On Apr. 15, 2021, the World Health Organization (WHO) reported that the world was still failing to develop desperately needed antibacterial treatments, despite growing awareness of the urgent threat of antibiotic resistance. The WHO revealed that none of the 43 antibiotics that are currently in clinical development sufficiently address the problem of drug resistance in the worldﾒs most dangerous bacteria. Almost all the new antibiotics that have been brought to market in recent decades are variations of antibiotic drugs classes that had been discovered by the 1980s.

The impact of AMR is most severe in resource-constrained settings and among vulnerable groups such as new-borns and young children. Bacterial pneumonia and bloodstream infections are among the major causes of childhood mortality under the age of 5. Approximately 30% of neonates with sepsis die due to bacterial infections resistant to multiple first-line antibiotics.

WHO’s annual Antibacterial Pipeline Report, reviews antibiotics that are in the clinical stages of testing as well as those in early product development. The aim is to assess progress and identify gaps in relation to urgent threats of drug resistance, and to encourage action to fill those gaps.

The report evaluates the potential of the candidates to address the most threatening drug-resistant bacteria outlined in the WHO Bacterial Priority Pathogens List (WHO PPL). This list, which includes 13 priority drug-resistant bacteria, has informed and guided priority areas for research and development since its first publication in 2017.

The 2020 report reveals a near static pipeline with only few antibiotics being approved by regulatory agencies in recent years.  Most of these agents in development offer limited clinical benefit over existing treatments, with 82% of the recently approved antibiotics being derivatives of existing antibiotic classes with well-established drug-resistance. Therefore, rapid emergence of drug-resistance to these new agents is expected.