Too few antibiotics in pipeline to tackle global drug-resistance crisis, WHO warns

Too few antibiotics are in the pipeline to tackle the global crisis of drug resistance, which is responsible for the rise of almost untreatable infections around the world, the World Health Organisation (WHO) warns.

Among the alarming diseases that are increasing and spreading is multi-drug resistant tuberculosis (TB), which requires treatment lasting between nine and 20 months. There are 250,000 deaths a year from drug-resistant TB and only 52% of patients globally are successfully treated. But only two new antibiotics for the disease have reached the market in 70 years.

The new WHO report, showing the paucity of new antibiotics being developed, lists 12 other pathogens that are serious dangers to health because we are running out of drugs to treat the infections they cause. Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacteriaceae that have become resistant to the carbapenem class of antibiotic are all on the critical priority list. They are what are known as gram-negative bacteria, capable of causing a range of life-threatening infections such as pneumonia, sepsis and meningitis.

Hospital infections such as C. difficile and MRSA (methicillin-resistant Staphylococcus aureus) are also of major concern. They are a particular danger to patients who are already sick and have fragile immune systems.

“Antimicrobial resistance is a global health emergency that will seriously jeopardise progress in modern medicine,” said Dr Tedros Adhanom Ghebreyesus, director-general of the WHO. “There is an urgent need for more investment in research and development for antibiotic-resistant infections including TB, otherwise we will be forced back to a time when people feared common infections and risked their lives from minor surgery.”

Ed Whiting, director of policy at the Wellcome Trust agreed and said: “There is no doubt of the urgency – the world is running out of effective antibiotics and drug-resistant infections already kill 700,000 people a year globally. We’ve made good progress in getting this on the political agenda. But now, a year on from a major UN agreement, we must see concerted action – to reinvigorate the antibiotic pipeline, ensure responsible use of existing antibiotics, and address this threat across human, animal and environmental health.”

The report’s authors have found 51 new antibiotics and biologicals currently in development that may be able to treat the diseases caused by these resistant bugs. But that will not be anywhere near enough because of the length of time it takes to get drugs approved and onto the market, and because inevitably some of the drugs will not work.

“Given the average success rates and development times in the past, the current pipeline of antibiotics and biologicals could lead to around 10 new approvals over the next five years,” says the report. “However, these new treatments will add little to the already existing arsenal and will not be sufficient to tackle the impending antimicrobial resistance threat.”

More investment is needed in basic science, drug discovery and clinical development, it says, especially for those pathogens on the WHO’s critical priority list. Gram-negative bacteria are getting less research attention because they are harder to find drugs against.