Two new reports reveal a weak pipeline for new antibiotics to combat drug-resistant infections.
The World Health Organization (WHO) says this is due to declining private investment and the lack of innovation in the development of new antibiotics.
“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.”
The reports — Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline and Antibacterial agents in preclinical development — also found that small- or medium-sized enterprises primarily drive research and development for antibiotics. Large pharmaceutical companies are continuing to exit the field.
Of the 50 antibiotics in the pipeline, 32 target WHO priority pathogens, the reports state. However, the majority have only limited benefits when compared to existing antibiotics. Two of these are active against the multi-drug resistant Gram-negative bacteria. Gram-negative bacteria, such as Klebsiella pneumoniae and Escherichia coli, can cause severe infections that pose a particular threat for people with weak or not yet fully developed immune systems.
The report highlights a concern against the highly resistant NDM-1 (New Delhi metallo-beta-lactamase 1) as there are only three antibiotics in the pipeline. NDM-1 makes bacteria resistant to a broad range of antibiotics, including those from the carbapenem family.
“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.”
The good news is that the pipeline for antibacterial agents to treat tuberculosis and Clostridium difficile (which causes diarrhea) is more robust. Also, the pre-clinical pipeline shows more innovation and diversity, with 252 agents being developed to treat WHO priority pathogens. However, these products are in the very early stages and still need to be proven effective and safe.