For the antimicrobial resistance (AMR) community, 2024 was always going to be a pivotal year. With the second United Nations General Assembly (UNGA) High-Level Meeting on AMR due to take place in September, it was an opportunity to cast the spotlight on AMR and foster commitment from world leaders to tackle this global crisis. For GARDP it was also a chance to raise awareness about the important work we do and the central role it plays in the global response.

However, the timing of that meeting and the urgency of our mission took on a whole new relevance with the publication of the new GRAM study in The Lancet. Its findings suggest that we have now reached a tipping point with AMR, with the number of people dying from drug-resistant infections now expected to rise sharply. By 2050 this could increase by as much as 70%, with as many as 169 million associated AMR deaths during this time.

The good news is that we can still prevent this from happening, and the interventions that will have the greatest impact are also the focus of our work. This is namely the development of effective new treatments for Gram-negative infections and improving access to new and essential antibiotics. That change won’t happen overnight, but the milestones we have achieved this year, spanning the entire antibiotic research and development ecosystem, will certainly bring us closer to it.

In April, at the 34th Annual European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Congress in Barcelona, we presented our phase 3 clinical trial results for zoliflodacin to the scientific community for the first time. This marked both the end of a long clinical journey for this potentially important new first-in-class antibiotic treatment for gonorrhoea, and the beginning of a new one through the regulatory pathways with a New Drug Application planned for early next year.

And as one trial concluded others began, with the launch of a new pivotal clinical trial in South Africa and Kenya last year. NeoSep1 is aimed at identifying optimal treatment regimens and doses for newborns with sepsis, ultimately bringing us a step closer towards providing newborns with the antibiotic treatments they so desperately need.

We also made advances towards improving access to treatments this year by signing the technology transfer agreement with Indian manufacturer Orchid for the production of cefiderocol.

Our ongoing relationship with India represents a significant step forward towards our goal of upending the antibiotic R&D model. For example, new partnerships with innovative Indian companies like Bugworks Research aren’t just about co-developing novel broad-spectrum antibiotics, they are also about moving away from traditional models geared towards the needs of high-income countries. By embracing partnerships that are instead more focused on the needs of high-burden countries, we can get the affordable antibiotic treatments that the world needs.

Upending the model like this will become an increasingly important part of our work, and not just in India. Indeed, this year we also expanded our reach into Latin America and South-East Asia. Our new agreement with the Pan American Health Organization (PAHO), for example, is aimed at improving regional antibiotic R&D, manufacturing and access. Similarly, the MOU signed with the Republic of Korea’s National Institute of Infectious Diseases lays the groundwork for joint antibiotic research and development activities to address AMR in Korea and beyond.

New partnerships, such as these, are also a strong indication that the work we are doing is getting noticed. Indeed, our presence on the global health stage is becoming increasingly prominent, with GARDP attending the G20 in Brazil, co-hosting events at the UNGA and a high-level meeting on access in New Delhi just last month. The value of our work is also reflected in the new funding we are receiving with an unprecedented EU 60 million in pledges announced in September. This is particularly encouraging given that global health funding has been shrinking in recent years.

This places us in a strong position as we press ahead with our five-year strategy. It will help see us through to an exciting new phase, where the treatments we are helping to develop start to reach the people who need them, and will enable us to continue to expand our portfolio. As we embark on this journey, we do so under the leadership of our new Board Chair, Professor Glenda Gray, and our new Vice-Board Chair, Dr Bernard Pécoul, both of whom bring a wealth of knowledge and experience to the roles. In the coming years, under their leadership, and together with our partners, we can help tip the balance in favour of protecting people from drug-resistant infections.

Yours sincerely,

Manica Balasegaram
Executive Director, GARDP