes, the shortage is expected to be temporary. But the supply-chain woes put a fresh spotlight on the fragility of the supply and the need for new antibiotics. It's a multifaceted problem, one requiring innovation and funding, to address short-term problems and the even more daunting challenge of meeting the long-term need for new versions as bacteria become more resistant to current medications.

Congress now has an opportunity to ensure that humans stay ahead in this critical medical arms race. Legislation dubbed the "Pioneering Antimicrobial Subscriptions to End Upsurging Resistance" (PASTEUR) Act would provide a timely $6 billion boost to entice drug companies to continue developing new antibiotics.

Passing it would play a pivotal role in keeping this arsenal stocked with new treatments for future generations. Public investment is necessary because the market incentives that work for other drugs — spend big money to develop a new drug, make back even more through sales — don't work well here.

It can take hundreds of millions of dollars or more to develop a new antibiotic, but there may be only a limited number of patients who need this treatment, and many need it for only a short period. Thus, the return on investment pales in comparison to drugs — such as those that lower cholesterol — that are taken long-term by a wide number of people.

At the same time, enacting PASTEUR wouldn't absolve lawmakers of the pressing responsibility to find additional solutions. A worthy proposal: an influential group of medical experts is calling to set up a nonprofit organization to guide and fund future antibiotics development.

They contend this approach offers a less expensive approach to new drug development and could more effectively target available resources to meet evolving medical needs. A New England Journal of Medicine commentary offers a compelling argument for this approach and is a must-read for policymakers and other stakeholders. Could language or funding to develop the nonprofit approach be added to the PASTEUR bill?

The PASTEUR Act was introduced in 2020 by Sens. Michael Bennet, D-Colo., and Todd Young, R-Ind., as well as two Republican House members. The measure continues to have bipartisan support. Minnesota Republican Rep. Tom Emmer and Democratic Rep. Angie Craig are both cosponsors, for example. Despite this, progress at the Capitol has been disappointingly slow.

But the lame-duck session of Congress offers a chance to remedy this oversight. While lawmakers have a crowded agenda before the end of the year, a push by public health organizations has generated momentum on Capitol Hill.

"We know that the pipeline is already inadequate to address current resistant threats, let alone those that will come in the future. This reinforces the need to urgently stimulate investment in novel antimicrobials to quickly bolster the pipeline,'' said a Nov. 16 letter to congressional leaders signed by the Infectious Diseases Society of America, The Pew Charitable Trusts and dozens of other reputable health care organizations.

Antibiotic resistance is a serious public health challenge. Addressing it requires an "all of the above" approach, not choosing one solution over another. Congress can and should pass PASTEUR and, while it's at it, set the innovative nonprofit approach in motion as well.