Twenty-three drug companies have joined forces to invest $1bn in a fund to develop new antibiotics, which are needed urgently to fight the worldwide rise in antimicrobial-resistant superbugs.
The AMR Action Fund, launched on Thursday, aims to support clinical research that will bring two to four new antibiotics to market by 2030. They will target bacteria that cause the most life-threatening diseases and have the greatest resistance to existing drugs.
David Ricks, chief executive of Eli Lilly and chair of the International Federation of Pharmaceutical Manufacturers and Associations, said the fund would “sustain an antibiotic pipeline that is on the verge of collapse, a potentially devastating situation that could affect millions of people around the world”.
According to IFPMA, 700,000 people a year die from infections that cannot be treated because the bacteria have evolved to resist available antibiotics — and “in some of the most alarming scenarios, it is estimated that by 2050 AMR could claim as many as 10m lives per year”.
Among many emerging “nightmare bacteria” are carbapenem-resistant Enterobacteriaceae, which kill up to half of infected patients, and multi-drug resistant Pseudomonas aeruginosa, a leading cause of fatal lung infections in people with cystic fibrosis.
The fund expects to invest in 15 to 20 novel antibiotics that have started clinical trials, of which 20 per cent to 25 per cent might be expected to show sufficient safety and efficacy to reach the market.
The AMR initiative was approaching completion at the beginning of this year. Then came Covid-19, which turned the attention of the pharma industry and the world’s infectious disease experts to fighting coronavirus rather than bacteria.
Although the pandemic has somewhat delayed the launch of the AMR Action Fund, industry leaders said it injected new urgency into the search for better treatments for infections — bacterial and viral.
“Unlike Covid-19, AMR is a predictable and preventable crisis,” said Thomas Cueni, IFPMA director-general. “We must act together to rebuild the pipeline and ensure that the most promising and innovative antibiotics make it from the lab to patients.”
Foundations and development banks are expected to add further resources to the AMR Action Fund, taking its value above $1bn. Werner Hoyer, president of the European Investment Bank, issued a supportive statement for the launch.
“EIB is actively supporting identified market failures with innovative financial instruments,” said Mr Hoyer. “Antimicrobial resistance is clearly one.”
The fund will be based in Boston, with an additional hub in Europe. It will invest in biotech companies “focused on developing innovative anti-bacterial treatments that address the highest priority public health needs, make a significant difference in clinical practice and save lives.”
The management team and its investors will also provide technical support to portfolio companies, tapping the expertise and resources of the large pharmaceutical companies that have invested in the fund.
The AMR Action Fund will add substantially to the resources deployed by two existing, smaller initiatives that aim to develop new antibiotics — and take the drugs further through clinical trials.
Carb-X, a global non-profit based at Boston University, is investing more than $500m provided by public and philanthropic sources between 2016 and 2021, to take projects into the first stage of clinical testing. Novo Holdings of Denmark launched Repair Impact Fund in 2018 to invest $165m in 20 AMR start-ups, early-stage companies and corporate spinouts.
At the same time the pharmaceutical industry will be lobbying governments to provide the financial incentives needed to pull antibiotics through an expensive development process and on to the market.
Drug companies have left the field over the past 20 years for a number of reasons, including the low price of generic antibiotics, the fact that the drugs are taken only for a short time — and the likelihood that governments will keep any effective new ones that emerge in reserve to treat the most serious infections and prevent resistance emerging through overuse.
Dame Sally Davies, UK special envoy on AMR and former Chief Medical Officer for England, called the new fund “a good start by the pharma industry to make up for their past disinvestment in antibiotics”.