Since its launch less than two years ago, the public-private partnership CARB-X has provided $85 million to three dozen biotech companies working on new therapies and diagnostics to fight antibiotic resistance.
Today, CARB-X, which stands for Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator is announcing two new funders: The Bill & Melinda Gates Foundation will give up to $25 million, and the U.K. government’s Global Antimicrobial Resistance Innovation Fund is giving up to $27 million (£20 million). That brings CARB-X’s total funding to over $500 million, making it a dominant force in supporting diagnostic, preventative, and therapeutic product development for antibiotic-resistant bacteria.
According to the Centers for Disease Control & Prevention (CDC), some 23,000 people die in the U.S. every year from bacterial infections that are resistant to available antibiotics. In April, CDC reported that more than 200 instances of unusual resistance in “nightmare bacteria,” such as carbapenem-resistant Enterobacteriaceae (CRE), were detected in 2017. Germs such as CRE “can spread like wildfire,” the agency said.
That warning illustrates why the U.S. and U.K. governments have dedicated more than $450 million to CARB-X through 2021. But antibiotic resistance exerts an even greater toll on low- and middle-income countries—a problem that the Gates Foundation and the Innovation Fund hope to help solve.
Kevin Outterson, executive director of CARB-X and a health and disability law professor at Boston University, says the new funds will be used mostly for “vaccines, prevention, monoclonal antibodies, microbiome, and other nontraditional alternatives to antibiotics, with a particular focus on health needs in low- and middle-income countries.”
The Gates Foundation, well known for funding work to curb malaria, tuberculosis, and diarrheal diseases, is particularly interested in prevention. It recently increased efforts to prevent deaths from pneumonia and neonatal sepsis, a bacterial blood infection that kills over 300,000 infants annually.
CARB-X uses most-wanted lists published by the World Health Organization and CDC to set its priorities for which bugs to focus on. CRE and drug-resistant strains of pneumonia and tuberculosis are on those lists.
Although small-molecule drug development isn’t mentioned as a priority for CARB-X’s newest funding, the organization already backs several small-molecule projects spanning nine new classes of antibiotics. Many of those target Gram-negative bacteria, a large and diverse category of bacteria sharing anatomical features that make them particularly tough to kill.
“We need new classes to overcome bacterial resistance,” Outterson says. The last new class of antibiotic approved by the U.S. Food & Drug Administration for Gram-negative bacteria was discovered in 1962.
CARB-X currently funds 33 projects, which together could receive more than $100 million in additional funds for meeting project milestones. CARB-X will begin accepting applications for its next round of funding on June 1.