There has been a persistent call from early stage innovators to shine a spotlight on building anti-infective defenses in light of the looming crisis of antimicrobial resistance (AMR). Unfortunately, it has taken recent events to drive action within governments, big pharma and investment communities rather than a proactive approach which could have been taken years earlier. During the months leading up to April 2020, the industry realized the global impact of not being pro-active against infectious disease. To combat COVID-19, huge deals have been struck between investors, biotechs and large pharma companies; and many investment houses have closed huge billion-dollar sized capital raises for new funds which will also now focus on things such as Health Security. However, the lack of prior attention in the anti-infective space is particularly impactful when one considers that many COVID-19 patients die as a result of opportunistic hospital-acquired infections (HAIs) and ventilator-associated pneumonia (VAP), and not necessarily the virus itself.
In 2015, the US CDC published a five-year National Action Plan to tackle AMR, and as a result the Obama administration nearly doubled federal funding to begin to action the recommendations1. The following year in the UK, the O’Neill review on AMR2 commissioned by Prime Minister David Cameron, reported an analysis of the global problem of rising drug resistance from a medical, economic and social perspective, and proposed concrete actions to tackle the problem internationally. Similar reports were produced at around the same time by other governments and international agencies, but sadly, not much has changed since the publication of these reports, despite widespread agreement of the conclusions among governments and policymakers. The key reason for a lack of interest from pharma and investors has been their inability to see a commercial return, given a challenging reimbursement environment for anti-infectives and the requirement for product stewardship, meaning innovative anti-infectives would remain mostly on the shelf. Early-stage antimicrobial companies desperately looking for investment or collaborations have had to make do with whatever grant funding has been made available – most notably from CARB-X3. Promisingly, in 2019 the UK announced a trial of antibiotic market reforms called ‘PULL incentives’- under the scheme, NICE and NHS England would compensate pharma companies based on the value of their medicines rather than sales volume. This was a welcome step forward at the time, but now proper support must be made available to grow early-stage anti-infective biotech companies through real investor and industry engagement. To do this, industry has to be confident that such mechanisms are applied globally and are here to stay.
Unlike COVID-19, the impending crisis of AMR is something we can be therapeutically armed for. According to a 2019 WHO report, drug-resistant diseases already cause at least 700,000 deaths per annum globally, and approximately 2.4 million people could die in high income countries alone between 2015 and 2050 without a sustained effort to contain AMR4. Bear in mind, these estimates are only based on the infectious diseases we are currently aware of. Given these alarming statistics, it seems illogical not to take the time, whilst we still have it, to develop new therapeutics in the fight against AMR. Perhaps COVID-19 will finally shake governments out of their complacency.
Alacrita and AMR
There are currently hundreds of first-rate anti-infective technologies, including some totally new mechanisms of action and modalities, waiting in the wings to obtain funding and advance into clinical development, and now is the time to pro-actively make investments in AMR and drive innovative products to market. But how do you find these gems quickly in the middle of a national lockdown? The Alacrita team has conducted asset scouting for years on behalf of pharma and biotech clients, building up technology databases with each assignment. The most common focus has been around trending therapeutic areas such as fibrosis, inflammation, oncology and anti-infectives. We have built an asset database with several hundred, mostly early stage, anti-infective technologies - many of which are not in the public domain. We are open to working with select investors or partners in two ways: providing access to this database and/or scouting for more assets. If interested in learning more about how we can assist, please contact us.
Bibliography
- https://www.cdc.gov/drugresistance/us-activities/national-action-plan.html
- https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf
- https://carb-x.org/about/overview/
- https://www.who.int/antimicrobial-resistance/interagency-coordination-group/IACG_final_report_EN.pdf?ua=1