World Health Organisation 370.
(photo credit: REUTERS)
There is a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance, a report from the UN’s World Health Organization shows.
The situation is a “global emergency that will seriously jeopardize progress in modern medicine,” according to the report, titled “Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline, including Mycobacterium tuberculosis.”
WHO director-general Dr. Tedros Ghebreyesus noted that most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and are only short-term solutions.
The report found very few potential treatment options for those antibiotic-resistant infections identified by WHO as posing the greatest threat to health, including drug-resistant tuberculosis, which kills around 250,000 people each year.
“There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB; otherwise, we will be forced back to a time when people feared common infections and risked their lives from minor surgery,” the director-general said.
In addition to multidrug-resistant tuberculosis, WHO has identified 12 classes of priority pathogens – some of them causing common infections such as pneumonia or urinary tract infections – that are increasingly resistant to existing antibiotics and urgently in need of new treatments.
The report identifies 51 antibiotics and biologicals in clinical development to treat priority antibiotic-resistant pathogens, as well as tuberculosis and the sometimes deadly diarrheal infection Clostridium difficile. However, among all these candidate medicines, only eight are classed by WHO as innovative treatments that will add value to the current antibiotic treatment arsenal.
There is a serious lack of treatment options for multidrug- and extensively drug-resistant M. tuberculosis and gram-negative pathogens, including Acinetobacter and Enterobacteriaceae (such as Klebsiella and E.coli), which can cause severe and often deadly infections that pose a particular threat in hospitals and nursing homes.
There are also very few oral antibiotics in the pipeline, yet these are essential formulations for treating infections outside hospitals or in resource-limited settings. Pharmaceutical companies around the world have been reluctant to invest the huge sums required to develop new antibiotics, which are not as profitable as cancer drugs, for example.
“Pharmaceutical companies and researchers must urgently focus on new antibiotics against certain types of extremely serious infections that can kill patients in a matter of days, because we have no line of defense,” added Dr. Suzanne Hill, director of the WHO’s essential medicines department.
To counter this threat, WHO and the Drugs for Neglected Diseases Initiative set up the Global Antibiotic Research and Development Partnership. Earlier this month, Germany, Luxembourg, the Netherlands, South Africa, Switzerland and the United Kingdom, along with Britain’s Wellcome Trust, pledged more than €56 million for this work.
“Research for tuberculosis is seriously underfunded, with only two new antibiotics for treatment of drug-resistant tuberculosis having reached the market in over 70 years,” said Dr. Mario Raviglione, director of the WHO’s Global TB Program. “If we are to end TB, more than $ 800m. per year is urgently needed to fund research for new anti-TB medicines.”
New treatments alone, however, will not be sufficient to combat antimicrobial resistance, the WHO report said. “We work with countries and partners to improve infection prevention and control and to foster appropriate use of existing and future antibiotics. WHO is also developing guidance for the responsible use of antibiotics in the human, animal and agricultural sectors.”
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