Composing Policy Interventions for Antibiotic Development

Sammanfattning: Antibiotic resistance is eroding the efficacy of the drugs we have and, unless future science dictates otherwise, bacteria will eventually become resistant to whatever new antibiotics we discover. We must therefore plan for a continuous stream of innovation. Unfortunately, pharmaceutical firms have left the scene to pursue more profitable areas. While the free market may eventually give rise to a solution, the question is how much destruction we are willing to accept on the way, and whether it eventually will be too late. A plethora of policy interventions, aimed at stimulating antibiotic research and development, have been suggested, and simulation modelers have begun estimating their effects. Suggested interventions range from prizes, grants, and competitions to regulatory fast-tracking and non-profit development. No unified picture of what to do has emerged. From the perspective of policy-makers, the need does not seem to be for more but for better information. This thesis suggests that to truly compare policy interventions, aimed at stimulating antibiotic development, we should draw on simulation model alignment techniques. To support such an endeavor this thesis presents the seeds of a compositional language capable of formally expressing policy interventions as offers that can be actualized into contracts. The language is not merely theoretical but implementable and usable within actual simulation models. The language is not only derived from previous research on compositional contracts in functional languages and the resources-events-agents ontology, but also the author's unique position as a participant in DRIVE-AB, which comprised 16 public and 7 private partners from 12 countries, and finally six separately published simulation experiments that are all based on work by the author. A constructive proof is provided to establish the utility of the solution in terms of its capacity to capture important facets of important policy interventions.