Antibiotic resistance is a threat to the vision to eradicate tuberculosis (TB) by 2035. The ERA4TB project, along with eight other European research projects have published a call for sustainable investment in antimicrobial research and antibiotics development in Nature Reviews Drug Discovery. Emphasizing the need to maintain expertise and capability for new treatments for infectious diseases, like TB.
Together, the nine projects which make up the ‘AMR Accelerator’ call on government leaders, the private sector and other stakeholders to invest in the development of new antibiotics and research on antimicrobial resistance (AMR), to secure a sustainable future for large-scale efforts.
“Tuberculosis remains one of the world’s most deadly infectious diseases, resulting in 1.5 million deaths per year. Increasing numbers of people with drug-resistant forms of tuberculosis, mean it is imperative that we continue to fund research into the development of new antimicrobial treatment regimens for Tuberculosis. Sustained funding is needed to ensure that current efforts from projects such as ERA4TB, to keep a flow of new antibiotic treatment regimens through the drug discovery pipeline, are maintained, but also to ensure that new generations of scientists can be trained to continue this work in the future” – Juan Jose Vaquero, ERA4TB Project Coordinator andProfessor of Bioengineering, Universidad Carlos III de Madrid
Increasing drug resistance is not a problem that TB faces alone. In fact, antimicrobial resistance is recognised as one of the greatest global challenges of our time, undermining healthcare systems that rely heavily on antibiotics to prevent and treat infections. The need for new antibiotics is well-recognized, and on 26 September, the United Nations General Assembly will spotlight this issue in a high-level meeting on AMR. However, the low return on investment in this area has caused many large pharmaceutical companies to leave the field. This has led to a decline in the rate of development of new drugs and therapies for bacterial infections.
According to the authors, collaboration and risk-sharing can help keep companies in anti-infective drug development. Public-private partnerships like the AMR Accelerator projects allow different organisations to share risks and costs, and long-term collaborative efforts build expertise and capacity for antibiotics research and development. However, without continued investments, there is a risk that the new generation of experts trained across the AMR Accelerator projects also leave the field.
The broad scope sets the AMR Accelerator apart from other large-scale efforts: covering research on Nontuberculous mycobacteria (NTM), and Gram-negative bacteria provides a unique opportunity for translational R&D. At the same time, the mix of partners from industry, academia, and small R&D companies is also challenging our approaches. Which allows us to both learn and optimise our efforts.
The projects have received funding from the European Commission via the Innovative Medicines Initiative (IMI) and pharmaceutical companies that are members of EFPIA. With a total budget of €479 million, the AMR Accelerator has progressed 44 antibacterial programmes over the past 5 years. So far, the effort has resulted in 16 preclinical and clinical candidates, two completed Phase I studies, and five ongoing Phase I and II studies. The continuing success of the AMR Accelerator demonstrates the value of public-private partnerships, replenishing the antibiotics pipeline and providing tools and infrastructure for the global research community.
“ERA4TB is one of the largest early-phase Tuberculosis research initiatives globally, from pre-clinical activities to Phase 1 first-in-human clinical trials. As part of the AMR Accelerator, ERA4TB works closely with projects focused on the later stages of drug development, such as UNITE4TB. This collaboration enables the efficient progression of novel drug molecules and combinations through the development pipeline, with the aim of reaching TB patients in lower income countries. By working together, we can change the trajectory of TB.” Dr David Barros, ERA4TB Project Lead and VP and Head of Tuberculosis Research, Global Health R&D, GSK
The AMR Accelerator has created critical mass and synergies that have allowed the transfer of assets, knowledge, and expertise between projects. The results are tangible: better and more efficient science, a strengthening of the antibiotic pipeline, and a legacy of research infrastructures that can support the global fight against antibiotic resistance. For ERA4TB these include, standardized TB infection and disease evolution models, sets of non-invasive TB biomarkers, a new clinical trial network, and TB preclinical and clinical trial data repositories and more. However, the key challenge for all nine projects is to ensure the long-term sustainability of assets, infrastructures and expertise. Which in turn requires a commitment from governments and the pharmaceutical industry to long-term investment in antimicrobial research and antibiotics development.
The call to action was published in the comment section of Nature Reviews Drug Discovery. The text can be freely accessed from the journal’s website between 23 September and 6 October 2024.
The AMR Accelerator: from individual organizations to efficient antibiotics development partnerships.
To access the article after 6 October without a subscription, please go to the AMR Accelerator website.
