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U.S. Department of Health and Human Services


Powering the next generation of antibacterial innovation to enhance national security

Author: Tyler Merkeley, MS, MBA, CARB-X Program Manager, BARDA
Published Date: 3/30/2017 11:50:00 AM
Category: Public Health Preparedness; Medical Countermeasures; Innovations; National Health Security;

It’s about the people. Picture a worried mother from Arizona walking into the hospital with her 11-year-old daughter. The girl had gone from tired to intense hip pain and a high fever in just a few days. A blood test revealed a potentially fatal condition called sepsis from a Staphylococcus infection. The infection had begun as an abscess in her hip muscle, spread into her blood, and eventually caused a devastating antibiotic-resistant bacterial pneumonia in her lungs.

Mom sat day-in and day-out watching her daughter’s health rapidly fade; tubes ran all over her body, and a special machine helped her breathe. Other complications developed, and she suffered a stroke. As a last resort, doctors placed her on an intravenous antibiotic known to be toxic to people’s kidneys, and they prepared the family for the worst.

This little girl, who had loved playing softball, swimming, and running track, finally began to recover. She left the hospital in a wheelchair five months after she had arrived. She had lost the use of her left arm, had almost no vision in her left eye, and had restricted vision in her right eye. She had limited use of her left leg. She would need medical attention and therapy for the rest of her life.

It’s for families like these that we’re pursuing new and innovative antibacterial products – drugs, diagnostics, and therapies – through CARB-X, one of the world’s largest public-private partnerships dedicated to developing products that combat antibiotic-resistant infections. Today, we are honored to announce the first projects to be powered by CARB-X.

The CARB-X board thoroughly vetted 168 proposals and selected 11 projects that represent truly exciting early stage research. Three of them could become the first in new classes of antibiotics, and four are innovative non-traditional products. Some of the projects also take new approaches, known as mechanisms of action, to target and kill bacteria. All of the potential new medicines target Gram-negative bacteria prioritized by the U.S. Centers for Disease Control and Prevention and the World Health Organization.

These first projects create a diverse CARB-X portfolio and represent the innovation of the CARB-X partnership. My agency, along with Wellcome Trust in the United Kingdom, the U.S. National Institutes of Health and our other CARB-X partners, are taking Silicon Valley’s incubator/accelerator business model a step further. This early in development, the vast majority of products – 80 percent or more – fail for a variety of reasons. To minimize that risk, we’re providing more than non-dilutive funding for these products; we’re also providing the business support and drug development expertise the companies, including start-ups, need to increase their odds of success. That way at least one or two reach clinical trial.

At BARDA we're dedicated to investing in innovative science through novel public-private partnerships. Because drug-resistant infections complicate the medical response in chemical, biological, radiological or nuclear emergencies, we devised a three-part strategy that leverage push and pull incentives to progress promising new antibacterial products from the bench to the bedside. Our role in national security is to protect our nation by supporting the development of these and other products that will either prevent harm from exposure to some of the greatest threats we face as a nation, or will bring you back to full recovery as quickly as possible following such events.

In addition to CARB-X, we have a clinical-stage antibacterial program which is sponsoring development of 13 promising products through partnerships with individual companies. These partnerships include four companies that formed strategic alliances with us to create portfolios of new antibacterial products.

BARDA also is exploring new ways to shift the current commercial market paradigm through "market entry rewards", because the current model of selling enough to recoup development costs and make a profit does not work well for antibiotic development. To be effective, antibiotics should be seldom used, which translates into far too little incentive for companies to develop new drugs to address this threat.

In the coming months we anticipate adding other products to the Powered by CARB-X portfolio, You can find out more about the initial 11 products Exit Icon and follow along as we look to expand our portfolio to up to 20 products. In 2017, CARB-X will seek new partners - funders and accelerators who want to join our team as we “Xccelerate global antibacterial Innovation”. Watch for these opportunitiesExit Icon.

We expect a multi-faceted return on investment for the U.S., the U.K. and the world - enhanced national security and healthier communities - as we attempt to bend the curve on the projected health care costs of deadly drug-resistant bacterial infections.

With CARB-X we’re stimulating the market for the public good while enhancing national security and global health security. Our most important return on investment are the lives we can save by accelerating development of new products to prevent, diagnose and treat antibacterial-resistant infections. Ultimately, it's about the people.​


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