A new report from the World Health Organization (WHO) shows a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance.
Most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and are only short-term solutions. The report found very few potential treatment options for those antibiotic-resistant infections identified by WHO as posing the greatest threat to health.
Challenges in research and development of new antibiotics
The report, Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline, including Mycobacterium tuberculosis, identifies 51 new antibiotics and biologicals in clinical development to treat priority antibiotic-resistant pathogens as defined by WHO, tuberculosis and Clostridium difficile. Only eight of these drug candidates have been classified as truly innovative, highlighting the difficulties in research and development of new antibiotics. Considering a success rate of 14% from phase I trials to approval, only ten of the substances can be expected to reach the market within 10 years. One or two of these are potentially active against Gram-negative pathogens.
“Antimicrobial resistance is a global health emergency that will seriously jeopardize progress in modern medicine.”
says Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, in context of the release of the report.
“There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery.”
New treatments alone will not be sufficient
There is a serious lack of treatment options for multidrug-resistant tuberculosis and Gram-negative pathogens, which can cause severe and often deadly infections that pose a particular threat in hospitals and nursing homes.
New treatments alone, however, will not be sufficient to counter the threat of antimicrobial resistance. As recent reports from the South East Asian region highlight, national action plans need to be created and implemented. Infection prevention and control need to be improved and existing and future antibiotics need to be used appropriately in all sectors, human as well as animal.
The report shows the crucial need for push funding to boost innovation
The report is sobering input to a global policy debate which recently has focused a lot on establishing expensive pull incentives. In fact, it shows quite clearly that there is little innovation of global health value to “pull” out of the pipeline.
“To move new promising compounds into the R&D pipeline, policy makers need to promote push investments in early discovery stages.”
points Helle Aagaard, Policy Advisor at ReAct Europe, out.
“This strategy would ensure that funding is transforming the innovation ecosystem by targeting a broader set of actors, as opposed to late stage pull incentives which tend to only target big pharmaceutical companies.”
“In addition, we must not forget that many existing antibiotic treatments and prevention measures are not readily available in low and middle-income countries.”