As the COVID-19 pandemic began to engulf the world by storm, the World Health Organization (WHO) and The Pew Charitable Trust (Pew) released each assessment of the global antibiotic pipeline. Both found that there are still not enough antibacterial treatments in clinical development worldwide to fight the increased risk of drug-resistant bacterial infections.
Developing new, innovative antibiotics is resource-intensive and scientifically difficult. And, when more antibiotics are used, they become less effective, so new antibiotics are often kept in reserve to help maintain their potency. This is good for public health, but as a result of the relatively low potential sales volume, it becomes challenging for companies to remodel their investments. As a result, major pharmaceutical companies have shied away from antibiotic development. The remaining small companies struggle to maintain their operations – many still facing bankruptcy after successfully bringing antibiotics to the new market.
Today almost all antibiotics in our arsenal are based on discoveries for more than 35 years. And currently only 1 in 4 candidates in the development pipeline represent the new types of drugs needed to overcome resistance. Even more problematic is that historical data suggest that many candidates will fail clinical trials, with only a small fraction receiving regulatory approval.
COVID-19 reminds us so poignantly We need to create a more flexible health system that includes access to effective antibiotics to deal with future outbreaks. Antibiotic resistance is a dangerous public health crisis requiring better preparation, including a strong clinical antibacterial development pipeline.
Pew and WHO ask policymakers, pharmaceutical companies, research funds and antibiotic innovation stakeholders:
- Increase in public funding for early stage research for innovative antibiotics To overcome the basic scientific challenges of antibiotic discovery.
- Promising antibiotics successfully proceed through clinical development This includes public private partnerships such as CARB-X and GARDP – by increasing push and pull incentives.
- Identify innovative solutions for a substantial return on investment for new antibiotics while ensuring their proper use. This may include different reimbursement and procurement models to facilitate the immediate need to bring antibiotics to market.
These efforts must be strong and sustained to stabilize and revive the broken antibiotic development pipeline and market. As the risk of antibiotic resistance continues to increase, novel antibiotics are urgently needed – now more than ever.
The WHO is committed to shaping the public health R&D priority setting agenda to combat antimicrobial resistance and continues to review the preclinical and clinical antibacterial pipeline on an annual basis as well as expanding to fungal pathogens of public health importance Will keep
Pew Charitable Trust Tracks the global antibiotic pipeline to shed light on the state of antibiotic development, to evaluate and advocate public policies, and to bring researchers together to discover new drugs. Pew also works to reduce inappropriate use of antibiotics in human medicine and animal agriculture which intensify drug resistance.