Big pharma’s bold plan to bring four new antibiotics to the table by 2030

An unprecedented partnership A new Antimicrobial Resistance Action Fund (AMR) will inject nearly US $1 billion into the collapsing antibiotic development pipeline, aiming to bring two to four new antibiotics to patients by 2030. Launched Thursday by the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), it’s the biggest single investment in antibiotic research in four years that brings 23 different pharma companies towards a common goal, said IFPMA’s director-general Thomas Cueni on Thursday.

“We must act together to rebuild the pipeline and ensure that the most promising and innovative antibiotics make it from the lab to patients,” said Cueni as he launched the virtual event on Thursday. “The AMR Action Fund is one of the largest and most ambitious collaborative initiatives ever undertaken by the pharmaceutical industry to respond to a global public health threat.”

AMR will hit us hard if we don’t hit it now. AMR infections claim over 700,000 lives every year, a higher death toll than COVID-19 so far, Cueni notes. But mortality from drug resistant infections could kill up to 10 million people a year by 2050 under business-as-usual scenarios, according to a recent UN interagency report.

But the toll of infections extends beyond physical health, and affects livelihoods as well. AMR could push 28 million more people into poverty at a staggering cost of $ 60-100 trillion, according to the IFPMA.

Innovation is desperately short. Investments in antibiotic development are lacking despite their growing need. Given that new antibiotics are closely rationed to prevent the development of resistance against them, it’s difficult to turn a profit on antimicrobials that have just hit the market because the new drugs can’t be sold in large quantities. As a result, biotech firms have gone bankrupt or turned away from antibiotic research in recent years - even when they had developed successful new products. Cueni:

“Fact of the matter is, right now the worst which can happen to somebody who invests in antibiotics is that they succeed, because then they will lose more money than when they just have to write off research expenditure.”

COVID-19 will exacerbate AMR The pandemic may hasten the long looming threat of antimicrobial resistance as hospitalizations due to the disease ramp up. Here’s why:

• Healthcare professionals are increasingly likely to prescribe antibiotics to patients with Covid-19 in hospital settings to ward off secondary bacterial or fungal “co-infections”. As a result, antibiotic use is currently soaring. Meanwhile, hospitals risk becoming new breeding grounds for antimicrobial resistance.

• One review of treatments administered to over 2,000 hospitalized Covid-19 patients, published by researchers at Imperial College, London and the United Kingdom’s National Health Service, found that 72% of them had received antimicrobial treatment although only 8 % had bacterial or fungal co-infections when they were admitted.

“AMR is a slow tsunami that threatens to unwind a century of medical progress,” said WHO director-general Dr Tedros Adhanom Ghebreyesus, in a video message at the AMR Action Fund Launch. “So game-changing investments into biotechnology companies around the world are required now.”

A lifeline for small innovators The AMR Action Fund provides “an urgently needed lifeline for innovators,” said Jeremy Farrar, director of The Wellcome Trust, especially for small and medium sized enterprises (SMEs), which have shied away from developing antibiotics in the current landscape.

Bridging solutions for synergy The AMR Action Fund is a “bridging solution” rather than a solution in itself, emphasized Cueni, complementing other initiatives at the regional level. Nathalie Moll, director-general of the European Federation of Pharmaceutical Industries and Associations cites that 12 AMR-related funding projects are ongoing in Europe. Here’s one example of how that will work:

• The Impact Repair Fund is a $165 million fund which supports early-stage development of AMR therapies; it is led by the Danish-based investor Novo Holdings.

• However, later stage R&D -which is more expensive - remains poorly funded.

• The new AMR Action Fund can synergize with Novo’s Impact Repair Fund, sealing the investment vacuum at later stages of R&D. Drugs showing promise at early stages can be carried forward throughout the development pipeline without financial roadblocks getting in the way.

“The Impact Repair Fund [of Novo Holdings] is focused on the earlier stages of development”, said Novo Holdings CEO Kasim Kutay. “We were always counting on other investors to take the products into the more complicated and more expensive later stages [of R&D], but with investors having fled the field, we were trying to do both at the same time, which is just not practical.”