G7 Health ministers 3-4 June communique / Implications for choosing wisely

Note: Newsletter now updated to include the communique from the G7 Finance Ministers!

Dear All,

The G7 met in Oxford this past week and we now have communiques released from by both the Health and Finance Ministers. Let’s look first at the two fascinating statements from the Health Ministers:

In the general communique, Points 24-31 are about AMR. Points 32-33 then link to the statement on trial collaboration. Let me briefly summarize each:

  • #24: AMR is important! We need infection and prevention measures to be used.
  • #25: We appreciate the Global AMR R&D Hub, GARDP, BARDA, CARB-X, Novo REPAIR, IMI, and the AMR Action Fund!
  • #26: We need incentives to secure new antibiotics and their supply chains! Here’s a quote from this one:
    • “we will seek to overcome the economic barriers to an endurable supply of antimicrobial products and to ensure sustainable innovation in antimicrobial R&D
    • “… whilst encouraging appropriate provisions for stewardship, diversity and security of supply chains, environmental protection in manufacturing and disposal, and global access.
    • To achieve this, we will bring together health and finance officials…”
  • #27: We recognize the value antibiotics bring to healthcare systems and society! As a result, “We will develop a set of shared valuation principles, based on public health needs and taking into account the WHO priority pathogen list…”
  • #28: We acknowledge the pressure on supply chains and that this may make it difficult to access to older antibiotics
  • #29: We recognize the need to strengthen supply chain resilience
  • #30: Environmental release of antibiotics is a problem that must be addressed
  • #31: We will work on acceptable environmental standards for manufacturing
  • #32 and #33: These point to the communique on trial collaboration: In short, coordination is need at multiple levels to ensure that trials are efficient and deliver useful information.

The Finance Ministers have also released a communique and in Para. 20 they likewise speak directly to the need to address AMR as well as pandemic preparedness. Here’s the full text with bullets added for clarity:

  • “It is vital to continue learning lessons from Covid-19 and ensure we are better prepared for future pandemics.
  • “We look forward to the Pandemic Preparedness Partnership’s Report to G7 Leaders and the G20 High Level Independent Panel’s findings, and will consider their recommendations, particularly on financing mechanisms.
  • “Recognising the urgent need to avoid a repeat of the Covid-19 crisis, we commit to work together, and with relevant international partners, to improve international coordination and accountability between global health and finance policy makers.
  • “We will work together with our health colleagues in the second half of this year, including with industry, to explore proposals for strengthening market incentives for antibiotic drug development to help tackle antimicrobial resistance – the “silent pandemic”.
  • “We must act now to secure the health and economic prosperity of our citizens and that of future generations.

Wow! Fantastic! Certainly a very strong step forward in terms of sharing need for action at a senior political level.  

And, there is a clear message here for developers. The idea of “a set of shared valuation principles” points directly at themes discussed in prior newsletters and a recent paper in JID:

  • The 17 Mar 2021 newsletter entitled “Where’s the innovation?” discusses the fact that while the current clinical pipeline has limited novelty, the emerging preclinical pipeline is showing a lot of innovation
  • The 7 June 2020 newsletter entitled “Assessing Antibiotic Value” discusses ways to think about and measure innovation
  • The 29 Mar 2020 newsletter entitled “UK Antibiotic Subscription Pilot” discusses the point scoring system used by the UK in their pilot project
    • The 25 April 2021 newsletter entitled “Global views” provides a detailed discussion of the UK scoring scheme as well as link to a conversation with Christine Ardal about how 13 countries (10 in the EU plus Canada, Japan, and South Africa) are would like to find a path to ensuring they pay only for useful value
  • In similar vein to the UK point scoring system, the 30 Sep 2020 newsletter about the PASTEUR Act (soon to re-introduced, I hear!) makes it clear that not all new products will earn the same reward (or any reward at all)
  • Sinha 2021 JID entitled “The Wrong Cure: Financial Incentives for Unimpressive New Antibiotics” expresses concern over the possibility that large Pull incentives might be given to antibiotics that offer only limited utility
    • Aside: Note that this paper also expresses a wish for data showing superior efficacy. I am sympathetic to this wish but we also have to keep in mind the difficulty with actually showing this that was discussed in the 19 Sep 2020 newsletter entitled “In praise of non-inferiority”

In short, if governments are going to pay substantial delinked rewards, it will only be for new compounds where we can all say “Yes, I really want one of those!” As the comments above make clear, it is possible even now to make choices about your project that will position it to earn a substantial Pull incentive. Stated differently, this is the message “Choose wisely” that Indiana Jones learns when he is searching for the Holy Grail: 

On that note, please get busy! And if you need some inspiration, please (re)visit the continuously updated newsletter entitled “Movies to discover antibiotics by”!

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.

Current funding opportunities (most current list is here):

  • MTEC has announced an RFP seeking proposals focused on diagnostics, prevention of endemic diarrhea, and selected antivirals. Go here for the full RFP and search for “FA2.13” to find the infection-focused topics. White papers are due 17 June 2021.
  • GNA NOW (part of the IMI AMR Accelerator) has an open call to identify a novel mechanism antibacterial to add to its portfolio. The selected project would receive resources equivalent up to several million € (to be defined according to project needs); see also this 11 May 2021 newsletter for details. Expressions of interest are due by 18 June 2021.
  • [NEW] The International Society for Infectious Diseases (ISID) is collaborating with Pfizer fund projects identifying and addressing AMR in the outpatient setting across low-income countries or under-resourced settings in middle-income countries. A total of $1 million USD is available in funding, and programs can apply for a maximum of $100,000 USD to cover program expenses over three years. Go here for details. The deadline is 18 June 2021!
  • CARB-X recently announced that their existing resources will be reserved to fund their existing portfolio (more than 80 total awards, and counting, as they include contracting from prior rounds). New rounds from CARB-X will occur only after new funding is obtained in 2021.
  • It’s not a funder, but AiCuris’ AiCubator offers incubator support to very early stage projects. Read more about it here.
  • The Global AMR R&D Hub’s dynamic dashboard (link) summarizes the global clinical development pipeline, incentives for AMR R&D, and investors/investments in AMR R&D.
  • In addition to the lists provided by the Global AMR R&D Hub, you might also be interested in my 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):

  • 7-9 Jun 2021 (virtual, various times): 5th International Conference on Responsible Use of Antibiotics in Animals. This conference runs only every few years … the 4th instance was in 2016. Go here to register.
  • [NEW] 10 June 2021 (virtual, 15:30-17:00 CEST): GARDP-sponsored webinar entitled “Openly accessible resources for the global antimicrobial R&D community.” The webinar will be moderated by Katie Prosen of The Pew Charitable Trusts and you can register for it here.
  • 20-24 Jun 2021 (Toronto): International Symposium on Pneumococci and Pneumococcal Diseases (ISPPD-12). Go here for details.
  • 20-24 Jun 2021 (virtual, various times): World Microbe Forum sponsored by the American Society for Microbiology (ASM) and the Federation of European Microbiological Societies (FEMS). Go here for more details and to register.
  • 24 Jun 2021 (virtual, 09:30 AM – 05:30 PM CEST): Workshop entitled “Advancing Data Technologies to corner AMR.” Sponsored by AMR Insights, you can register here.
  • 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.
  • 9-12 Jul 2021 (virtual): Annual ECCMID meeting (#31)
    • [NEW] Grants supported by the Bill & Melinda Gates Foundation are available to support participation from persons residing in Low- and Lower-middle income countries! Go here for details. Applications are due 10 June.
  • 26 Jul-30 Jul 2021 (online): Small World Initiative Instructor Training Workshop – training for undergraduate professors in the wet lab techniques, parallel curricula, & pedagogical instruction to engage students in the hunt to find new antibiotic-producing soil microbes. Go here to register.
  • 14-29 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.
  • 24-26 Aug 2021 (virtual, timings not stated but presumably EU-centered): The 5th edition of the annual AMR conference sponsored by the BEAM Alliance, CARB-X, the Novo REPAIR Impact Fund, the IMI Accelerator, and the European Biotechnology Network. The in-person version of this meeting is consistently excellent; the video-based version will have to do for 2021. Go here for details. 
  • 8-11 Oct 2021 (Aberdeen, Scotland): 10th Trends in Medical Mycology. Go here for details.
  • 11-15 Oct 2021 (physical, somewhere in the UK): UK-focused Innovation Mission sponsored by Innovate UK in collaboration with AMR Insights and Oxford innovation. This free event seeks to connect AMR-focused start-ups, SMEs and Multinationals, Academia, Research Institutes, Regional Development Companies and other interested stakeholders in the UK, Europe and other parts of the world. Go here for more 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. 
  • 25-28 Oct 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.
  • 5-8 Nov 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.
  • 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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