Author: Anna Sundin

JPIAMR is pleased to welcome the Republic of Moldova as a full member. JPIAMR now engages 28 nations to curb antibiotic resistance (AMR) with a One Health approach.

Moldova is represented in JPIAMR by the National Agency for Research and Development (NARD). NARD is the central public authority, responsible for the implementation of R&I policy according to National Program. The Agency offers investment in research, including within the domains of health and wellbeing. Nine public specialised research organisations have been established under the Ministry of Health Labour and Social Protection of Moldova. The State’s Program in the frame of the Strategic Priority “Health” has launched two projects in AMR for the period 2020-2023. The goals are to study the mechanisms of AMR resistance in gram-negative bacilli and to explore of nosocomial infections in intensive care units, as well as the development of new antibacterial preparations. Moldova has a draft of the National Program for Surveillance and Control of AMR (2019-2028) based on strategic objectives of the Global AMR Action Plan, with the support of WHO.

– We are very pleased to welcome Moldova as a member of JPIAMR, strengthening this unique platform for research collaboration across borders. Now Moldova will now take part of JPIAMRs One Health approach and in funding research to meet the global challenge of AMR. says Jan-Ingvar Jönsson, Acting Chair of JPIAMR

Two new reports from WHO reveal a weak pipeline for antibiotic agents. The 60 products in development bring little benefit over existing treatments and very few target the most critical resistant bacteria.

WHO recently released the analyses of the preclinical and clinical antibacterial pipeline in two reports: Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline and its companion publication, Antibacterial agents in preclinical development
The JPIAMR Scientific advisory board has provided input to the development of the preclinical pipeline.

Declining private investment and lack of innovation in the development of new antibiotics are undermining efforts to combat drug-resistant infections. These two new reports reveal a weak pipeline for antibiotic agents. The 60 products in development (50 antibiotics and 10 biologics) bring little benefit over existing treatments and very few target the most critical resistant bacteria (Gram-negative bacteria). Of the 50 antibiotics in the pipeline, 32 target WHO priority pathogens but the majority have only limited benefits when compared to existing antibiotics. Two of these are active against the multi-drug resistant Gram-negative bacteria, which are spreading rapidly and require urgent solutions. The reports highlights a worrying gap in activity against the highly resistant NDM-1 (New Delhi metallo-beta-lactamase 1), with only three antibiotics in the pipeline.

The pre-clinical pipeline shows more innovation and diversity, with 252 agents being developed in 145 institutions with wide geographical distribution, 66 (45.5%) institutions in the European Region, 51 (35.2%) in the Region of the Americas, 22 (15.2%) in the Western Pacific Region, 5 (3.4%) in the South-East Asia Region and 1 (0.7%) in the African Region to treat WHO priority pathogens, M. tuberculosis and C. difficile. However, these products are in the very early stages of development and still need to be proven effective and safe which means that it will take years before they reach patients. Really compelling novel antibacterial are very rare. Improved versions of existing-class compounds should be more explored. The optimistic scenario, the report indicates, is for the first two to five products to become available in about 10 years. The reports also found that research and development for antibiotics is primarily driven by small- or medium-sized enterprises (71%) with large pharmaceutical companies continuing to exit the field.

The JPIAMR Activity Report that was published today summarises the JPIAMR achievements and major events for the year 2019.

The JPIAMR Activity Report that was published today summarises the JPIAMR achievements and major events for the year 2019, including:

• Global consolidation of JPIAMR with the establishment of global regional workshops in Asia, Latin America and Eastern Europe, as well as the geographical expansion of its membership.
• JPIAMR has been highlighted as a key transnational initiative to address AMR by the highest international bodies, for example, in the IACG UN recommendations on a global AMR governance, the G20 Health Ministers conclusions and the EU Council Conclusion on AMR.
• Launch of the updated Strategic Research and Innovation Agenda (SRIA), as well as the Roadmap of Actions 2019-2024.
• Publication of the mapping of AMR Research Funding national distribution and launch of the AMR Research Funding Dashboard.
• Progress in the development of the JPIAMR-Virtual Research Institute. The JPIAMR-VRI builds on the outcomes of the funded research networks.
• Launch of a first Hackathon on AMR which was a major success, awarding teams with new innovative digital solutions to address AMR.
• Launch of a joint research call in the area of “Diagnostics and Surveillance” together with Development Agencies which has enabled the engagement with the scientific community of LMICs.

Download the full report: JPIAMR Activity Report 2019 (pdf 2 MB, opens in a new window)

A review article on “The global preclinical antibacterial pipeline” has been published recently in Nature Reviews Microbiology that provides comprehensive analyses on discovery and preclinical development projects that were at least in the lead generation phase (hit-to-lead phase) but had not yet reached first-in-human studies. The focus is to identify whether enough antibacterial drugs are being discovered and developed and provide decision support for all actors in this field. JPIAMR has supported WHO in the preclinical pipeline analysis and the contribution of JPIAMR has been acknowledged in the article.

Briefly, the review highlights that the current preclinical antibacterial pipeline consists of 407 highly diverse projects from 314 institutions, most of which are small and medium- sized

enterprises (SMEs). Less than half of the projects involve direct- acting small molecules and 70% of these aim at new targets.  The focus is on Gram- negative pathogens, particularly bacteria on the WHO priority bacteria list. The preclinical pipeline shows a strong trend towards non- traditional approaches, including diverse antivirulence approaches, microbiome- modifying strategies, and engineered phages and probiotics.

The innovative potential and the high levels of diversity of the preclinical pipeline is encouraging but fragile. Of the many reasons highlighted, the dearth of funding available for clinical development of antibacterial therapies is a major challenge that contributes to barriers for progression of preclinical projects to human trials. Other than strong dependence on public and/or philanthropic funding, a long- term commitment of sustained push funding, pull incentives and new concepts for commercializing and delivering future therapies is necessary.

Download the full article (pdf 1 MB, opens in a new window)

A back to back viewpoint was also published in Nature Reviews Microbiology on the “Antibiotic development – economic, regulatory and societal challenges”. Seven experts, including one of the members of the JPIAMR Scientific Advisory Board (SAB), Ramanan Laxminarayan, highlighted the challenges that are contributing to the decline in antibiotic drug discovery and development. JPIAMR has been highlighted as one of the international initiatives aimed at incentivizing research and the development of new antibiotics.

Download the full article (pdf 0,8 MB, opens in a new window)

Romania is organising a 1,5 day JPIAMR workshop in Bucharest on the 5-6 December targeting the policy making level with the aim to explore opportunities for putting together EU and global experience and sharing resources and achievements in order to find sustainable solutions for tackling AMR in the Eastern Europe Region. Speakers from different European countries will share their experiences.

Read more

Download final workshop program (pdf 0,2 MB, opens in a new window)

We are launching a regional JPIAMR Workshop in Asia: Fostering knowledge on Clinical Epidemiology, AMR policy, Therapeutics and Diagnostics to combat AMR in Asia. This workshop will bring together experts and researchers from Asia to provide insights on Antimicrobial Resistance in Asia. The workshop will be held at Sungkyunkwan University, Suwon, South Korea, December 4-5, 2019.

The workshop is organised by Korea and supported by the National Research Foundation of Korea (NRF), the Japan Agency for Medical Research and Development (AMED) and by JPIAMR.

Read more and register.