Weekly Digest: WHO aims to reduce medication-related errors; CARB-X announces first investment portfolio

31 Mar 2017
Authors: Ellyse Stauffer, Shalini

A weekly roundup of news on drug resistance and other topics in global health.  

CDDEP Blog: Eating for 9 billion. CDDEP Research Analyst Wendi Jiang writes of "eating for 9 billion," and changing our diets to accommodate growing populations, while limiting environmental degradation. Not all proteins are equal in their impact on the environment and consumers have a role to play in shifting demand to improve the sustainability of food production. Even small reductions in the consumption of animal-based protein over a large population could lead to significant gains. Jiang writes, "To meet growing demand, changes are needed across sectors, with a focus on increasing sustainable production on existing farmland and changing current dietary patterns. Most of us have no direct control over agricultural practices, but we can change what we eat." [CDDEP]

WHO aims to reduce medication-related errors. The WHO launched The Global Patient Safety Challenge on Medicine Safety to reduce medication-associated harm by 50 percent globally within five years. According to the WHO, medication errors cause at least one death every day and injure approximately 1.3 million people annually in the United States alone. The Challenge will focus on four areas for improvement: patients and the public; healthcare professionals; medicines as products; and systems and practices of medication. The goal is to improve the way medicines are prescribed, distributed, and consumed, and to avoid the situations that can lead to problems, including health worker fatigue, overcrowding, staff shortages, poor training, and misinformation given to patients. This is the third global patient safety challenge, following Clean Care is Safe Care for improved hand hygiene in 2005 and Safe Surgery Saves Lives in 2008. [WHO]

Brookings report examines health governance capacity of LMICs. In its new report, Health governance capacity: Enhancing private sector investment in global health, the Brookings Institution investigates the capacity of 18 low- and middle-income countries (LMICs) to effectively use external investment in global health research and development, published as part of the Brookings Private Sector Global Health R&D Project. The report provides scorecards for the selected LMICs in Sub-Saharan Africa and Asia according to their performance across five dimensions: management capacity, regulatory processes, health infrastructure and financing, health systems, and policy conditions. Vietnam, South Africa, China, and Ghana rank highest on the composite “Health Governance Capacity Index” (HGCI), indicating their capacity to attract and leverage private investment in health R&D. The report concludes that LMICs can attract more private R&D investment by “increasing government transparency and stability, lowering tariffs on medical products, expediting the regulatory process for new drugs, investing in health infrastructure, and increasing government spending on health care in an efficient and targeted manner.” [Brookings]

CARB-X announces multi-million dollar investments at “Powered by CARB-X” launch event. The Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) announced a $48 million investment to help biotech companies and research teams in the United States and UK accelerate the development of novel antibacterials. CARB-X will provide an additional $24 million in milestone-based payments over three years. The funded projects are early stage research programs and include three new classes of potential small molecule antibiotics. Projects selected for the first “Powered by CARB-X” portfolio were weighted toward Gram-negative bacteria, often responsible for multidrug-resistant infections, and toward non-traditional approaches. [CARB-X, CIDRAP]

Potential new  antimalarial drug advances.. Two studies published in The Lancet Infectious Diseases on a new drug candidate for treating malaria show promising results. The need for new antimalarials is critical, as resistance to the current anchor class, the artemisinins, continues to spread in Southeast Asia and possibly in Africa. The new compound, DSM265 , which will eventually  be paired with compatible antimalarials, is a possible single-dose cure. The drug, however, may be particularly vulnerable to the development of antimicrobial resistance. An editorial accompanying the papers says that is “looks to be a promising antimalarial of the future.” [Lancet ID comment, Lanced ID study (1), Lancet ID study (2)]

Ten AMR Diagnostic Challenge semi-finalists selected. The prize—which may award up to $20 million—is sponsored by two US agencies, the Biomedical Advanced Research and Development Authority (BARDA) and the National Institutes of Health. The goal is to foster “innovative rapid, point-of-need diagnostic tests to combat the emergence and spread of drug resistant bacteria.”  Ten semi-finalists will be given $50,000 each to develop prototypes of their diagnostics by September 2018, after which the devices will be tested and further evaluated. The idea behind the challenge is to provide doctors with information quickly for informed treatment decisions, which should also reduce antibiotic use. Current diagnostic tests sometimes require days to give results. Underscoring the importance, BARDA Director Rick Bright, said, “Diagnostics that are fast, accurate, and easy-to-use are critical to address antibiotic resistance that could imperil not only each person’s health but also our nation’s security from natural and intentional threats.” [NIH]

When antibiotic susceptibility testing for new antibiotics is not available. On the American Society for Microbiology Blog, Thea Brennan-Krohn, Pediatric Diseases Fellow at Boston Children’s Hospital, writes of a “clinical laboratorian’s dilemma,” in which access is granted to critically ill patients for an investigational antibiotic, but for which antibiotic susceptibility testing (AST) is not yet available. Brennan-Krohn writes, “Clinicians are often confused and frustrated when they learn that their lab can’t immediately perform AST for a newly introduced antibiotic. There are many reasons for the delay between the introduction of a new antibiotic and the availability of AST for that antibiotic, [...] but the implications for patients of this delay in AST availability are significant.” The author illustrates the process of developing AST for new antibiotics and suggests intermediary options for clinicians when AST is not yet available. [ASM]

The potential of antivirulents in the face of antimicrobial resistance. A review in Nature Reviews: Drug Discovery highlights the potential of antivirulence agents as an alternative to traditional antibiotics. Antivirulents can sidestep the development of antimicrobial resistance by “disarming” pathogens of their virulence factors while leaving bacterial growth pathways (targeted by traditional antibiotics and the gateway to antibiotic resistance) unimpaired. The review references CDDEP’s State of the World’s Antibiotics 2015. An editorial in Future Microbiology also espouses the potential of antivirulents and asserts their place in research efforts for novel antimicrobial agents. [Nature, Future Microbiology]

CDC calls for innovative proposals to combat antibiotic resistance. The Centers for Disease Control and Prevention (CDC) has announced a funding initiative to support seven broad priorities including new diagnostic, sequencing, and metagenomic tools; transmission, colonization, and prevention of resistant pathogens; microbiome disruption; and antibiotic-resistant pathogens and genes in the environment; among other priorities. [CDC]

 

Image via Balaram Mahalder (CC BY-SA 3.0)