Can we Prevent Antibiotic Resistance?
Antibiotics are losing effectiveness—and millions are dying as a result. CARB-X has been given up to $370 million in new funding from the US government and charitable foundation Wellcome.
Can we Prevent Antibiotic Resistance?
Antibiotics are losing effectiveness—and millions are dying as a result. CARB-X, a BU-based partnership that aims to solve antimicrobial resistance, has been given up to $370 million in new funding from the US government and charitable foundation Wellcome.
Antibiotics have saved countless lives since they were introduced in the 1940s, curing infections and making procedures like chemotherapy and surgeries safer. But as bacteria evolve, many have become resistant to antibiotics. An estimated 1.27 million people died worldwide in 2019 from infections caused by drug-resistant bacteria, according to a study published in The Lancet. It’s an estimated death toll that has nearly doubled in the past five years.
Since 2016, BU has been at the forefront of an international effort to combat antimicrobial resistance, leading CARB-X, a nonprofit partnership that channels funding and expertise to companies developing lifesaving new antibiotics, vaccines, and rapid diagnostics.
Now that work has been given a boost, with CARB-X receiving up to $370 million in additional funding. The Biomedical Advanced Research and Development Authority (BARDA), part of the US Department of Health and Human Services, will provide CARB-X up to $300 million over 10 years. Wellcome, a global charitable foundation that supports biomedical research, will provide up to $70 million over three years. Both were founding supporters of the initiative, contributing $355 million in its first six years.
“Antibiotics are unlike other medicines. As bacteria evolve to become resistant, the problem keeps getting worse,” says Kevin Outterson, CARB-X founding executive director and BU Law professor, who has spent much of his career researching business models and incentives for antibiotic development. “We have to run faster, just to avoid falling behind.”
Despite their importance—and in contrast to drugs that treat chronic conditions and make blockbuster profits for drug companies—antibiotics lose money. The pipeline of new antibiotics to treat resistant infections has been dwindling for years, even though demand continues to increase. With low sales volumes, small antibiotic companies have been filing for bankruptcy, and many large pharmaceutical companies have shuttered their anti-infective divisions.
Antibiotics are unlike other medicines. As bacteria evolve to become resistant, the problem keeps getting worse.
CARB-X brings together leading scientists and biotech experts to accelerate projects with the greatest potential to target the most dangerous bacteria. Since its founding, the organization has received 1,163 applications for support, awarding $361 million to 92 projects from 12 countries.
Although CARB-X’s efforts to foster research and development are beginning to pay off, Outterson believes sustained innovation needs to be supported by policy reform that pays for value rather than volume. Members of Congress are developing bipartisan legislation, the PASTEUR Act, which would function for antibiotics like Netflix does for movies, charging a subscription fee regardless of how many shows customers watch. Under this model, the US government would pay developers an annual fee for a predetermined period based on the product’s value to public health. Without the pressure to sell a high volume of drugs, companies could recover their upfront expenses and be incentivized to continue developing new antibiotics, while physicians would maintain good stewardship practices to slow the spread of resistance.
“The best-informed estimate is that the world needs four breakthrough antibiotics every decade. The last new FDA-approved class of antibiotics against Gram-negative bacteria was discovered in 1962. I’m 59 years old. That’s my lifetime,” says Outterson. “More than 30 therapeutics in our portfolio qualify as a new class. If any one of these makes it through, that will be the biggest antibiotic news in more than 60 years.”
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