G20 Health Ministers: Let\’s take action on AMR!

Dear All,

As we\’ve discussed previously (1 Oct 2024 newsletter), the HLM on AMR at UNGA 2024 is but one stop along the road to global action on AMR (acronymics: HLM on AMR at UNGA 2024 = High-Level Meeting on AMR at the 2024 UN General Assembly).

In follow-up, we now have two AMR-related declarations from a 31 Oct 2024 meeting in Rio of the G20\’s Health Ministers. As you look at the documents, you\’ll also need to know the acronym HWG (Health Working Group) — this shorthand seems to consistently refer to the G20 Health Ministers. Here are the links you need:

• The general Ministerial declaration
• The Ministerial declaration on Climate Change, Health and Equity, and One Health
• The website for the G20 Sherpa Track on Health, a subset of the full G20 website
  • Exploring the full website will give you a feel for the breadth of the global conversation.
  • The Health Sherpa track is where you\’ll find the links to the declarations
• And finally, don\’t forget that the AMR.Solutions UNGA 2024 webpage collects relevant links and documents

Let\’s start with the general declaration. I\’ve excerpted paragraph 7 in which the declaration re-affirms the commitment to action and also points to the upcoming 4th Global High-Level Ministerial conference on AMR that is planned for 15-16 Nov 2024:

It\’s interesting to scan this document\’s subheadings. After the 16-paragraph Preamble (this is where the AMR paragraph appears), we have paragraphs that cover

• Global Coalition for Local and Regional Production, Innovation, and Equitable Access
  • This one is about access: \”We welcome the establishment of a Coalition for Local and Regional Production, Innovation and Equitable Access centered on voluntary cooperation in order to promote access to vaccines, therapeutics and diagnostics, and other health technologies for neglected diseases and persons in vulnerable situations…\”
  • The establishment of a \”Coalition for Local and Regional Production, Innovation and Equitable Access\” is a new and interesting idea!
• Digital Health: Telehealth can be transformative!
  • \”we recognize the potential capacity of digital health solutions to advance the Sustainable Development Goals with a view to achieving equitable access to quality and affordable health services, including target 3.7 of the SDGs.\” (SDG = the UN\’s Sustainable Development Goals)
• Health Workforce: This one is focused on the health workforce
  • It also reminds me of the loss of people who know how to AMR-related R&D — see the 8 Feb 2024 newsletter entitled \”Leaving the lab: The decline in AMR R&D professionals\”
• Long/Post COVID-19 Condition: A call for  information-sharing and standardized terminology

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Next up, we have the declaration on Climate Change, Health and Equity, and One Health. After covering Climate Change and the need to consider and reduce the impact of climate change on health, there is a wide-ranging One Health section that covers AMR in Paragraph 30:

That\’s a clear call for coordinated action on AMR! As a reference, here\’s your acronym decoder for the 4 organizations noted in the text as part of the Quadripartite Joint Secretariat on AMR (QJS-AMR):

• WHO: World Health Organization
• UNEP: UN Environment Programme
• WOAH: World Organization for Animal Health (formerly, OIE)
• FAO: Food and Agriculture Organization

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The continued discussion is great to see … we need AMR to remain high on the global to-do list! And I find the call for a Coalition for Local and Regional Production to be an intriguing new idea! Onward to the 15-16 Nov 2024 High-Level Ministerial meeting in Jeddah! 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

• NIAID\’s RFA-AI-24-069 is a notice of funding opportunity (NOFO) soliciting applications to establish Centers for Accelerating Phage Therapy to Combat ESKAPE Pathogens (CAPT-CEP). The CAPT-CEPs will focus on developing preclinical assays, tools, and models for robust phage therapy research and development (R&D) and advancing phage clinical research. Applications are due by 28 Jan 2025; letters of intent must be received 30 days prior to the due date.
• ENABLE-2 has continuously open calls for both its Hit-to-Lead program as well as its Hit Identification/Validation incubator. Applicants must be academics and non-profits in Europe due to restrictions from the funders. Applications are evaluated in cycles … see the website for details on current timing for reviews. 
• CARB-X has open calls at intervals that span four areas: (i) Therapeutics for Gram-Negatives, (ii) Prevention for Invasive Disease, (iii) Diagnostics for Neonatal Sepsis, and (iv) Proof-Of-Concept for Diagnosing Lower-Respiratory-Tract Infections. See this 6 Mar 2024 newsletter for a discussion of the call and go here for the CARB-X webpage on the call. There are multiple opportunities to submit — see the CARB-X webpage for details.
• BARDA\’s long-running BAA (Broad Agency Announcement) for medical countermeasures (MCMs) for chemical, biological, radiological, and nuclear (CBRN) threats, pandemic influenza, and emerging infectious diseases is now BAA-23-100-SOL-00004 and offers support for both antibacterial and antifungal agents (as well as antivirals, antitoxins, diagnostics, and more). Note especially these Areas of Interest: Area 3.1 (MDR Bacteria and Biothreat Pathogens), Area 3.2 (MDR Fungal Infections), and Area 7.2 (Antibiotic Resistance Diagnostics for Priority Bacterial Pathogens). Although prior BAAs used a rolling cycle of 4 deadlines/year, the updated BAA released 26 Sep 2023 has a 5-year application period that ends 25 Sep 2028 and is open to applicants regardless of location: BARDA seeks the best science from anywhere in the world! See also this newsletter for further comments on the BAA and its areas of interest.
• HERA Invest was launched August 2023 with €100 million to support innovative EU-based SMEs in the early and late phases of clinical trials. Part of the InvestEU program supporting sustainable investment, innovation, and job creation in Europe, HERA Invest is open for application to companies developing medical countermeasures that address one of the following cross-border health threats: (i) Pathogens with pandemic or epidemic potential, (ii) Chemical, biological, radiological and nuclear (CBRN) threats originating from accidental or deliberate release, and (iii) Antimicrobial resistance (AMR). Non-dilutive venture loans covering up to 50% of investment costs are available. A closing date is not posted insofar as I can see — applications are accepted on a rolling basis; go here for more details.
• The AMR Action Fund is open on an ongoing basis 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.
• 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/).
• These things aren\’t sources of funds but would help you develop funding applications
  • 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.
  • Diagnostic developers would find valuable guidance in this 6-part series on in vitro diagnostic (IVD) development. Sponsored by CARB-X, C-CAMP, and FIND, it pulls together real-life insights into a succinct set of tutorials.
• 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).

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!

• 25-26 February 2025 (Basel, Switzerland): The 9th AMR Conference 2025. Go here to register! 
• 11-15 April 2025 (Vienna, Austria): ESCMID Global 2025, the annual meeting of the European Society for Clinical Microbiology and Infectious Diseases. Go here for details. 
• (no date as yet) 2025 ASM/ESCMID Joint Conference on Drug Development to Meet the Challenge of Antimicrobial Resistance. Go here to see details of the outstanding 2024 meeting!
• 19-22 Oct 2025 (Georgia, USA): IDWeek 2025, the annual meeting of the Infectious Diseases Society of America. Details pending; go here for the general meeting website.

  Upcoming meetings of interest to the AMR community:

• [NEW] 18-24 Nov 2024 (everywhere): World AMR/Antibiotic Awareness Week. Events are happening globally. I can\’t show them all … you should do a search of the form \”MyCountry World AMR Awareness week.\” As examples, see the summary webpages from WHO, the US CDC, the European CDC, and the Australian Safety and Quality Commission! 
• 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.
• 28-29 Jan 2025 (online and in-person, Washington, DC): PACCARB (US Presidential Advisory Council on Combatting Antimicrobial Resistant Bacteria): This particular meeting of PACCARB is unusually important as it will seek (i) public input into NAP for CARB 2025-2030 and (ii) work to sustain the momentum regarding the commitments at the High-Level Meeting on AMR at the 2024 UN General Assembly (UNGA HLM AMR). Go to http://hhs.gov/paccarb for details and to register.

• 4-5 Feb 2025 (online, 1-5p GMT timing on both days): Antimicrobial Chemotherapy Conference by GARDP and BSAC in collaboration with CEPID-ARIES and Fiocruz. Now in its 6th year, the free program offers a good review of antimicrobial R&D, ranging from drug discovery to preclinical and clinical activities. Go here to register; the abstract deadline is 15 Nov 2024.
• 25-26 February 2025 (Basel, Switzerland): The 9th AMR Conference 2025. See list of Top Recurring meetings, above.
• 11-15 April 2025 (Vienna, Austria): ESCMID Global 2025, the annual meeting of the European Society for Clinical Microbiology and Infectious Diseases. See Recurring Meetings list, above.
• 19-22 Oct 2025 (Georgia, USA): IDWeek 2025, the annual meeting of the Infectious Diseases Society 
• 11-15 April 2025 (Vienna, Austria): ESCMID Global 2025. See list of Top Recurring meetings, above.
• [NEW] 30 June-1 July 2025 (virtual and in Washington, DC): BID2025: BARDA Industry Days — Enhancing Health Security With a Sustainable Future.  BID provides the opportunity to discuss U.S. government medical countermeasure (MCM) priorities, provide the private sector an informal opportunity to interact with BARDA and ASPR teams, and identify potential areas of collaboration in the field of MCM research and development. Go here for details.
• 19-22 Oct 2025 (Georgia, USA): IDWeek 2025. See list of Top Recurring meetings, above.
• [2025 dates now posted] 11-19 Oct 2025 (Annecy, France, residential in-person program): ICARe (Interdisciplinary Course on Antibiotics and Resistance) … and 2025 will be the 9th year for this program. Patrice Courvalin orchestrates content 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 should open ~March 2025 — go here for more details.

Noteworthy self-paced courses and training materials (this is a new section — comments on it would be appreciated!):

• OpenWHO: \”Antimicrobial Resistance in the environment: key concepts and interventions.\” Per the webpage for the course, it will teach you \”…why addressing AMR in the environment is essential and gain insights into how action can be taken to prevent and control AMR in the environment at the national level.\” This course builds on WHO\’s 2024 Guidance on wastewater and solid waste management for manufacturing of antibiotics. For further reading, see also the 25 Sep 2023 newsletter entitled \”Manufacturing underpins both access and stewardship: Cefiderocol as a case study\” and the 28 Jan 2024 newsletter entitled \”EMA Concept Paper: Guidance on manufacturing of phage products\”.