Breakthroughs Blog: Antimicrobial resistance

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. A recently published study, led by the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases (NIAID), found that three different antibodies independently protected monkeys from acquiring simian-HIV, findings that could inform the development of an HIV vaccine for people. The antibodies, one isolated from a person living with HIV and the other two from rhesus macaques, all target the fusion peptide, a site on an HIV surface protein that helps the virus fuse with and enter cells, with the results validating the fusion peptide as a potential target for a human vaccine. Hopefully, the approach will continue to show promise in future studies, although a vaccine for humans would need to be able to generate multiple varieties of antibodies directed at the fusion peptide to increase the likelihood that the vaccine could prevent the full diversity of HIV variants.A study published last week found that simnotrelvir, a COVID-19 drug administered as a series of pills, was effective in speeding recovery from mild to moderate disease. The drug was tested primarily in young people with standard levels of risk, a change from earlier antiviral drug trials during the pandemic, which included mostly people at high risk of severe COVID-19. The researchers combined simnotrelvir with a component of Paxlovid, currently the most widely used COVID-19 pill, with strong results and the only downsides similar to those of Paxlovid: bad taste and incompatibility with some common medications. Simnotrelvir has been available in China under an emergency use authorization since early last year and has been incredibly popular due, in part, to its much lower price tag compared to Paxlovid.Last week, the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) announced that it is awarding $633,000 to Intravacc to develop a vaccine for gonorrhea, which is the world’s second most reported sexually transmitted infection. The new vaccine could be a game changer in curbing new cases of gonorrhea, as well as addressing the rising spread of resistance of Neisseria gonorrhoeae to the only antibiotic still effective in treating it. The funding will support the early-stage development of Intravacc’s meningococcal outer membrane vesical vaccine, which includes antigens designed to protect against infections caused by N. gonorrhoeae.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. There is new hope that yaws, a chronic, disfiguring childhood disease, could be eradicated by 2030 with a renewed focus and hopefully, some new tools, especially given the emergence of resistance in the last few years to azithromycin, which has been used as an alternative to penicillin for yaws treatment since 2012. Despite the need for new tools to address the remaining burden of the disease, there are disappointingly few in the pipeline. There is one drug, linezolid, being evaluated that, like azithromycin, is easy to transport and administer, as well as an updated mass community treatment approach with azithromycin. Although the bacteria that causes yaws is tricky to target with a vaccine, ongoing research on a syphilis vaccine that targets the same bacteria that causes yaws could offer cross-protection. With underreported cases also a barrier to eradication, new, robust tests are also a major gap in the tools in our arsenal. The first human trial of a new vaccine against the deadly Nipah virus began last week after the work, which started in 2017, was paused during the COVID-19 pandemic. South Asia faces the greatest burden of Nipah virus, the priority pandemic pathogen that can be fatal in up to 75 percent of cases. There are currently no treatments or vaccines available against Nipah. The new vaccine, ChAdOx1 NipahB, which was developed using the same viral vector vaccine technology as the University of Oxford and AstraZeneca’s COVID-19 vaccine, will be evaluated over the next 18 months in a trial led by the Oxford Vaccine Group and funded by the Coalition for Epidemic Preparedness Innovations (CEPI). The World Health Organization (WHO) recently prequalified the novel oral poliovirus vaccine type 2 (nOPV2), the first prequalification of a vaccine being used under WHO's emergency use listing. nOPV2 was developed by an international consortium, which included GHTC members: Bill & Melinda Gates Foundation and PATH, and is as safe and effective as its predecessor, the oral polio vaccine, but more genetically stable, meaning it is much less likely to lead to vaccine-derived outbreaks. Nearly 1 billion doses of the vaccine have been administered across 35 countries since the rollout began in March 2021, and it has already played a key role in addressing outbreaks of type 2 variant poliovirus. WHO's decision now paves the way for even more countries to receive the vaccine.The Novo Nordisk Foundation, the nonprofit holding of Novo Nordisk and Novozymes, has announced a new grant of $25 million to the Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X). With this grant, the Novo Nordisk Foundation joins major governments and foundations in supporting the work of CARB-X to accelerate the early-stage development of innovative tools to prevent, diagnose, and treat drug-resistant bacterial infections. Efforts are focused on the most dangerous bacteria, which have been prioritized by the World Health Organization and the US Centers for Disease Control and Prevention, the syndromes with the greatest morbidity and mortality across the world, and the performance characteristics that clinicians and patients need the most. Since 2016, CARB-X has funded 93 projects in 12 countries, with 19 projects having advanced into or completed clinical trials; 12 actively in clinical development, including late-stage clinical trials; and two diagnostic products on the market.  

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. Newly published research found that a new compound worked in test tubes and mice against infections caused by the carbapenem-resistant Acinetobacter baumannii (CRAB) bacterium. CRAB can cause serious infections and death in critically ill hospital patients, is classed as a priority pathogen by the World Health Organization, and is resistant to many known antibiotics. The drug, zosurabalpin, was identified after screening about 45,000 small molecules with potential antibiotic properties and seems to be effective against the bacterium’s notoriously tricky structure. While research is still in early stages, the results provide hope for the potential treatment of hard-to-treat infections caused by CRAB and other bacteria.A research team used artificial intelligence (AI) to discover a new class of antibiotics for methicillin-resistant Staphylococcus aureus bacteria, better known as MRSA, which kills thousands globally every year. The researchers used deep-learning models to screen approximately 12 million commercially available compounds and then conducted lab tests for around 280 of them, eventually identifying and testing in mice two promising antibiotic candidates from the same class. The research not only points to a potential treatment for MRSA but also highlights the potential of AI in speeding up drug discovery. A recent study provided insight into newly identified flu-fighting antibodies that could lead to the development of broader, more durable flu vaccines. The researchers examined the curiously strong immune responses in certain individuals after they received a trivalent flu vaccine and discovered the production in some people of a specific type of antibody that targets two dominant flu strains. By reverse-engineering their immune responses, researchers hope to improve our understanding of how to produce a vaccine that could elicit antibodies against multiple strains of the flu. While this research does not take us closer to developing a truly universal flu vaccine, these insights could lead to improved vaccines that offer better, longer-lasting protection against multiple flu subtypes.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. A phase 3 trial testing a new malaria drug could offer hope for addressing the burden of malaria in babies, which despite being a leading cause of death across Africa, is often underdiagnosed, mistreated, and not studied in this population. There are no malaria treatments for babies weighing under 11 pounds (about three months old or younger), whose cases also often go undiagnosed because malaria presents differently and can easily be mistaken for common childhood illnesses in children this young or they have not even been tested due to resource shortages. Clinical trials, including those for the RTS,S and R21 malaria vaccines, often exclude children under five months because of the assumption that mothers confer immunity. The ongoing trial, which is supported by the PAMAfrica Consortium and co-funded by the European & Developing Countries Clinical Trials Partnership and Medicines for Malaria Venture, is expected to publish results early next year.The Novo Nordisk Foundation has announced a new initiative, developed with the University of Copenhagen, that will invest up to $260 million to create new or improved vaccines for serious respiratory diseases. It is the first global vaccines initiative to solely focus on how to produce immunity in the airway itself as a way to prevent airborne disease infection. The initiative will initially focus on candidates for tuberculosis, the flu, and Group A Streptococcus. The partners hope that the new project can help to address the rise of antimicrobial resistance, which is driven, in part, by the overuse or misuse of antibiotics to treat airway infections, as well as to address the high death toll globally from these diseases.The European Medicines Agency Committee for Medicinal Products for Human Use recently adopted a positive scientific opinion for the investigational drug arpraziquantel for schistosomiasis, a neglected tropical disease that affects more than 240 million people globally, including 50 million preschool-aged children. There is no child-friendly schistosomiasis medication for preschool-aged children, despite safe and effective treatments available for both adults and school-aged children. The Global Health Innovative Technology (GHIT) Fund has supported the Pediatric Praziquantel Consortium’s development of the drug since 2013 and is now working with the consortium’s implementation research program to prepare for the introduction of the drug in endemic African countries to ensure equitable and sustainable access in the countries where it is most needed.