Lives saved + ROI of PASTEUR-like pull in Canada, UK, EU, Japan!

Dear All (and with thanks to Kevin for co-authoring), Building on their excellent analysis of the value over 30 years (29 Nov 2022 newsletter) to the United States as well the value to the entire globe of a PASTEUR-style pull that creates 18 new qualifying antibiotics, Bonnifield and Towse have now released country-by-country analyses using the same principles for Canada, UK, EU, and Japan.

The newsletter cited above gives a guided tour of the methods … and here’s the overall summary of the cost and benefit of such a 30-year program:

CountryLives savedROIG7+EU shareDiscounted 30-year cost
Canada48,10020:14.0%$1.54b
EU385,00018:134.0%$13.25b
Japan270,00028:19.8%$3.83b
UK88,40011:16.4%$2.47b
US383,00028:145.8%$17.9b
Global*9,933,000125:1100%$38.9b

*The global data are in the foundational US-specific paper. Please start with it and the explanatory newsletter.

As we said in that prior newsletter, these are as close to slam dunk economic analyses as you will ever see: country-by-country, the value in terms of lives saved and DALY-based ROI is huge. The analyses are also congruent with the STEDI-based analyses used in the UK’s pilot showing that the high social value of antibiotics is evident even with very conservative estimates.

Note further that the estimates of global economic value did not rely on savings to the health systems from better antibiotics, or any productivity gains from healthier people. These are thus conservative estimates; the actual savings are likely to he higher. Given their impressive social value, the funding proposed in the PASTEUR Act for compelling new antibiotics is truly a bargain

It’s time to make this happen both in the US and globally! All best wishes, John & Kevin

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Operating Partner, Advent Life Sciences. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://amr.solutions/blog/. All opinions are my own.

Kevin Outterson, JD, Professor of Law, Boston University & Executive Director, CARB-X (these views are personal and do not necessarily reflect the views of CARB-X or any of its funders) @koutterson

Current funding opportunities (most current list is here)

  • FDA have announced five RFPs spanning antifungal animal models, usability of antimicrobial drug labeling, urine PK-PD, and interpretive breakpoints. Applications are due dates of 23 Jan 2023 — see this newsletter for more details.
  • Current funding rounds from CARB-X are as described in this newsletter!
  • The AMR Action Fund is now open to proposals for funding of Phase 2 / Phase 3 antibacterial therapeutics. Per its charter, the fund prioritizes investment in treatments that address a pathogen prioritized by the WHO, the CDC and/or other public health entities that: (i) are novel (e.g., absence of known cross-resistance, novel targets, new chemical classes, or new mechanisms of action); and/or (ii) have significant differentiated clinical utility (e.g., differentiated innovation that provides clinical value versus standard of care to prescribers and patients, such as safety/tolerability, oral formulation, different spectrum of activity); and (iii) reduce patient mortality. It is also expected that such agents would have the potential to strongly address the likely requirements for delinked Pull incentives such as the UK (NHS England) subscription pilot and the PASTEUR Act in the US. Submit queries to contact@amractionfund.com.
  • BARDA’s long-running BAA-18-100-SOL-00003 offers support for both antibacterial and antifungal agents. This BAA has offered 4 deadlines/year since 2018 … check the most current amendment for details.
  • INCATE (Incubator for Antibacterial Therapies in Europe) is an early-stage funding vehicle supporting innovation vs. drug-resistant bacterial infections. The fund provides advice, community, and non-dilutive funding (€10k in Stage I and up to €250k in Stage II) to support early-stage ventures in creating the evidence and building the team needed to get next-level funding. Details and contacts on their website (https://www.incate.net/).
  • It’s not a funder, but AiCuris’ AiCubator offers incubator support to very early stage projects. Read more about it here.
  • The Global AMR R&D Hub’s dynamic dashboard (link) summarizes the global clinical development pipeline, incentives for AMR R&D, and investors/investments in AMR R&D.
  • In addition to the lists provided by the Global AMR R&D Hub, you might also be interested in my most current lists of R&D incentives (link) and priority pathogens (link).


Upcoming meetings of interest to the AMR community (most current list is here):

  • 1-2 Feb 2023 (virtual): Antimicrobial Chemotherapy Conference by GARDP and BSAC in collaboration with ReAct Africa and Africa CDC. Go here for details.
  • [NEW] 16-17 Mar 2023 (timings suggest hybrid EU-US): 7th AMR Conference, hosted by the BEAM Alliance with many co-sponsors. This has historically been a very good networking event. Go here for details.
  • 14 Apr 2023 (Copenhagen, Denmark; 3-6.30p CEST): ECCMID and the Global Leaders Group on AMR will jointly sponsor a symposium entitled “Forging partnerships between science and policy in Antimicrobial Resistance (AMR).” Go here to register.
  • 15-18 Apr 2023 (Copenhagen, Denmark): 33rd ECCMID. Go here for details and to register.
  • 8-12 May 2023 (Lisbon, Portugal): 41st Annual Meeting of the European Society for Paediatric Infectious Diseases. Go here for details.
  • 14-22 Oct 2023 (residential, Annecy, France): ICARe, the Interdisciplinary Course on Antibiotics and Resistance. Now in its 7th year, this course is a deep-dive into the world of antibiotic development. Intense, rigorous, and HIGHLY recommended. Seats are always limited … apply sooner rather than later! Go here for details.

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EPA (part 5): Interagency Framework on AMR Risks of Antibacterial and Antifungal Pesticides

This is the fifth of a 5-part newsletter series. There is an initial 27 Sep 2023 newsletter introducing the EPA concept note, a second (28 Sep 2023) newsletter that expands on the EPA concept note, a third (12 Jan 2024) newsletter about ending the use of streptomycin spray on citrus crops, and a 4th newsletter (27 Jan 2024) containing some additional resources. Dear All, Excitingly, the US EPA

HLM on AMR at UNGA: The end of the beginning

Aside: Please refer to our UNGA 2024 webpage for additional post-HLM notes and updates. Dear All (and with thanks to Damiano for co-authoring), Last week in NYC, the UN General Assembly (UNGA) and all its surrounding activities created a lot of energy (not to mention a giant traffic jam)! After a series of side meetings

Without action, AMR costs go from $66b to $159b/yr by 2050

Dear All, A new paper from Anthony McDonnell and a team led by the Center for Global Development extends estimates of the health-related impact of AMR (e.g., death) to a consideration of the economic ($) cost of AMR. To follow the plot, here are the links you will need: The new paper: “Forecasting the Fallout

UN TV: You can watch the AMR High-Level Meeting at UNGA

Dear All, The AMR HLM (High-Level Meeting) at the UN General Assembly starts at 10a ET today.  You can watch it here on UN TV: https://webtv.un.org/en/asset/k11/k11knc6w2t Addendum: It’s available for replay at that same link. See also the 1 Oct 2024 newsletter for a review of the HLM. All best wishes, –jr John H. Rex, MD

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