The development of new antibiotics is “stagnant” and insufficient to deal with the growing threat of microbial resistance, warns the World Health Organization (WHO).
Since 2017, only twelve antibiotics have been approved, ten of them from classes already facing resistance.
“There is a huge gap in the discovery of antibacterial treatments, and even more so in the discovery of innovative treatments. This poses a serious challenge to overcome the growing antimicrobial resistance pandemic and it leaves us all increasingly vulnerable to bacterial infections, including the simplest ones,” said Hanan Balkhy, WHO deputy director for this area.
According to annual WHO reviews, in 2021 there were only 27 new antibiotics in clinical development against pathogens that are considered a priority, compared to 31 in 2017.
More broadly, the report describes that of the 77 antibacterials in clinical development, 45 are “traditional” and 32 are “non-traditional.” Among the latter are monoclonal antibodies and bacteriophages, which offer new opportunities to tackle infections by antimicrobial-resistant bacteria from different angles.
On average, resistance to most new drugs develops two to three years after they enter the market.
A long way to approval
Barriers to new product development include the long road to approval, high cost, and low success rates. Currently it takes between 10 and 15 years to get an antibiotic candidate from the preclinical to the clinical phase. For antibiotics in existing classes, only one in 15 in preclinical development reaches patients. In the case of the most innovative, the figure is reduced to one in 30 candidates.
Currently, of the 27 antibiotics in clinical development that address priority pathogens, only six meet at least one of the WHO innovation criteria.
The COVID-19 pandemic has also hampered progress, delaying clinical trials and diverting attention from already limited investors.
The WHO notes that urgent and concerted investments in research and development by governments and the private sector are needed to accelerate and expand the supply of antibiotics, especially those that may have an impact in low-resource settings, which are the most affected. for microbial resistance.