The next pandemic? It may already be upon us

‘Antimicrobial resistance (AMR) won’t race across the world like Covid-19, but its effects will be devastating. Thankfully, we already know what we need to do to defeat it...

‘Reining in the inappropriate use of antibiotics, in humans and in farmed animals, is key to staying ahead of AMR, but we also need novel anti-infectives coming down the pipeline – new last resorts. The thing holding up that pipeline to date has been the same thing that meant we had no coronavirus vaccines at the start of this pandemic: the economic incentives are few. Because antibiotics tend to be needed in relatively small quantities at a time, there are no economies of scale to be had either.

‘That’s the bad news; now for the good. Efforts are afoot to stimulate the development of novel anti-infectives. Outterson is the founder and executive director of CARB-X, which is funded by the British and German governments, the Wellcome Trust, the Bill & Melinda Gates Foundation and several arms of the US government, and which promotes the early stages of R&D – technically, the preclinical and phase 1 clinical phases. Meanwhile, last July the International Federation of Pharmaceutical Manufacturers and Associations launched a $1bn initiative, the AMR Action Fund, to finance the much more expensive phase 2 and 3 clinical trials that bring a drug – the few that get that far – to the threshold of regulatory approval. And the UK is experimenting with a new subscription-style payment model that pays drug companies upfront for access to novel antibiotics, so decoupling profit from volume sold.’

Read here (The Guardian, Feb 15, 2021)

Why it’s so hard to make antiviral drugs for Covid and other diseases

‘Antibiotics abound, but virus-fighting drugs are harder to come by. Fortunately, scientists are getting better at making and finding them...

‘The pandemic has sent scientists scrambling to find treatments. Heise [virologist Mark Heise of the University of North Carolina at Chapel Hill], for one, is testing a wide range of drugs—not just standard antivirals—against SARS-CoV-2 in lab dishes, as part of the Rapidly Emerging Antiviral Drug Discovery Initiative (READDI). The idea is that, because the virus depends on many processes in human cells, a variety of medications that act on human proteins might give doctors an edge by hurting the virus more than the patient. That throws the doors open to considering medications that were originally designed for cancer, psychosis, inflammatory conditions and autoimmune disease, to see if they might have a shot against Covid-19.

‘But the READDI collaborators—including academic centers, pharmaceutical companies and nongovernmental organizations—are aiming for more than a Covid-19 treatment. READDI hopes to identify and test potential medications for as-yet-unknown infections that may crop up in the future.

‘By getting early human safety testing done ahead of time, they’ll be ready to spring into action when those future outbreaks happen. As Heise says, “We don’t want to repeat what we’ve just been through.”

Read here (Scientific American, Feb 11, 2021)