  Drug resistance is a serious public health problem that threatens to thwart
our ability to treat many infectious diseases. Repeatedly, the introduction of
new drugs has been followed by the evolution of resistance. In principle there
are two ways to address this problem: (i) enhancing drug development, and (ii)
slowing drug resistance. We present data and a modeling approach based on
queueing theory that explores how interventions aimed at these two facets
affect the ability of the entire drug supply system to provide service.
Analytical and simulation-based results show that, all else equal, slowing the
evolution of drug resistance is more effective at ensuring an adequate supply
of effective drugs than is enhancing the rate at which new drugs are developed.
This lends support to the idea that evolution management is not only a
significant component of the solution to the problem of drug resistance, but
may in fact be the most important component.
