The CARB-X Initiative for Combating Antibiotic Resistance

The CARB-X Initiative for Combating Antibiotic Resistance

By Subramanian Krishnan

The Combating Antibiotic Resistant Bacteria (CARB-X) initiative is a global research accelerator program to counteract the alarming increase in antibiotic resistance in bacteria. The initial five-year program worth $350 million will strive to accelerate human testing of more than twenty highly promising antibacterial products in addition to providing funding, mentoring, and support. Led by the Boston University, key participants include the US Government (BARDA and NIAID) and the UK (Wellcome Trust and AMR Centre).

Antibiotic Resistance: The Ugly Side of Evolution

Charles Darwin famously quoted, “Intelligence is based on how efficient a species became at doing the things they need to survive.” Unfortunately, antibiotic resistance is an intelligent strategy of evolution employed by bacteria for their own survival that is unleashing havoc on humanity.

Aside from understanding the scientific basis of antibiotic resistance, the imminent need is to create awareness in the younger generation, addressing the supply problem to replace older and currently inefficient antibiotics with newer ones, restricted use in animals, humans, and most importantly, in agriculture.

We’re on the Losing Side – At Least for Now

Antibiotics played a major role in the leap in progress of modern medicine. Paradoxically, antibiotic resistance in bacteria was identified even before the first antibiotic penicillin was discovered. This is indeed alarming since it appears that bacteria were already prepared for it. Development of antibiotic resistance occurs due to mutations in bacteria in order to keep up with the sustained selective pressure from continued use of antibiotics.

According to the Center for Disease Control and Prevention (CDC), there are 2 million affected cases and at least 23,000 deaths every year in the USA due to antibiotic-resistant bacterial infections. Europe has recorded approximately 19,000 deaths every year due to the same cause. The main culprits are the “Gram-negative” bacteria that have an additional outer membrane that “pumps” out antibiotics or prevents antibiotic entry.

The CARB-X initiative is a unique measure that focuses not only on antibacterial products but also the development of vaccines, devices, and diagnostic tools. Fittingly enough, the initial focus will be on targeting Gram-negative bacteria. Moreover, since antibiotic resistance is a global issue, it aims at eventually expanding globally through partnerships with international organizations interested in fighting antibiotic resistance.

Interest in Antibiotic Research Rekindled

For many years, big pharmaceutical companies gave up on antibiotic development due to the inevitable development of resistance in bacteria for any new product. However, the current scenario requires a battle cry in unison to fight antibiotic resistance, which could kill 10 million lives every year by 2050. Fortunately, these companies have started to reconsider antibiotic development thanks to initiatives like CARB-X. Most importantly, a number of parallel global initiatives like the Fleming Fund in the UK and the Global Innovation Fund which is a UK-China collaborative.

In expectation of a successful outcome of these initiatives, a global alliance is being considered or proposed to provide incentives for the successful developers of novel antimicrobial products, purchase, and pricing of the products, and stringent rules to prevent “over-prescribing.” CARB-X has indeed foreseen these hurdles and is, therefore,encouraging diagnostic tools/kits development. This may help in rapid confirmation and hence avoid antibiotic abuse.

Fighting antibiotic resistance is a massive challenge. But the time to act on it is now and is the only way for the survival of the future generations.

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