WHO have released for consultation an updated draft of their EML (Essential Medicines List) Antibiotic handbook. For those not familiar with it, WHO’s EML (now in its 22nd edition!) provides a guide to a core set of medicines that every country should have. The antibiotic-focused version does this for antibiotics and then adds guidance on use via WHO’s Access-Watch-Reserve paradigm. Here are the links you need:
- Overview webpage
- The EML Antibiotic handbook
- An infographic version (1-3 pages per infection) version of the handbook
The EML Handbook provides guidance on how to best use the EML antibiotics based on the AWaRe (Access-Watch-Reserve) concept:
- AWaRe classifications are based on these goals:
- Maximizing clinical effectiveness
- Minimizing toxicity
- Minimizing unnecessary costs to patients and healthcare systems
- Reducing the emergence and spread of antibiotic resistance (i.e. prioritizing antibiotics that are less likely to lead to antibiotic resistance in an individual patient and the community)
- Parsimony (i.e. avoiding the inclusion of many similar antibiotics)
- Simplification (i.e. favoring a smaller number of antibiotics that can be used to treat different infections)
- Alignment with existing WHO guidelines
- Access antibiotics have a narrow spectrum of activity, lower cost, a good safety profile and generally low resistance potential. They are recommended as empiric first- or second-choice treatment options for common infections.
- Watch antibiotics are broader-spectrum antibiotics, generally with higher costs and are recommended only as first-choice options for patients with more severe clinical presentations or for infections where the causative pathogens are more likely to be resistant to Access antibiotics (e.g. upper urinary tract infections).
- Reserve antibiotics are last-choice antibiotics used to treat multidrug-resistant infections
A public consultation is ongoing through 31 Jan 2022: Please send in your comments!
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):
- The AMR Action Fund is now open to proposals for funding of Phase 2 / Phase 3 antibacterial therapeutics. Per its charter, the fund prioritizes investment in treatments that address a pathogen prioritized by the WHO, the CDC and/or other public health entities that: (i) are novel (e.g., absence of known cross-resistance, novel targets, new chemical classes, or new mechanisms of action); and/or (ii) have significant differentiated clinical utility (e.g., differentiated innovation that provides clinical value versus standard of care to prescribers and patients, such as safety/tolerability, oral formulation, different spectrum of activity); and (iii) reduce patient mortality. It is also expected that such agents would have the potential to strongly address the likely requirements for delinked Pull incentives such as the UK (NHS England) subscription pilot and the PASTEUR Act in the US. Submit queries to firstname.lastname@example.org.
- INCATE (Incubator for Antibacterial Therapies in Europe) is a newly launched early-stage funding vehicle. Details are still coming into focus, but per comments on 25 Aug 2021 at the BIOCOM conference, their goal is to support ~4 companies per year with about $250k/company. Contact details are on their website (https://www.incate.net/).
- 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):
- 18-24 Nov 2021: World Antimicrobial Awareness Week (WAAW), sponsored by WHO. The theme is “Spread awareness, stop resistance.” Go here for details.
- [New] 22 Nov 2021 (virtual, 1-2p CEST): “A WHO conversation with the experts on fungal infections and AMR”. This event discusses WHO’s approach to the threat from fungal pathogens (e.g., the Global Coordination Department (GCD) plan to develop a global priority fungal pathogens list. Click here to register. If you’re new to world of fungal pathogens, Maryn McKenna’s June 2021 article in Scientific American is a superb introduction.
- [New] 23 Nov 2021 (virtual, 7-8a EST / 1-2p CEST): AMR Industry Alliance-sponsored webinar entitled “Supporting the optimal use of antimicrobial medicines through innovation.” It’s a strong agenda that includes senior staff from WHO, Industry, and national AMR programs around the world. Go here to register.
- 24 Nov 2021 (virtual, 9-10a New York / 3-4p Paris): Webinar sponsored by the Global Coalition on Aging and MSD entitled “AMR Threat to National Health Systems and Economies: A Call-to-Action.” The webinar will feature a discussion of GCOA’s 2021 AMR Preparedness Index as well as an upcoming report entitled “Developing National Strategies to tackle Antimicrobial Resistance across countries in the Eastern Europe, Middle East and Africa (EEMEA) region.” Go here to register.
- 24 Nov 2021 (virtual, 10a CET and also 3.30p CET): WHO-sponsored webinar entitled “Applying behavioural and cultural insights to tackle antimicrobial resistance.” Register here for the 10a webinar, here for the 3.30p edition. I find this to be a fascinating topic … good for WHO!
- 26 Nov 2021 (virtual, 9.30a-12.30p, EU-centric timing): Webinar entitled “Horizon Europe Tackling Diseases and Antimicrobial Resistance (AMR) Webinar and Partnering – Cluster 1 / Destination 3 and 5′. Multiple calls for consortia participation (vaccines, pandemic preparedness, and more) as well as discussion of an upcoming JPIAMR Therapeutics Call that is expected to be announced on 18 Nov 2021. Go here to register.
- [NEW] 30 Nov-1 Dec 2021 (virtual, 10a-3.30p EST on both days): US PACCARB (Presidential Advisory Council on Combatting Antimicrobial Resistant Bacteria) is holding a 2-day meeting that includes updates from the Global Leaders Group (GLG), the World Health Organization (WHO), and the recent National Academies report entitled “Examining the Long-term Health and Economic Effects of Antimicrobial Resistance in the United States”. This sounds like an excellent update! Go here for details and to register.
- 1 Dec 2021 (virtual, 9a-1p UK): Westminster Health Forum policy conference “Tackling antimicrobial resistance in the UK and the UK’s role on the global stage.” Chaired by Kevin Hollinrake MP (Co-Chair, All-Party Parliamentary Group on Antibiotics, APPG-Antibiotics) and Professor the Lord Trees, Emeritus Professor, U Liverpool; and Treasurer, APPG-Antibiotics, this 5-h session includes keynotes from Dame Sally Davies and Haileyesus Getahun (WHO) and speakers spanning the UK’s AMR efforts. Go here to register.
- 1 Dec 2021 (virtual, 4-5p CET): Spotlight session at ISPOR 2021 entitled “Methods to Estimate the Value of New Antibiotics in the Context of Antimicrobial Resistance.” ISPOR is the International Society for Pharmacoeconomics and Outcomes Research and this spotlight session at their annual meeting will feature discussions of the modeling used by the UK in support of its “Netflix” delinked purchase pilot model. Go here to register if you are interested in the whole meeting; I am working to try to make this specific session free to access by streaming after the session.
- 3 Dec 2021 (Boston, in person, 9a-6.30p, COVID vaccination required): 8th annual BAARN (Boston Area Antimicrobial Research Network) meeting. Go here for details; registration link is here.
- 3 Dec 2021 (virtual, US daytime timings): Symposium entitled “Advances in Antibacterial Discovery” sponsored by the St. Jude Department of Chemical Biology and Therapeutics, is a part of the broader Bringing Chemistry to Medicine series and is supported by the St. Jude T32 Infectious Disease Therapeutics training program. Go here for details and to register.
- 8-9 Dec 2021 (virtual, 9a-noon East Coast US): ASM-ESCMID-sponsored joint conference on antimicrobial drug development. This is the 2021 online version of one of my favorite meetings and I strongly encourage attendance on both days to gain a perspective on how new reimbursement models are going to change the R&D landscape. Online agenda is here, registration link is pending so just mark your calendar for now.
- 8 Dec: “The New Winds Pushing and Pulling Antibacterial Development.” DO NOT MISS THIS ONE! Featuring talks from the UK team behind the NHS “Netflix” pilot, Kevin Outterson’s recently released report documenting the need for global Pull incentives to have a value of $2.2 – 4.8b, and speakers covering PASTEUR and work in the EU on pull incentives, this promises to be a key update for the whole community.
- 9 Dec: CARB-X – GARDP Boot Camp: What Makes a Good Project Succeed? Featuring speakers with many years of R&D experience, this session makes a good companion to the 8 Dec talk and will leave you well informed on best ways to guide your search for new antibiotics.
- 14 Dec 2021 (virtual, 9a-1030a EST): CDC webinar entitled “Hooves, Paws, or Feet: A Multispecies Examination of Antimicrobial Use and Stewardship Practices”. This event is the third installment of the AMR Exchange webinar series. Click here for details.
- 2-3 Feb 2022 (virtual): 10th Advances Against Aspergillosis and Mucormycocosis. Registration closes on 30 Jan 2022. Go here for details.
- 2-3 Feb 2022 (virtual): Antimicrobial Chemotherapy Virtual Conference jointly organised by GARDP with the British Society for Antimicrobial Chemotherapy (BSAC), Center for Disease Dynamics, Economics & Policy (CDDEP) and the Indian Council of Medical Research (ICMR). Click here for details.
- 3-6 Mar 2022 (Albuquerque, New Mexico): Biannual meeting of the MSGERC (Mycoses Study Group Education and Research Consortium). Details are here.
- 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.
- 7-8 Apr 2022 (Basel and in person, we hope): The 6th 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. Go here for the hold-the-date page and a way to be kept informed about the meeting.
- 9-13 May 2022 (Athens and online): 40th Annual Meeting of the European Society for Paediatric Infectious Diseases, Go here for details.
- 20-24 Sep 2022 (New Delhi): 21st Congress of the International Society for Human and Animal Mycology (ISHAM). Go here for details.
- 25-28 Oct 2022 (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.