Global AMR Action: EU Pharmaceutical Strategy; One Health Global Leaders Group on AMR

Dear All (and note the related 29 Apr 2021 newsletter),

As was discussed at length in the recent Wellcome Trust-sponsored analysis of the AMR-related needs for the coming decades (see this newsletter), it is critical that we build and maintain momentum around AMR-focused work. As a big part of that revolves around being visible in high-level political discussions, two recent events are very exciting: (i) An EU Pharmaceutical Strategy that includes pull incentives and a BARDA-like facility for Europe and (ii) the launch of a high-level political Global Leaders Group for AMR. Here we go…

First, the EU has announced a Pharmaceutical Strategy for Europe. Go here for the main webpage, here for the .pdf of the strategy, and here for brief factsheetAddendum: There was a prior newsletter about the call for comments on the strategy;  Kevin Outterson and I submitted these comments (.pdf).

This substantial initiative was triggered by a 10 Sep 2019 letter from Ursula von der Leyen (EC President) to Stella Kyriakides, Commissioner for Health and Food Safety in which Dr. von der Leyen said, “I want you to look at ways to help ensure Europe has the supply of affordable medicines to meet its needs. In doing so, you should support the European pharmaceutical industry to ensure that it remains an innovator and world leader.”

The comprehensive strategy encompasses access, unmet medical needs, competitiveness, innovation, sustainability of the EU’s pharmaceutical industry, medicine quality, and crisis preparedness and response. The proposed actions are called out as a series of topics for Flagship Initiatives:

  • Antimicrobial Resistance
  • Enhancing Europe’s Health Crisis Response mechanisms by creation of an EU Health Emergency Response Authority
    • In the document, this is actually the next-to-last initiative … I moved it up for convenience.
  • Unmet Needs (pediatrics and rare diseases)
  • Access to Medicines (includes an analysis of the root causes of deferred market launches)
    • Relatedly, you might be interested in a prior newsletter on delayed antibiotic launches
  • Affordability
  • Competitiveness (efforts around intellectual property and building the workforce)
  • Innovation (lots of high-tech digital ideas here)
  • Regulatory Efficiency
  • Open Strategy Autonomy (lots of work on the security of drug manufacturing supply chains)
  • Quality and Environmental Sustainability (good manufacturing practices)
  • International Cooperation

Looking in detail at the AMR-focused topics, here are some relevant text excerpts:

  • On AMR itself, specific initiatives are:
    • “Pilot innovative approaches to EU R&D and public procurement for antimicrobials and their alternatives aiming to provide pull incentives for novel antimicrobials.”
      • Wow! The text commentary notes that “Current incentive models do not provide a sustainable solution; new business approaches are required, including new incentives to develop antimicrobials as well as new pricing systems.”
    • “Promote investment and coordinate research, development, manufacturing, deployment and use for novel antibiotics as part of the new EU Health Emergency Response Authority (HERA), prior to the start of the authority’s operations preparatory action on AMR.”
      • Is this Europe’s equivalent of BARDA? Sure sounds like it … see also below.
    • “Consider in the review of the pharmaceutical legislation to introduce measures to restrict and optimise the use of antimicrobial medicines. Explore new types of incentives for innovative antimicrobials.”
      • These two items appear in one bullet point. Good stewardship is of course a good idea and it is great to see the need for incentives stated twice.
  • On enhancing Europe’s health crisis response mechanisms, we have Creation of an EU Health Emergency Response Authority (HERA):
    • “HERA fills a major structural gap in the EU’s crisis preparedness and response infrastructure, and will strengthen the coordination of operations across the whole value chain and develop strategic investments for research, development, manufacturing, deployment, distribution and use of medical countermeasures.
      • “This will require the assembly of ecosystems of public and private capabilities that jointly enable a rapid response when the need arises.
    • “HERA will anticipate specific threats and enable technologies through horizon scanning and foresight.
      • “It will identify and address investment gaps in key countermeasures including the development of innovative antimicrobials.
      • “It will monitor and pool production capacity, raw material requirements and availability, thus addressing supply chain vulnerabilities.
      • “It will support the development of crosscutting technological solutions (e.g. vaccine platform technologies) that sustain preparedness and response planning for future public health threats and development of specific countermeasures, including through research, clinical trials and data infrastructure.”

Wow! Wow! Wow! A specific shout-out for incentives and new business approaches? Creation of a BARDA-like authority for Europe? Fantastic!

Relatedly, there was a thoughtful commentary in the 28 Nov 2020 issue of The Lancet on the recently created One Health Global Leaders Group on Antimicrobial Resistance (OH-GLG-AMR, OK, I couldn’t resist that acronym!).This is the kind of high-level leadership that will keep AMR on the global political agenda:

  • The GLG was created in response to the 2019 “No Time to Wait: Securing the Future from Drug-Resistant Infections” report to the UN Secretary-General (UNSG) from the Interagency Coordination Group (IACG) on Antimicrobial Resistance.
  • The GLG is a 20-member group that is co-chaired by the Prime Ministers of Bangladesh and Barbados and includes ministerial leadership from Bhutan, Iraq, Sweden, Australia, Saudi Arabia, and Singapore as well as leaders from academia, the private sector, and civil society.

All good stuff that is so very exciting to see! And I now confess that I’m going to return to the Thanksgiving pie … cheers! –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: All opinions are my own.

Current funding opportunities (most current list is here):

  • The National Institute of Allergy and Infectious Diseases (NIAID) Applicant Assistance Program (AAP) opens on October 22, 2020. This program provides no cost support for companies planning to apply for a Phase II, Fast Track, or Direct-to-Phase II SBIR or STTR Award. Go here for details.
  • Novo REPAIR Impact Fund closed its most recent round on 31 Jul 2020. Go here for current details.
  • CARB-X recently announced that their existing resources will be reserved to fund their existing portfolio (75 total awards, and counting and they conclude contracting on prior rounds), including future options on those awards. New rounds from CARB-X will occur only after new funding is obtained in 2021.
  • The Global AMR R&D Hub’s dynamic dashboard (link) summarizes funders and projects by geography, stage, and more.
  • It’s not a funder, but AiCuris’ AiCubator offers incubator support to very early stage projects. Read more about it here.
  • ARLG (Antibiotic Resistance Leadership Group, link) is currently open for applications for its 2-year ARLG Fellowship program. The application deadline is 1 Dec 2020; full details are here.
  • Finally, you might also be interested in the most current lists of R&D incentives (link) and priority pathogens (link)

Upcoming meetings of interest to the AMR community (most current list is here):

  • 2 Dec 2020 (online, 3 sessions spanning 5am-5.15p GMT): Global AMR Hub-sponsored conference entitled “Translating AMR R&D mapping into policy and action.” Go here for the full program
    • 5-7.15a GMT: “Identifying research gaps to address antimicrobial resistance relevant to the Asia Pacific Region”
    • Noon-2.15p GMT: Filling AMR R&D gaps in animal health at country, regional and global level
    • 3p-5.15p GMT: Working together to fill AMR R&D gaps – collaboration and partnerships
  • 3 Dec 2020 (online, 9-10:30a CET; 5-6:30p KST): Multi-sponsored webinar entitled “Evidence to Action – Advancing the Antimicrobial Resistance agenda during a pandemic.” Go here to register. Co-hosted by the International Vaccine Institute (IVI), the International Centre for Antimicrobial Resistance Solutions (ICARS), and the Embassy of Denmark in Korea, this webinar includes Dame Sally, Hanan Balkhy (WHO), and the Minster of Health from both South Korea and Denmark! 
  • 26-28 Jan 2021 (online, runs ~7.30a-5.00p Central each day): 4th Annual Texas Medical Center Antimicrobial Resistance and Stewardship Conference. Sponsored by McGovern Medical School, ARLG, and the Gulf Coast Consortia, the agenda includes both poster sessions and keynotes. The call for abstracts closes 18 Dec 2020. Go here for more details.
  • 10-12 Mar 2021 (Stellenbosch, South Africa): The University of Cape Town’s H3D Research Centre will celebrate its 10th anniversary with a symposium covering the Centre’s research on Malaria, TB, Neglected Tropical Diseases, and AMR. Go here to register; abstract deadline is 15 Nov 2020.
  • 9-12 Jul 2021 (Vienna): Annual ECCMID meeting (#31)
  • 18-21 May 2021 (Albuquerque, New Mexico): Biannual meeting of the MSGERC (Mycoses Study Group Education and Research Consortium). Save-the-date announcement is here, details to follow.
  • 20-24 June 2021 (Toronto): International Symposium on Pneumococci and Pneumococcal Diseases (ISPPD-12). Go here for details.
  • 3-7 Jun 2021 (Anaheim), ASM Microbe 2021. Go here for details.
  • 27 Jun-2 Jul 2021 (Ventura, CA): Gordon Research Conference entitled “Antimicrobial Peptides”. Go here for details, go here for the linked 26-27 Jun Gordon Research Seminar that precedes it.
  • 5-21 Aug 2021 (Marine Biology Laboratory, Woods Hole, MA): Residential course entitled “Molecular Mycology: Current Approaches to Fungal Pathogenesis.” This 2-week intensive training program has run annually for many years and gets outstanding reviews. Go here for details.
  • 8-11 Oct 2021 (Aberdeen, Scotland): 10th Trends in Medical Mycology. Go here for details.
  • 16-24 Oct 2021 (Annecy, France): Interdisciplinary Course on Antibiotics and Resistance (ICARe). This is a soup-to-nuts residential course on antibiotics, antibiotic resistance, and antibiotic R&D. The course is very intense, very detailed, and gets rave reviews. Registration is here and is limited to 40 students. Bonus feature: For obvious reasons, the course didn’t happen in 2020! But as a celebration of the course’s 5th year, a webinar version was held on 29 Oct 2020: go here to stream it. 
  • 6-11 Mar 2022 (Il Ciocco, Tuscany): Gordon Research Conference entitled “New Antibacterial Discovery and Development”. Go here for details, go here for the linked 5-6 Mar Gordon Research Seminar that precedes it.


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