Weak pipeline for antibiotic agents

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.

JPIAMR Activity Report 2019

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:

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

Winners of Hacking AMR 2019

The grand prize in the Hacking AMR 2019 event that was arranged in Stockholm, Sweden, 13-15 December was won by team ‘Mission Prescription’. The winning project presented an idea to support doctors in their prescribing behaviours by providing them with a tool to monitor their own prescribing in relation to the rest of the medical community. This type of intervention has the goal to reduce incorrect use of antibiotics.

The members in team ‘Mission Prescription’ were, from back row, left to right, in picture above: David Barber, Family Physician and researcher, Queen’s University, Canada; Lennard Epping, PhD student, Robert Koch Institute, Germany; David Hinrichs, Data scientist, Robert Koch Institute, Germany; Sabrina Wong, Health researcher and nurse, Canada; Vendela Wiener, Public Health Agency of Sweden; Sumeet Tiwari, PhD student, Robert Koch Institute, Germany. Missing in picture is Ewan Gray, Researcher, University of Edinburgh, UK.

The People’s choice award and Honourable Mention went to team ‘The Waiting Game’ who developed the concept for a game that can be played while a patient is in a doctor’s waiting room. The goal of the game is to educate the patient on AMR, limiting requests for unnecessary antibiotics.

The aim of the Hacking AMR 2019 hackathon was to bring together scientists, designers, patients, developers, innovators, students and entrepreneurs to collaborate, dream up & create solutions to real-world problems to improve human, animal and environmental health and wellbeing with regards to Antimicrobial Resistance. During the hackathon 40 participants formed seven different teams and worked on diverse digital solutions to AMR.

Royalty free photos by Eva Garmendia.

Hacking AMR 2019 is a Joint Programming Initiative on Antimicrobial Resistance – Virtual Research Institute (JPIAMR-VRI) activity organised by the Swedish Research Council, Institute of Infection and Immunity (III) of the Canadian Institutes of Health Research (CIHR), the Research Council of Norway, Uppsala Antibiotic Center (UAC), and the University of Edinburgh, Edinburgh Medical School. Hacking Health Foundation were consultants for Hacking AMR 2019.

Showreel about the workshop

Articles in Nature Reviews

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)

JPIAMR-VRI network CONNECT survey

The main aim of the JPIAMR-VRI network CONNECT is to identify priorities on the research in the field of AMR, in a One Health approach, in Europe through the creation of a platform that will allow knowledge, resource, findings, database exchange, and connection between researches.

In order to improve connection between researchers, the network is preparing a list of main projects, research centers and networks on AMR research, regardless of the source of funding. For this purpose, a survey has been developed to collect research institutions, scientific societies, infrastructures, projects, networks related to research on antimicrobial resistance in a One Health Approach. The survey also allows adding information regarding the issues perceived as priorities for the research in the field of AMR in a One Health approach.

The survey is open until the 11 of December 2019: CONNECT survey – Research projects, research centers and networks on antibiotic resistance with a One Health approach (link, opens in a new window)

Regional JPIAMR Workshop in Eastern Europe

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)

AMR Dx Global Survey

The JPIAMR-VRI network AMR DX Global has published a survey about the current state of training, teaching and awareness in AMR diagnostics. The main aim of this survey is to get a better understanding of the current and future needs, availability and gaps of AMR diagnostics training to a wide variety of stakeholders such as patients, healthcare workers, farmers, legislators, and innovators. As AMR concerns us all, the network accepts input from any type of stakeholder. This survey will help shape the input into the future VRI offerings.

The survey is open until 29 February 2020 and is completely anonymous. AMR Dx Global does not track your visit to the survey website. Join the survey AMR Diagnostics-Teaching and Training

AMR Diagnostics Teaching & Training Resource
The AMR DX Global mapping of teaching and training resources globally includes online (such as MOOCs, webinars, etc.) and offline resources such as (classes, workshops, conferences, etc.). The resulting database will feed into the future activities of the JPIAMR VRI.

If you like to join the family and promote an AMR diagnostics teaching & training resource you are involved with, you can use the following form: AMR Diagnostics Teaching & Training Resource – Self Registration

Hacking AMR 2019

JPIAMR is organising an international hackathon in Stockholm 13-15 December 2019: Hacking AMR 2019 – Using the digital world to fight antimicrobial resistance

The hackathon aims to bring together scientists, designers, patients, developers, innovators, students and entrepreneurs to collaborate, dream up & create solutions to real-world problems to improve human, animal and environmental health and well-being with regards to Antimicrobial Resistance.

We have decided to allow for up to 10 extra spots in the participants group of Hacking AMR 2019! If you have heard of anyone that had previously missed the cut off date and really wanted to join this exciting, high energy, creative and fun JPIAMR-VRI activity, they have another chance to register until 10 December at midnight.

To read more about the event, please click here.

This Hackathon is a Joint Programming Initiative on Antimicrobial Resistance – Virtual Research Institute (JPIAMR-VRI) activity supported and co-organised with the following groups: Swedish Research Council; Institute of Infection and Immunity (III) of the Canadian Institutes of Health Research (CIHR); Research Council of Norway; Uppsala Antibiotic Center (UAC); Hacking Health Foundation

#HackingAMR2019

Regional JPIAMR Workshop in Asia

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.

Results of the JPIAMR Call on Diagnostics & Surveillance 2019

Twelve projects involving 55 partners from 25 different countries have been awarded funding within the JPIAMR 9th transnational call: “Call on Diagnostics and Surveillance 2019”. The total funding amount is 12,1 M€.

For a list and description of all awarded projects, please visit the following page: Projects awarded funding within the 9th JPIAMR Joint Call

Today and during the World Antibiotic Awareness Week (18 – 24 November 2019) JPIAMR will publish videos where some of the awarded projects are presented by the project coordinators. Please visit the JPIAMR YouTube channelfor updates.

The call was launched in December 2018 and supported by 20 research-funding organisations from JPIAMR member countries. The primary aim of the call was to support innovative research projects on new or improved diagnostic and surveillance strategies, tools, technologies and methods. The call also aimed to support research projects that have the potential for impact in areas where the risk and burden of AMR is greatest, such as in LMIC settings in Asia and Africa.