The World Health Organization's (WHO) annual report on the development and testing of new antimicrobials in 2020 notes that, despite the recognition of the threats posed by antibiotic resistance, promising new antimicrobials are still lacking. None of the 43 antibiotics currently in various stages of testing address the problem of multidrug resistance in dangerous pathogenic bacteria.

Almost all new antibiotics introduced into clinical practice over the past decades belong to already known classes of antibiotics discovered before the 1980s.

The consequences of antibiotic resistance are most alarming in resource-limited settings and among vulnerable populations, particularly young children. Approximately 30% of newborns with sepsis die from bacterial infections resistant to multiple first-line antibiotics.

The WHO report aims to assess progress in the field of new antimicrobials, identify gaps in the threat of drug resistance and stimulate action to overcome these gaps.

The report assesses the potential effectiveness of drug candidates for treating infections caused by the most dangerous bacteria on the WHO list of priority bacterial pathogens.

In recent years, only a few antibiotics have been approved for use, most of which offer no clinical advantages over existing therapies. Moreover, 82% of newly approved antibiotics are derivatives of antibiotics already in use, and resistance to them is already widespread. Therefore, bacterial resistance to these new drugs can be expected to emerge soon. The report notes that "clinical developments and antibiotics recently approved for use are generally insufficient to address the problem of increasing and spreading antimicrobial resistance."

The WHO report emphasizes the need for innovative approaches to treating bacterial infections. For the first time, the report includes a review of alternative antibacterial agents, including bacteriophages, antibodies, and drugs that modulate the microbiome.

The challenges of developing innovative antimicrobial agents are not only scientific but also a lack of investment: due to the low return on investment in successful antibiotics, private investors and most pharmaceutical companies are not interested in developing this area.

The COVID-19 coronavirus pandemic crisis has forced the world to recognize the consequences of an uncontrolled global spread of the infection, both for healthcare and the economy. The crisis has also highlighted the lack of sustainable funding for drug and vaccine development, but has also demonstrated the possibility of rapid progress in this area with the right political will and resources.

WHO experts believe the COVID-19 pandemic is an opportunity to highlight the need for sustained and targeted investment in the research and development of new, effective antibiotics. WHO is currently participating in the Global Antibiotic Research and Development Partnership (GARDP) and collaborating with non-profit funding partners to stimulate antibacterial research. Another initiative, the AMR Action Fund , is a partnership created by a coalition of pharmaceutical companies, philanthropic organizations, and the European Investment Bank, with support from WHO. Its goal is to accelerate the development of new antibiotics by increasing global co-financing.