A Nature Article, a PASTEUR Act Op-Ed, and a VERY Important Phone Number

Dear All,

First, Nature published an excellent article entitled “The importance of antimicrobial resistance in medical mycology” by Gow et al. The first sentence of the introduction really packs a punch — “The age of antibiotics, spanning only 80 years, is now entering a period of progressive and widespread emergence of drug-resistant organisms that threaten to bring this era to an end“. Indeed, indeed … and as you would guess from the title, this article goes beyond our usual topic of antibacterial resistance to the the problem of antifungal resistance.

For those not familiar with the challenges of finding new antifungal agents, the essential point is that we are relatively closely related to the fungi genetically and thus “The eukaryotic biochemistry of fungi makes them particularly pernicious pathogens because of a more limited number of selective drug targets against which inhibitors can be designed…”. Recommended reading!

Second, Senator Todd Young of Indiana released an op-ed about the PASTEUR Act that discusses AMR in an easy to understand language. If you ever wanted to share an article with someone who was unfamiliar with the issues around AMR, this one might be a good starting point. Some of my favorite quotes from the article:

  • “Our health system must preemptively combat antibiotic resistance and ensure we do not return to an era when even a simple medical procedure could be deadly.”
  • “Currently, the drug reimbursement system in our country rewards volume, not value. The federal government pays for antimicrobials in a way that fails to drive innovation or appropriate use. The PASTEUR Act would introduce a new model for paying for novel antimicrobials—one that incentivizes the development of antimicrobials based upon the value they provide for public health, rather than the volume used.

Finally, a call to action that builds on Senator Young’s op-ed! I’ve previously provided details about how to write to your Congressional representatives but now I’m asking for you to call the Capitol operator at +1-202-224-3121 and ask to speak to the offices of Rep. Pelosi, Rep. McCarthy, Sen. Schumer, or Sen. McConnell. Once connected, ask to leave a message with the Senator/Representative about both the PASTEUR Act and the FORWARD Act. If you need some inspiration as to what to say, here are my talking points:

  • Hello, my name is John Rex and I am a board-certified internist and Infectious Disease specialist who has spent 30+ years working to develop the types of drugs needed to treat lethal infections. 
  • I’m calling today to encourage you to support both the PASTEUR Act and the FORWARD Act. 
  • These two Acts will protect all of modern medicine by supporting the development of critically important new antibiotics for bacterial and fungal infections.
  • To understand the problem, ii is important to recognize that antibiotics are the fire extinguishers of medicine!
    • Infections, like fires, occur suddenly and progress quickly … and we have to prepare in advance to put them out / treat them!
    • When a fire breaks out in a house, you’re always able to reach for a fire extinguisher instantly.
    • But unlike our good support for fire extinguishers and fire departments, we don’t currently have a way to pay in advance for the antibiotics needed for highly resistant infections — and this puts all of modern medicine at risk!.
  • Because of the broken economics of new antibiotics, the global pipeline of new antibiotics is dangerously thin
  • Even now there are infections that cannot be adequately treated — and it is thus possible for a cancer patient to die of an infection even though their cancer is cured! 
  • The PASTEUR Act and the FORWARD Act are key to addressing this threat to modern medicine and I’d ask you to make them a priority. The entire modern medical system as we know it depends on antibiotics–this is a matter of life and death. 
  • Thank you!

I know it may feel uncomfortable to reach out in this way, but voices from the community really do make a difference! You can also write to them instead if you would prefer! Or in addition to! And, don’t forget about the opportunity to sign those letters to the California and Texas legislative legislative contingentsThis is a critical time for FORWARD and PASTEUR: the more voices speaking out in support of both these initiatives, the better.

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 contact@amractionfund.com.
  • [updated] INCATE (Incubator for Antibacterial Therapies in Europe) is an early-stage funding vehicle supporting innovation vs. drug-resistant bacterial infections. The fund provides advice, community, and non-dilutive funding (€10k in Stage I and up to €250k in Stage II) to support early-stage ventures in creating the evidence and building the team needed to get next-level funding. Details and contacts on their website (https://www.incate.net/).
  • New funding rounds from CARB-X are expected soon now that funding for the next 10 years has been announced! For the most current update, watch this 30-minute video from the June 2022 kick-off webinar.
  • 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):

  • 20-24 Sep 2022 (New Delhi): 21st Congress of the International Society for Human and Animal Mycology (ISHAM). Go here for details.
  • [NEW] 21 Sep 2022 (virtual): Joint webinar from the WHO Nursing & Midwifery Department and WHO Antimicrobial Resistance Division entitled “Infection Prevention and Antimicrobial Stewardship – The Role of Nurses in Preventing AMR”. Go here for details. 
  • [FDA AdComm … don’t miss it!] 22 Sep 2022 (virtual, 8.30-5.00p ET): FDA Advisory Committee discussing an application for approval of Rebyota (Fecal Microbiota, Live) with a requested indication to “reduce the recurrence of Clostridioides difficile infection (CDI) in adults following antibiotic treatment for recurrent Clostridioides difficile infection.” The P3 data on this product showed superiority over placebo … and the AdComm will be an important master class for everyone interested in microbiome-based therapies. Go here for details.
  • 4-7 Oct 2022 (Dublin, Ireland): The 2022 ASM/ESCMID Joint Conference on Drug Development to Meet the Challenge of Antimicrobial Resistance. This is an excellent meeting, especially for developers … and if you’ve missed it, the recordings from the 2021 meeting are online. Go here for details on the 2022 meeting.
  • [NEW] 13-14 Oct 2022 (virtual, 8.30a-5p ET). Workshop entitled “Accelerating the Development & Uptake of Rapid Diagnostics to Address Antibiotic Resistance.” Convened by the National Academies’ Forum on Drug Discovery, Development, and TranslationForum on Medical and Public Health Preparedness for Disasters and Emergencies, and Forum on Microbial Threats (wow, say that 3 times fast!), this workshop has a broad-ranging agenda focused practical approaches to developing rapid, point-of-care diagnostics. Go here for details and to register.
  • 19-23 Oct 2022 (Washington, DC): IDWeek 2022, the joint annual meeting of the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP). Go here for details.
  • 15-23 Oct 2022 (in person, residential, Les Pensières, Veyrier-du-Lac, France): The 6th edition of Patrice Courvalin’s fabulous ICARe residential training course covering all things AMR is on for 2022! This is a soup-to-nuts training in AMR: it is very intense, very detailed, and always gets rave reviews from attendees. Registration is open 21 Mar 2022 to 21 June 2022 and is limited, so book your slot as soon as you can. Go here for details.
  • 19-23 Oct 2022 (Washington, DC): IDWeek 2022, the joint annual meeting of the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP). Go here for details.
  • 23 Oct 2022 (Cape Town, South Africa): Symposium entitled “Tackling AMR: How implementation research is vital in a One Health approach” sponsored by the AMR knowledge hub of TGHN (The Global Health Network). 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.
  • 17-20 Nov 2022 (Kuala Lumpur, Malaysia): The International Congress on Infectious Diseases will take place for the first time as a hybrid event. Go here for details. 
  • 27-30 Nov 2022 (Perth, Australia): 32nd International Congress of Antimicrobial Chemotherapy is the biennial congress of the International Society of Antimicrobial Chemotherapy (ISAC). Go here for details.
  • 3-7 Dec 2022 (Banff, Canada): Novel Approaches Against Emerging Antimicrobial Resistance by Keystone Symposia. Go here for details. 
  • 8-12 May 2023 (Lisbon, Portugal): 41st Annual Meeting of the European Society for Paediatric Infectious Diseases. Go here for details.


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