500 experts at the 7th AMR Conference in Basel

That antimicrobial resistance can no longer be considered a silent pandemic became abundantly clear at the AMR Conference in Basel from March 16-17. Unlike the rich G7 countries, resource-poor regions such as India and Africa already have a glimpse of AMR’s future – much like climate change. Some 30-50% of deaths here are already due to drug-resistant hospital-acquired pathogens – 70% of which are Gram-negative, it was said in Basel: according to the 85 international speakers at the conference, Africa and India currently account for more than 75% of annual AMR-related deaths. At the same time, access to low-cost agents that have also been tested in children is limited, and appropriate use of antibiotics, for example, is still a major challenge in India and Africa.

The 7th AMR conference, sponsored by the BEAM Alliance (more than 60 European SMEs) and organised by Bamconn GmbH, therefore focused on India’s AMR hotspot in a separate session. “India has the largest population in the world, and we need solutions born in India,” Anand Anandkumar (Bugworks) emphasized to the nearly 500 international visitors at the conference. Because some of the pathogens there have developed unique resistance mechanisms, diagnostics and anti-infectives developed by SMEs in the even less affected industrialized countries are of little help there.

Reason enough, says David Paterson of the National University of Singapore, to test agents adapted to Asian populations with meaningful study endpoints such as 28d mortality, clinical cure and nephrotoxicity. Recently, about $60 million has been allocated locally for Phase II to IV clinical trials under the ADvance-ID (ADVANcing Clinical Ecidence in Infectious Diseases) program, which also manufactures the compounds for the trials. “Clinical trials are important because recent data show that there is no correlation between preclinical data and clinical success of agents against carbapenem-resistant pathogens,” Paterson said.

But globally, the drug cushion against drug-resistant microbial priority pathogens is still not comfortable: “Since 1980, only three new classes of compounds have been discovered and developed” warned AMR expert John Rex at the conference, who, as CMO of UK-based F2G Ltd, is now taking his earlier research into fungicides, antibiotics and antivirals for Big Pharma, which has largely dropped out of development, forward in an SME. “Five or six years ago, nobody would have believed that all G7 would be at the AMR conference. Now, it is reality: we have gone so far,” Rex said. Nonetheless, drug discovery urgently needs more funding and, most importantly, appropriate new legislation to enable modern trial designs and endpoints to effectively counter AMR, according to Rex and Marlieke de Kraker, who is working on modern trial designs as part of the Innovative Medicines Initiative’s AMR Accelerator under the ENABLE-2 funding program, whose funding call is due to be published in April, according to program director Anders Karlén. 

Funding currently primarily includes PUSH initiatives, with initiatives such as the Novo REPAIR Impact Fund and CARB-X advancing preclinical and GARDP, BARDA, IMI and the AMR Action Fund advancing clinical testing of innovative drug candidates, such as phage-based or microbiommodulatory candidates, and diagnostic approaches, as well as information dissemination to curb the increasing AMR pandemic.” ERA-invest also plans to provide fresh money in May.  But PULL initiatives, as already tested in the UK, Japan, or the TEE model supported by SMEs and pharmaceutical companies in the EU, are also urgently needed to give developers a return on investment and thus incentives to innovate.

“We need to transfer the progress we made during the pandemic into progress in the AMR field,” emphasized Alexandra Cameron of the WHO. “Particularly in financing, we made good progress from initially national funding to more and more international funding approaches,” she added. “In addition to privately funded initiatives, there is agreement that governments must also provide public funding”, said Rolf Sudbrak of the Global AMR R&D Hub. “There is also a need to bridge the gap between academic research and business,” said Douglas Häggsdtröm of INCATE. Marc Gitzinger, CEO of Swiss-based Bioversys and chairman of the BEAM Alliance, called for improved communication on AMR, saying that in light of the coronary pandemic, the topic has been pushed into the background. “Monitoring is crucial to get a picture of where we are stranded regarding hospital-acquired infections,” he said. “Currently, the biggest task for the BEAM Alliance is the implementation of measures that bring the field forward in Brussels .”

Highlights of the conference for SMEs were the partnering session with around 450 meetings of potential new partners and investors such as the Boehringer Ingelheim Venture Fund, who presented its portfolio companies in a separate session, and the presentations of eleven selected start-ups in the Pitch Contest. The Pitch Award, supported by INCATE and sponsored by Vossius with €10,000, was won by the University of Southampton spin-out iFast Diagnostics. It offers an AMR susceptibility test that takes between four and eight hours and measures the electrical properties of specific bacteria in a low-cost microfluidic chip: the Brits plan to launch the product in late 2024.
 
The 8th AMR Conference will be held at the Congress Center Basel on March 6-7, 2024.