In a policy brief published earlier this week, the World Health Organization (WHO) called for global coordination on policies to strengthen the antibacterial pipeline.
The brief highlights a problem the WHO and other antimicrobial resistance (AMR) experts have been warning about for several years—the insufficient number of antibiotic candidates, and the limited innovation in the antibiotic research and development (R&D) pipeline. The WHO notes that of the 128 antibacterial agents in the development pipeline over the past 6 years, only 16 have received market approval, and only 2 have met the WHO's innovation criteria. Moreover, the products still in clinical development do not sufficiently address multidrug-resistant or pan-drug–resistant organisms and the evolving mechanisms of drug resistance.
The WHO cites the "persistent R&D challenges" that have created this situation and made the antibiotic pipeline "highly fragile." In particular, it notes that small biotechnology companies make up 93% of the active antibiotic developers in the space. Yet these companies have limited financial, scientific, and technical resources.
Governments need to ensure adequate resources for R&D
To address these problems, the policy brief calls on governments to ensure adequate resources, including financial push and pull incentives, to boost the antibiotic R&D pipeline and ensure equitable and global access to new antibiotics. It also urges governments to foster innovation in antibiotic R&D, focus on addressing the needs of the small biotechnology companies that are driving innovation in the sector, and strengthen the scientific and drug-development communities in the low- and middle-income countries (LMICs) most heavily impacted by AMR.
Other recommendations include emphasizing the development of oral antibiotic formulations, prioritizing new antibiotic treatment options for infants and newborns, and exploring the potential for non-traditional agents.
"Existing antibacterial agents are inadequate against the escalating challenge of drug-resistant infections," the WHO wrote. "Immediate global coordination and cooperation is essential to enhance innovative R&D, improve AMR data collection and sharing, and implement investment strategies that are focused on addressing the needs of vulnerable patients, particularly in LMICs, which lack equitable access to medicines, vaccines and diagnostics despite bearing the greater burden of AMR."