New medicines are desperately needed to treat a growing number of drug-resistant infections, but many companies developing the drugs are short on cash and investments.
Twenty of the world’s largest pharmaceutical companies on Thursday announced the creation of a $1 billion fund to buoy financially strapped biotech start-ups that are developing new antibiotics to treat the mounting number of drug-resistant infections responsible for hundreds of thousands of deaths each year.
The fund, created in partnership with the World Health Organization and financed by drug behemoths that include Roche, Merck, and Johnson & Johnson, will offer a short-term but desperately needed lifeline for some of the three dozen small antibiotic companies, many of them based in the United States, that have been struggling to draw investment amid a collapsing antibiotics industry.
Over the past year, three American antibiotic start-ups with promising drugs have gone bankrupt, and many of the remaining companies are quickly running out of cash.
The new AMR Action Fund will make investments in roughly two dozen companies that have already identified a promising drug with the goal of bringing two to four novel antibiotics to the market within a decade, according to the International Federation of Pharmaceutical Manufacturers and Associations, an industry trade group that is administering the fund.
Recipients will be chosen by an advisory panel made up of drug company executives, scientists and other experts in the field. The companies will also provide free expertise to biotech companies with promising drugs as they navigate the clinical and regulatory hurdles needed to bring an antimicrobial compound from laboratory to market.
“Antibiotics are the mortar that holds the entire health care system together,” said David A. Ricks, the chief executive of Eli Lilly, who helped spearhead the effort. “We make drugs for diabetes, cancer and immunological conditions, but you couldn’t treat any of them without effective antibiotics.”
In an interview, Mr. Ricks said he was well aware of the irony that Eli Lilly and many of the other companies contributing to the fund were once the giants of antibiotic development but have long since abandoned the field because of their inability to earn money on the drugs. “We know firsthand how broken the system is,” he said.
The crisis stems from the peculiar economics and biochemical quirks of drugs that kill bacteria and fungi. The more often antimicrobial drugs are used, the more likely they are to lose their efficacy as pathogens survive and mutate. Efforts to promote antibiotic stewardship mean that new drugs are used as a last resort, limiting the ability of companies to earn back the billions of dollars it can take to create a new product.
“It’s been a really tough time for companies doing antibiotic discovery despite the tremendous unmet need,” said Zachary Zimmerman, the chief executive of Forge Therapeutics, a San Diego company that has several new drugs in the pipeline. He said the fund would provide critical help for companies that have already spent millions identifying an innovative compound but lack the money to carry out the costly clinical trials needed to gain regulatory approval. “A fund like this can really help us get through that valley of death,” Mr. Zimmerman said.
The collapse of the antibiotic market has dramatically reduced the number of promising drugs. Between 1980 and 2009, the Food and Drug Administration approved 61 new antibiotics for systemic use; over the past decade that number has shrunk to 15, and a third of the companies behind those medicines have since gone belly up. Those backing the fund acknowledge that the effort is largely a stopgap measure. Industry executives and public health experts say that fixing the broken marketplace for antibiotics would require sweeping government intervention to create financial incentives for drug companies, including policy changes that would increase reimbursements for lifesaving drugs kept under lock and key and used only when existing therapies fail. Legislation that would address the problem has not gained traction in recent years.
Drug-resistant infections kill 700,000 people a year across the globe, according to the United Nations, which has warned that the death toll could rise to 10 million by 2050 without concerted action.
Dr. Peter Beyer, a senior adviser at the W.H.O. who led the effort to create the new fund, said the threat of antimicrobial resistance rivaled that of the coronavirus pandemic, but it was a slow-rolling crisis that could feel abstract to political leaders focused on the next election cycle.
“Hopefully this fund can bridge the gap until politicians realize the urgency of antimicrobial resistance,” he said.
Everly Macario, a public health expert at the University of Chicago Medicine who focuses on antimicrobial resistance, understands how abstract the threat can feel. In 2004, her 18-month- old son, Simon, died from a drug-resistant staph infection within 24 hours of arriving at a hospital emergency room with breathing difficulties.
“People think drug-resistant infections are something that affects other people,” she said. “But one day, all of us, both young and old, will need an antibiotic. A world in which antibiotics no longer work is something that should terrify everyone.”