Tackling the global health threat posed by antimicrobial resistance (AMR) will require numerous points of intervention and cross-sector partnerships, including the development of new economic strategies, according to Richard Hebdon, director for health & life sciences at Innovate UK, the country’s national innovation funding agency.
While the UK government has traditionally funded AMR initiatives in the form of collaborative R&D projects with industry, it has more recently recognized that interventions should focus on increasing the “flow of innovation, from ecosystem to industry,” Hebdon said during a 24 January Westminster Health Forum event on the future of AMR initiatives in the UK.
Last year, the UK pledged £30m ($38m) in support under an initiative known as PACE (pathways to antimicrobial clinical efficacy), which will run from 2023-2028 and aims to support early-phase antimicrobial and diagnostics projects.
PACE is one example of a “push” incentive, whereby funding is allocated to encourage early-stage R&D that is not contingent on the ultimate market success of a potential candidate. But according to Hebdon and many other AMR policy experts, new economic models are also required to fund drugs that do prove clinically effective.
Boosting investment in AMR “is about creating the right push and the right pull incentives [and] having new economic models to incentivize development,” Hebdon said, adding that it is also important to put “the right strategy and strategic framework in place from a government point of view” so that there is alignment on priorities.
Policymakers have long acknowledged the importance of offering both “push” and “pull” incentives to stimulate investment and interest in developing new antimicrobial drugs, but the global paucity of antimicrobial candidates has yet to be fixed.
In 2019, the UK health technology assessment (HTA) body, NICE, introduced the world’s first subscription-based funding model for new antibiotics under an initial pilot scheme.
Hebdon said the UK subscription pilot was “potentially one way forward,” and also referenced the US PASTEUR Act as another example of progress in antimicrobial funding elsewhere in the world.
“I know other countries are looking at similar initiatives. And that's important because we have to incentivize companies to make the investment in innovation in new antibiotics if we're to get the kind of pipelines that we want to see,” he added.
This issue is high on the agenda in many countries, including in the EU, where the European Commission has proposed the introduction of new antimicrobial incentives as part of an overhaul of the wider pharmaceutical legislation. (Also see "European Industry Proposes Incentive To Develop New Antimicrobials" - Pink Sheet, 14 February, 2022.)
Canada, too, has recently looked at the use of a subscription pull model to increase the number of new antimicrobials on the market.(Also see "Canada Tackles AMR With Drug Reserve List; Incentive Recommended To Motivate Antibiotic Development" - Pink Sheet, 20 October, 2023.)
PACE Initiative
The PACE project, a joint venture between co-funders Innovate UK and LifeArc, as well as the Medicines Discovery Catapult, which is a delivery partner, was set up to create more funding opportunities for researchers and businesses in the field of AMR.
“We are looking to take forward approaches that will help us accelerate the pace of developments to combat antimicrobial resistance,” Hebdon explained, noting that the idea of the initiative is that the skills, expertise and capabilities of all three organizations will be brought together.
“We're not only going to be funding projects, but providing access to industry-wide expertise, and an innovation ecosystem. And this innovation ecosystem will make it easier for small businesses, SMEs, researchers and innovators to progress new diagnostics and therapies for AMR,” he declared.
PACE has recently concluded its first call for applicants, to which it received a “fantastic response,” according to Hebdon, and there will be further opportunities for companies to apply in the future.
“When we look at some of our other funding programs for industry it's more of a trickle of projects coming through rather than the deluge that we absolutely need now. So part of the rationale behind PACE was really to help build and feed that pipeline.”
Diagnostic Support
Innovate UK has also separately provided support to companies that are developing novel AMR diagnostics using technology such as AI.
“There is funding there,” Hebdon told the conference, adding that with the PACE initiative, Innovate UK “felt from the very outset that supporting projects in the AMR diagnostic space was also going to be critical as well.”
“The value of AMR diagnostics in combating AMR I don't think can be overstated,” he said.
Deborah O’Neil, chief executive of NovaBiotics, a Scottish clinical-stage biotech based in Aberdeen, also stressed the importance of diagnostics during the same event, and outlined the market conditions that must be fixed if biotechs and SMEs are to deliver new solutions to the AMR crisis.(Also see "UK SMEs Can Help Restock The AMR Toolbox, But Only If The ‘Broken Market’ Is Fixed" - Pink Sheet, 29 January, 2024.)
Around 80% of AMR therapeutic candidates are owned by SMEs and biotechs, a figure that is “probably more” on the diagnostic side, O’Neil said, emphasizing the importance of addressing challenges faced by smaller companies specifically.
While biotechs working in any area of pharmaceutical research face similar challenges, there are additional struggles facing companies working in the AMR space, she warned.
“We'll be potentially losing some fantastic solutions, because they're just not seeing the light of day – as good as the science might be, they’re just not able to progress.”
