Clearly, we at Nature Microbiology should crow that our recent editorial on tackling antimicrobial resistance has been heard at the highest levels and translated into action (within 2 months no less!): today, a new US-UK private-public partnership named Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) was officially launched.
CARB-X represents one of the world's largest public-private partnerships with the explicit goal to help translate scientific discoveries into new human-testable clinical leads that can be used to treat drug resistant infections. The partnership combines several US governmental organizations including the Biomedical Advanced Research and Development Authority (BARDA), and the National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID) alongside science accelerator initiatives like the US-based Massachusetts Biotechnology Council (MassBio) and California Life Sciences Institute (CLSI). On the UK side, the Wellcome Trust and the public-private initiative, The AMR Centre will also provide oversight and funding support.
Often, promising candidates at biotechs or in academic laboratories languish due to the amount of money needed to conduct extensive preclinical trials. Lack of business expertise and regulatory familiarity also represent significant hurdles for researchers to find investors and actually translate their findings into viable products for human use. Thus, CARB-X aims to supply resources (e.g., reagents, animal models, chemical optimization) to ease early product development while also providing mentorship and business support to help navigate the future regulatory and commercialization waters. Over the next 5 years, CARB-X aims to put US $350 million ($250 million from BARDA, $100 million from the AMR Centre) into the cause, hoping to be moving about 20 promising products towards clinical testing at any given time. Currently, $30 million from BARDA has been fully committed for the first year.
Only time will tell if CARB-X actually develops the blockbuster therapies we are looking for, and the efficacy of the exclusive development focus of the venture is not without its concerns. In particular, though the initiative relies on having a stable of promising candidates to push forward, we still do not yet have a solid understanding of drug permeability in bacteria and thus how to develop libraries for finding promising Gram negative penetrating compounds. These fundamental science questions are currently out of scope for CARB-X and will remain under the auspices of basic science funding, which could be a future choke point. But, I think hopes are high that public-private initiatives like CARB-X that support early drug development (especially in the context of international cooperation) do represent a meaningful way forward for truly spurring more integrated and rapid responses to our increasingly global problems. After all, if disease knows no boundaries, then why should science?