WHO Pipeline Review: “The world is running out of antibiotics”

Dear All: 

Released just a few hours ago in parallel with the UN General Assembly meetings, WHO has produced a detailed review of the global pipeline. As they note on their overview webpage, “The report found very few potential treatment options for those antibiotic-resistant infections identified by WHO as posing the greatest threat to health, including drug-resistant tuberculosis which kills around 250 000 people each year.”

The core report is here (and in the spirit of full disclosure, know that I contributed to the report). The only comparable analysis is the ongoing Pew Trust Antibiotic Pipeline Analysis, a series that has the advantage of providing pipeline snapshots every 3-6 months going back as far Feb 2014. The two analyses are (no surprise) very similar.

WHO has also released a new document describing their priority pathogen list. The list is unchanged from the initial release in February but the new document contains a lot of supplemental details.

From my perspective, the key message of the new WHO pipeline report is found in Section 5.3 (emphasis added by me): “Given the average success rates and development times in the past (18), the current pipeline of antibiotics and biologicals could lead to around 10 new approvals over the next 5 years. However, these new treatments will add little to the already existing arsenal and will not be sufficient to tackle the impending AMR threat. More investment is needed in basic science, drug discovery and clinical development, especially for the critical priority Gram-negative carbapenem-resistant pathogens P. aeruginosa, A. baumannii and Enterobacteriaceae.

Although those of us who are active in the field feel like we hear this message every day, many others (including key policy makers) do not fully appreciate the depth of the crisis. Kudos to WHO for releasing such a clear report in a timely fashion for the UNGA audience and to Pew for their longitudinal work to monitor the pipeline.

And for all of you engaged in antibiotic R&D, the message is clear … please get busy and find a few new (and preferably novel mechanism) drugs!

All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Chief Strategy Officer, CARB-X | Expert-in-Residence, Wellcome Trust. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://13.43.35.2/blog/

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