Illustration by Joelle Bolt
As Bacteria Grow Stronger, Our Partnerships Must Too
Cross-sector collaborations in TB show how strategic partnerships can improve public healthSeventy years ago, the discovery of antibiotics revolutionized the treatment of bacterial infections and laid the groundwork for modern medicine. From treating common ailments to stemming a bacterial outbreak, the benefits of antibiotics are tremendous. Today, however, the growing problem of bacterial resistance threatens to undo the progress antibiotics have made and put global health at serious risk.
Even as drug-resistant bacteria become more pervasive, the pharmaceutical pipeline of antibiotics to address these “superbugs” remains lean. In the past 30 years, only two new classes of antibiotics have been introduced. With a host of scientific, regulatory and financial challenges associated with discovering new antibiotics, the struggle intensifies to meet this great need.
My experience in clinical development within the pharmaceutical industry has taught me that to overcome these challenges, we must form strategic partnerships that draw on the strengths of all participants. To make antibiotic discovery both feasible and attractive, we need the research vigor of academia and biotechs; the scientific and technological resources of pharma; the regulatory and multi-channel support of government; and the unifying ability of NGOs—all at the same table.
Collaborations like this are already under way to combat tuberculosis (TB), an infectious disease that claims 5,000 lives daily worldwide. Most people think of TB as a disease of the past, and while that’s a misconception, TB does have one archaic feature—it continues to be treated with decades-old antibiotics. These treatment regimens are relatively effective, but they are also long and complicated, leading to poor adherence, relapse, and drug resistance. Today, multi-drug resistant TB affects half a million people annually, takes two years to treat, and is cured in only half of all cases.
A breakthrough TB treatment would need to act against drug-resistant strains, simplify treatment regimens, and be compatible with treatments for HIV/AIDS (a common and perilous co-morbidity). To accelerate the development of such treatments, a major collaboration helmed by the Bill and Melinda Gates Foundation, the TB Alliance, and the Critical Path Institute has brought together pharmaceutical companies, government agencies, donors, advocates, academia and NGOs.
As an outcome of this cross-sector collaboration, the U.S. Food and Drug Administration is drafting new guidance to permit the testing and approval of experimental drug cocktails—as opposed to testing each component individually and then in combination. This guidance is expected to significantly accelerate the introduction of new treatments for TB as well as for other diseases. Right now, nine promising TB compounds are in development, including one from our organization, AstraZeneca.
The Critical Path to TB Drug Regimens is just one example of different sectors joining forces to combat global health threats. We still have a long way to go. In particular, we still must find solutions to financially incentivize companies to embark on this path. I urge all organizations with a stake in global public health to recognize that there is value in investing in antibiotics—and a very real threat if we don’t. No single entity has the skills, resources, or perspective to do it alone. Only by bringing our best assets to the table, can we hope to find a cure for tuberculosis, a solution to antimicrobial resistance, and a model for the treatment of many other diseases.
Author Bio:
Anders Ekblom is President AstraZeneca Sweden AB, and Director of the board of Albireo Ltd. He is an Associate Professor of Physiology at the Karolinska Institute, a medical doctor board certified in Anesthesiology and Intensive Care, and a doctor of dental surgery. He has long been active in both basic and clinical research resulting in over 60 original publications in peer reviewed journals and book chapters.
Photo: Illustration by Joelle Bolt
