Superb Book To Read & Share: “Superbugs, An Arms Race Against Bacteria”

Dear All:

I would like to draw your attention to a superb new book by William Hall, Anthony McDonnell, and Jim O’Neill. The names of the authors may be familiar as Jim O’Neill chaired the UK AMR Review and William Hall and Anthony McDonnell were two of the members of the core team who produced the Review’s seven excellent reports on AMR published during 2014-2016. 

Entitled Superbugs: An Arms Race Against Bacteria, and available on Amazon, the book features a foreword by Dame Sally Davies (Chief Medical Officer of the UK) followed by an introduction that crisply lays out both the problem of AMR and the goal of the book:

  • “At its heart, AMR is a problem of economic and political failure.
  • We need pharmaceutical companies to develop new antibiotics, but we must at the same time limit their use, which then makes it difficult for companies to recoup their investment.
  • The current rewards-based system does not work.
  • In this book, we combine economic policy ideas with our experience of global politics and global business investment to present workable solutions that policymakers can implement.”

The book’s survey of first the problem and then possible solutions (see below my signature for a summary of the chapter headings) is clearly written. Full of readily understood examples and supported by pithy quotes from current thought leaders, the book is perfect for a general audience. I thought the book did an especially good job of covering two key topics from a variety of perspectives:

Learning to think in economic terms. The book’s economic flavor brings together ideas in compelling ways. A great example of this is on pages 42-45 where the authors estimate the cost of AMR in several ways. Using the statistical value of a life (as estimated by the amount we routinely spend to prevent traffic fatalities!), the estimated cost is ~$900b/year. Using math grounded in health care costs and loss of productivity, the cost is $225b/year. Neither figure is perfect, but their scale is similar and the amounts needed to address AMR are a rounding error relative to the costs of AMR. For example, the final DRIVE-AB report calls for public sector push funding of $800m/year and pull funding of $1b/new antibiotic. Similarly, Superbugs itself recommends a global spend of about $4b/year to implement the full suite of approaches to tackling AMR.

Layout the options for solving the problem. Here the book drew heavily on both the UK AMR Review’s analyses + the ideas that were emerging in parallel from DRIVE-AB. The discussion of incentives for new agents builds on the need for public funding for research, collaboration by developers, and implementation of market entry rewards. The insightful discussion of prevention covers infrastructure, infection prevention, and behavior change. And the discussion of approaches to reducing use both in human medicine and food agriculture provide balanced perspectives on aspirations and reality in this space.

The book concludes by describing AMR as “a problem that can be solved.” I agree both with this and with the authors’ assertion that the challenge now is to find the political will to act. On this note, I am encouraged by the existence of ongoing conversations on both sides of the Atlantic. We’re not there yet, but at least we are talking.

Please consider reading and sharing this book as part of ensuring that this ongoing conversation continues! 

All best wishes, –jr

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

Outline of Superbugs

  • Part 1: The problem
    • Ch. 1: When a scratch could kill
    • Ch. 2: The rise of resistance
    • Ch. 3: Failures in tackling drug-resistant infections
  • Part 2: Solutions
    • Ch. 4: Incentives for new drug development
    • Ch. 5: Prevention is better than cure
    • Ch. 6: Reducing unnecessary use of antibiotics in humans
    • Ch. 7: Agriculture and the environment
    • Ch 8: Next steps

Upcoming meetings of interest to the AMR community:

Dear All,
 
The IDWeek 2024 program committee is again seeking programs on novel antimicrobial agents and novel diagnostics for presentation in pipeline sessions! Here’s what is sought:

  • “Industry partners are invited to submit antimicrobials that are in preclinical stages of development (Phase II and III preferred) or recently approved after January 2024.
  • “The pipeline sessions will include antibacterials, antifungals, and antivirals (excluding COVID-19 and HIV).
  • “The committee also invites companies developing novel diagnostic technologies with a minimum of some preliminary proof of concept data to submit.” 

This is a great opportunity to tell the story of your development project! The deadline to submit is Wednesday, June 26 via the application portal. Any questions should be directed to program@idsociety.org. Please share this email with anyone you think might be interested in applying!
 
In addition, I’ll also note that those with a more general story to tell should look at the BugHub Stage (and the Global BugHub stage). Both BugHub variants seek “presentations that touch on your experience of working in infectious diseases and presentations that ultimately lead to a greater understanding of our diverse field” via a TED Talk-esque speech about your work. The deadline for applications is 26 June, the same as for the pipeline sessions.

I look forward to seeing you there! All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Operating Partner, Advent Life Sciences. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://amr.solutions/blog/. All opinions are my own.

John’s Top Recurring Meetings

Virtual meetings are easy to attend, but regular attendance at annual in-person events is the key to building your network and gaining deeper insight. My personal favorites for such in-person meetings are below. Of particular value for developers are the AMR Conference and the ASM-ESCMID conference. Hope to see you there!

  • 27-30 April 2024 (Barcelona, Spain): 34th ECCMID, the annual meeting of the European Society for Clinical Microbiology and Infectious Diseases. Go here for details. 
  • 17-20 Sep 2024 (Porto, Portugal): ASM/ESCMID Joint Conference on Drug Development to Meet the Challenge of Antimicrobial Resistance. Go here for the meeting’s general website. You can’t register (yet) for the 2024 event, but save the date!
  • 16-20 Oct 2024 (Los Angeles, USA): IDWeek 2024, the annual meeting of the Infectious Diseases Society of America. Save the date! More details to come!
  • 25-26 February 2025 (Basel, Switzerland): The 9th AMR Conference 2025. Go here to register

Upcoming meetings of interest to the AMR community:

  • [NEW]  9 Apr 2024 (virtual, 830a-10a ET): GARDP’s next REVIVE webinar entitled “Progressing a discovery project – Criteria and challenges.” Register here.
  • [NEW] 9 Apr 2024 (virtual, 10a-1130a ET): CDC webinar “Impacts of Antimicrobial Resistance on Cancer Care.” Click here for details and to register.
  • 10-11 Apr 2024 (virtual): Sepsis Alliance AMR Conference, a 2-day conference focused on “Practical technologies to manage sepsis and counteract the expanding challenge of antimicrobial resistance.” Go here for details and to register.
  • 26 Apr 2024 (Barcelona, Spain): ESCMID workshop entitled “Using Data Science and Machine Learning for Infection Science: A Hands-on Introduction.” Click here to register or here for more details. 
  • 27-30 April 2024 (Barcelona, Spain): 34th ECCMID, the annual meeting of the European Society for Clinical Microbiology and Infectious Diseases. See Recurring Meetings list, above.
  • 26-31 May 2024 (Montreal, Canada): EDAR7, the McGill AMR Centre’s 7th edition of their Environmental Dimension of Antimicrobial Resistance conference. Go here for details; final abstract deadline is 21 Dec 2023.
  • 28-29 May 2024 (in person, Uppsala, Sweden): Uppsala Antibiotic Days, a broad-ranging 2-day program hosted by the Uppsala Antibiotic Center. Go here for details and to register.
  • [NEW] 30-31 May 2024 (face-to-face in Rockville, Maryland as well as online, 8.30-5.30p ET on 30 May, 9-2.40p on 31 May): NIAID-sponsored workshop entitled “Towards realizing the promise of adjunctive immune therapy for invasive fungal infections”. The agenda covers host immunity to invasive fungal infections, immune modulators in the context of fungal infections; and strategies for testing immune modulators as adjunctive therapy. Go here for more details and to register.
  • 9-13 June 2024 (in person, Ascona, Switzerland): “New Approaches to Combat Antibiotic-Resistant Bacteria, 2nd Edition” is a Sunday-Thursday residential workshop focused on the deep biology of AMR. Sponsored by NCCR AntiResist (a Swiss National Science Foundation consortium), the scientific program has the feel of a Gordon Conference. Space is limited, so you are encouraged to apply promptly — go here for details.
  • 13-17 June 2024 (Atlanta, Georgia): ASM Microbe, the annual meeting of the American Society for Microbiology. You can’t register yet, but you can go here for general details.
  • 17-20 Sep 2024 (Porto, Portugal): ASM/ESCMID Joint Conference on Drug Development to Meet the Challenge of Antimicrobial Resistance. See Recurring Meetings list, above.
  • 16-20 Oct 2024 (Los Angeles, USA): IDWeek 2024, the annual meeting of the Infectious Diseases Society of America. See Recurring Meetings list, above. 
  • 19-27 Oct 2024 (Annecy, France, residential in-person program): ICARe (Interdisciplinary Course on Antibiotics and Resistance). Now in its 8th year, Patrice Courvalin directs the program with the support of an all-star scientific committee and faculty. The resulting soup-to-nuts training covers all aspects of antimicrobials, is very intense, and routinely gets rave reviews! Seating is limited, so mark your calendars now if you are interested. Applications open in March 2024 — go here for more details.
  • 4-5 Dec 2024 (in person, Washington, DC): “Fungal Dx 2024: Fungal Diagnostics in Clinical Practice” is a 2-day in-person workshop organized by ISHAM‘s Fungal Diagnostics Working Group. The program and registration links are available at https://fungaldx.com/; the agenda is comprehensive and features an all-star global list of speakers.

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