Today, 26 September, the United Nations General Assembly is meeting to accelerate political actions on antimicrobial resistance (AMR). In an article published in Nature Reviews Drug Discovery on 23 September, scientists pointed to IHI’s AMR Accelerator as a model for how public-private partnerships (PPPs) can make an impact on the complex world of antibiotic research and development.
Tim Miles of GSK, who is involved in the COMBINE project that oversees the work of the AMR Accelerator, says that there are four main AMR challenges which cannot be overcome by one institution alone but must be tackled in collaboration.
“We need to discover novel modes of actions that are solutions to overcoming resistance, we need to achieve global equity to access to treatments, we need a sustainable business model for the entire lifecycle of treatments and we need expertise, because there is a continuing trend in reductions in AMR research and development professionals,” he says.
IHI’s AMR Accelerator, a public-private programme that consists of nine separate projects fighting AMR, tackles two of these – driving innovation and boosting expertise in AMR. The programme, with a total budget of €479 million from the European Commission and industry, fosters a global community of researchers from 98 different public and private organisations that shares knowledge and best practices. The formula works – to date, the Accelerator has progressed 44 antibacterial programmes and is on track to deliver 10 preclinical or clinical drug candidates and five phase II or phase III-ready assets.
“The AMR Accelerator so far shared the risk of antibiotic drug discovery for multiple partners and developed a key ecosystem in Europe, sharing expertise, knowledge and resources,” says Miles.
Antimicrobial drug development is a notoriously complex field, with high failure rates and long timelines. It currently takes between ten and fifteen years to get a preclinical candidate to the market, and on average resistance to most new agents is reported 2-3 years after market entry. Innovative, new antibiotics that challenge the status quo are badly needed, but the risks and potential costs are high for individual organisations – which is why a public-private partnership like the AMR Accelerator provides an ideal example to follow.
“Despite the high medical need, in AMR research the monetary incentives are low and the chance of return of investment infinitesimal,” says Kristina Orrling of Lygature, a not-for-profit organisation that is coordinating GNA NOW, one of nine public-private projects involved in the AMR Accelerator. “The only solution to this paradox is collaboration – I am utterly convinced that PPPs are necessary for bringing new antimicrobial drugs to patients.”
“Progressing complex antibiotic development programmes in solitude is very difficult, but with a diversity of partners you can find new solutions and pathways, and learn from each other,” says Marie Olliver of Uppsala University, the public partner which coordinates the COMBINE project. “Our experience is that PPPs are an efficient way to accelerate antibiotic R&D.”
To facilitate collaboration, the AMR Accelerator implements clear agreements on issues like data sharing and non-disclosure, and decisions are made through structured and open communication practices.
One of the key benefits of the AMR Accelerator model is that important structures and tools have been put in place to ensure long-term impact past the programme’s end.
“Unlike most other antibiotic R&D funding programmes, the AMR Accelerator has an overall mission of developing research infrastructures to build capability for future anti-infective R&D globally,” says Miles.
“For example, UNITE4TB aims to set a new standard for anti-TB regimen development by upgrading the current clinical trial methodology and enhancing the efficiency with which new regimens are delivered, while COMBINE is validating experimental procedures that could serve as globally harmonised standard pre-clinical models for the AMR community.”
Although antimicrobial resistance is on the rise and available treatments are less effective, the rate of development of new antibiotics has stalled. Public-private partnerships such as the AMR Accelerator can drive innovation in this field by building necessary infrastructures, uniting interdisciplinary experts, sharing risks and encouraging the development of new medicines to counteract dangerous drug-resistant bacteria. They are an important part of the ecosystem, addressing challenges in specific parts of the drug discovery and development process and value chain in synergy with other instruments.
The AMR Accelerator programme is supported by the Innovative Medicines Initiative, a partnership between the European Union and the European pharmaceutical industry.