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Dr Tedros Adhanom Ghebreyesus, Director-General, WHO

WHO dismayed at weak pipeline of antibiotics

Rohit Shishodia
The World Health Organization (WHO) has expressed concern over declining private investment and lack of innovation in the development of new antibiotics.

The WHO has said that this undermines its efforts to fight drug-resistant infections.

Two new reports, 'Antibacterial agents in clinical development-an analysis of the antibacterial clinical development pipeline' and "Antibacterial agents in preclinical development', reveal a weak pipeline for antibiotic agents.

“The 60 products in development (50 antibiotics and 10 biologics) bring little benefit over existing treatments and very few target the most critical resistant bacteria (Gram-negative bacteria),” said the WHO.

Dr Tedros Adhanom Ghebreyesus, Director-General, WHO, said that never has the threat of antimicrobial resistance been more immediate and the need for solutions more urgent. He added, “Numerous initiatives are underway to reduce resistance, but we also need countries and the pharmaceutical industry to step up and contribute with sustainable funding and innovative new medicines.”

The WHO said that in 2017 it published the priority pathogens list 12 classes of bacteria plus tuberculosis that are posing increasing risk to human health because they are resistant to most existing treatments.

The WHO said that of the 50 antibiotics in the pipeline, 32 target WHO priority pathogens but the majority have only limited benefits when compared to existing antibiotics. Two of these are active against the multi-drug resistant Gram-negative bacteria, which are spreading rapidly and require urgent solutions.

The WHO pointed out that Gram-negative bacteria, such as Klebsiella Pneumoniae and Escherichia coli, can cause severe and often deadly infections that pose a particular threat for people with weak or not yet fully developed immune systems, including newborns, ageing populations, people undergoing surgery and cancer patients.

The report highlights a worrying gap in activity against the highly resistant NDM-1 (New Delhi metallo-beta-lactamase 1), with only three antibiotics in the pipeline. NDM-1 makes bacteria resistant to a broad range of antibiotics, including those from the carbapenem family, which today are the last line of defence against antibiotic-resistant bacterial infections.

Hanan Balkhy, WHO Assistant Director-General for Antimicrobial Resistance, said, “It’s important to focus public and private investment on the development of treatments that are effective against the highly resistant bacteria because we are running out of options.”


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