Do we need a PDP to help us deal with Antimicrobial Resistance?

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Do we need a PDP to help us deal with Antimicrobial Resistance? How a product development partnership could promote innovation and responsible access to new antibiotics

Vision Establish a product development partnership (PDP) which, in collaboration with public and private partners in high-, middle and lowincome countries, sustainably promotes the research and development of new antibiotics and ensures their rational use and their preservation globally

Rational for a PDP A PPP/PDP model enables to: establish TPPs addressing global needs provide a coordinated strategic approach to drug development engage into and stimulate pioneering long term scientific strategies promote new innovative incentives and ensure accountable use of funds Insure responsible use of and access to drugs

The model Virtual and not-for-profit A virtual model is favored because: it provides flexibility does not immobilize capital and avoids costly overheads facilitates collaborations with external public and private entities A not-for-profit model is preferred because: Need assessments, TPPs definitions and scientific strategies will be defined solely by patient s needs No internal conflict to implement rationale use: no expectations of returns Advocacy, fundraising and access to public funds facilitated, because no perceived or actual conflicts of interest More freedom to design appropriate incentives and rewards, and to negotiate adequate premiums on the antimicrobials developed to insure patient access

Major tasks envisaged Module 1: R&D Establish research priorities (i.e TPPs), focusing on upstream discovery (long term) and specific downstream projects (short term) Foster test-and-treat paradigm by embedding point of care, fast diagnostics within the R&D strategy Module 2: Economic frameworks Business models, IP strategies, reward schemes Module 3: Procurement and Supply Address access strategies managing rational -but wide- use of the products from global health perspectives

Governance structure Should include HICs and LMICs, IOs, NGOs/not-for-profit, industry. Board of Director (BoD) and Scientific Advisory Committee (SAC): risk managments and key strategic directions, delegate operations to Executive Team. BoD composition: balanced country representatives, donors, leading health and research institutions, academia, industry, «AMR-specific» NGOs, Executive team : implement BoD strategy, supervise research consortiums and projects, BD activities, reward schemes and incentives, fundraising, advocacy & communication, drug facility to manage end products. Executive team composition: good mix of academia / not-for-profit, pharma, as well as scientific, public health and operational backgrounds. SAC composition: academic and private sector representation, to focus on technical issues, to provide recommendations to the Board to validate the strategy

Funding Sustained, significant and long term government funding key for perennial successful operations : Antibiotic Fund Look additionally at new sources of funding, including from MIC Innovative financing mechanisms (eg. airlines levies, IFFIm, GHIF, etc.)

Next steps Meeting report Side discussion at WHO EB Garner support at WHA via the GAP G7 concept note Coalition of countries to finance initial work Formal feasibility project team setup and hosting of the initial activities

Discussion points This is a global health agenda Despite several NCEs in development, identification of new anti-infective classes or new strategies to deal with infection remains a challenge => need significant governement support for basic research in anti-infectives Landscaping and prioritization of needs and gaps, with a forward and proactive approach in R&D in view of long timelines Need of mobilization of significant new financial resources: «antibiotic fund» Ability to construct alternative forms of incentives that promote R&D, rational use and strong implication of the private sector (eg. CEWG report, delinkage concept and beyond..)