A pair of reports from the World Health Organization (WHO) shows a weak incoming pipeline of antibiotics, and, according to the organization, this lack of innovation is only going to degrade efforts to counter drug-resistant infections.
Research and development, according to the twin reports, are primarily driven by small and medium-sized enterprises. These companies often struggle to compete against the larger pharmaceutical companies which dominate the industry, but those companies are increasingly stepping away from innovation. This is not helped by declining interest from private investors.
The latest reports are merely a culmination of a long-term trend. Now, with 60 products currently in development — 50 antibiotics and 10 biologics — the WHO reports that few of these bring much in the way of improvement over existing treatments or target the most critical of resistant bacteria. More hope lies with the more than 250 early stage, pre-clinical candidates currently being developed to target WHO priority pathogens, but WHO warns they will take years before reaching patients. Even in the most optimistic scenario, according to reports, perhaps two to five of those products become available in 10 years.
“Never has the threat of antimicrobial resistance been more immediate and the need for solutions more urgent,” Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, said. “Numerous initiatives are underway to reduce resistance, but we also need countries and the pharmaceutical industry to step up and contribute with sustainable funding and innovative new medicines.”
In 2017, WHO published a priority pathogens list consisting of 12 classics of bacteria and tuberculosis the organization found that posed increasing risk due to increasing drug resistance. This was meant to encourage medical research. Of the 50 antibiotics in the current pipeline, 32 target WHO priority pathogens. However, most of these have only limited benefits compared to predecessors, and only two are active against multi-drug resistant Gram-negative bacteria.
This poses a particular threat for newborns, the elderly, and others with compromised immune systems, such as surgery and cancer patients.
“It’s important to focus public and private investment on the development of treatments that are effective against the highly resistant bacteria because we are running out of options,” Hanan Balkhy, WHO Assistant Director-General for Antimicrobial Resistance, said. “And we need to ensure that once we have these new treatments, they will be available to all who need them.”