The discovery and introduction of antibiotics in the 1940s transformed modern medicine and enabled enormous progress in medical care and life expectancy. Today, this progress is threatened by a growing health crisis: antimicrobial resistance (AMR). Infections caused by bacteria resistant to antibiotics kill more than 30,000 Europeans a year, according to the European Center for Disease Prevention and Control (ECDC), a figure that rises to 700,000 people worldwide. In addition, the World Health Organization (WHO) warned a few years ago that by the year 2050 in the world there will be more deaths related to resistant superbugs than from cancer, even that it will be the main cause of death on the planet.
Antimicrobial resistance is therefore a health threat that can compromise many medical advances that rely on antibiotics, such as surgery, chemotherapy or the treatment of chronic diseases. Today there is only one way to combat AMR: effective new antibiotics and responsible use of existing ones.
As the world grapples with the Covid-19 pandemic, now more than ever is the time to think about delivering a robust and collaborative response to antimicrobial resistance. AMR is a natural process that occurs when microorganisms such as bacteria, viruses, fungi, and parasites change, so that the medications used to treat the infections they cause become ineffective. This means that a new generation of antibiotics is essential to guarantee the fight against the evolution of these pathogens.
A new report from the American innovative pharmaceutical industry association, PhRMA, shows that there is a strong commitment from the industry to respond to this problem for global public health. About 90 drugs are in development to fight infections resistant to current treatments. As can be seen in the graph below, these potential drugs are aimed at combating 17 different pathogens and the usefulness of many of them is being studied in several of these pathogens at the same time.
Researchers at pharmaceutical companies are working to develop new and effective drugs, including innovative antibacterial treatments – going beyond traditional R&D pathways – such as bacteriophage products, live therapeutics, and monoclonal antibodies. Unfortunately, there are obstacles in this area, such as the time required to research and develop new treatments and the lack of incentives.
The development of new drugs is a long, complex and risky process that requires between 10 and 15 years and an average investment of 2,500 million euros. If we talk about antibiotics, this process carries an even greater risk. The development of new antimicrobials can take between 10 and 20.5 years.
A market in need of incentives
At the same time, there is the paradox that, despite the enormous social costs that antimicrobial resistance implies, the new antibiotics are not commercially viable given their moderate use to preserve their effectiveness. This is the reason why in recent years several companies focused on this field have been forced to close and others have abandoned the investigation due to the lack of viability of the projects, according to PhRMA, which has resulted in a significant loss of knowledge and valuable resources, as well as a lack of products in the clinical phases.
To address the challenges of early clinical development and later phases of new antimicrobial drugs, innovative partnerships and initiatives have been established between the public and private sectors. The biopharmaceutical industry, in particular, is taking different measures, including those carried out through the AMR Action Fund. This $ 1 billion fund aims to bring 2-4 new antimicrobials to market by 2030, focusing on innovative drugs that address the highest priority public health needs. This industry-driven investment effort is also advocating for comprehensive policy reforms to promote new reimbursement models and create incentives for adequate patient access, creating a sustainable ecosystem for antimicrobial R&D and commercialization.
The fund will also provide technical support to startups, giving them access to the vast experience and resources of Big Pharma to strengthen and accelerate the development of new antibiotics. The success of this research process will thus make society more prepared for the next public health emergency.