Moral Entrepreneurship: Integrating Equity within Antimicrobial Resistance Innovation

Abstract

The AMR public health threat and the surge of AMR entrepreneurship initiatives under the current biopharmaceutical innovation ecosystem offer policy and industry decision-makers an opportunity to re-examine medical innovation governance. Pressing concerns include how R&D is financed, why manufacturing capacity is heavily consolidated in a few private actors, why science benefits are not equitably distributed, and whether the current biopharmaceutical business model is serving access to science. Ultimately, how can the invention of therapeutic interventions excel while improving equitable access to lifesaving products? In this essay, I argue it is urgent to integrate equity into the organizational structure, funding, and governance of firms and collaborative initiatives when designing antimicrobial innovation business models, paying attention to the market and political power silos in biotechnology. Offering a critical examination of the power dynamics present in healthcare technology innovation, this essay suggests equity-based governance strategies to mediate the tension between the production and accessibility of novel AMR treatments.

Section I provides a theoretical view of Hayek’s liberal thinking of entrepreneurship inefficiency and social justice. Section II examines the ‘power silo problem’ in biopharmaceutical R&D. Tracing back the inequitable production and distribution of mRNA COVID-19 vaccines, this section evidences the harms that market and political power concentrations created over public health. Section III invites readers to consider an alternative account to Hayek’s and suggests equity and efficiency play equal roles as drivers of sustainable biopharmaceutical innovation in the AMR realm. Section IV provides a normative account of equitable and moral entrepreneurship. By looking closely at the AMR Action Fund and the AMR Industry Alliance, this section suggests equity-based private governance strategies to identify organizational and financial challenges.

Keywords: AMR, access to medicine, equitable access, governance, health justice, innovation, business model, biotechnology

JEL Classification: I1, D6