Antibacterial agents in preclinical development: an open access database

Overview

This is the World Health Organization’s first comprehensive overview of the preclinical antibacterial pipeline to date based on publicly available data on each included project. This report and the respective WHO database capture 252 antibacterial agents in development targeting the pathogens on the WHO priority pathogens list, Mycobacterium tuberculosis and Clostridioides difficile. The preclinical pipeline is dynamic and scientifically diverse, with agents being developed in many parts of the world to prevent and treat drug-resistant bacterial infections:

• 252 agents are being developed by 145 individual institutions that target the WHO priority pathogens, M. tuberculosis and C. difficile.
• The review captures research projects from institutions with a wide geographical distribution, 66 (45.5%) institutions in the European Region, 51 (35.2%) in the Region of the Americas, 22 (15.2%) in the Western Pacific Region, 5 (3.4%) in the South-East Asia Region and 1 (0.7%) in the African Region.
• 108 (42.9%) are direct-acting small molecules (single agents) and 90 (35.7%) are nontraditional products that include phages, anti-virulence agents, immunomodulators, microbiome-modifying therapies and potentiators, among others.
• 100 (39.7%) agents target a single pathogen, of which 43 target M. tuberculosis.
• Almost 1/3 of the agents target cell wall synthesis or act directly on the membrane.
• Approximately 2-5 direct-acting small molecules and 1 nontraditional product may make it to the market in the next 10 years.
• The preclinical pipeline is dominated by small and medium-sized enterprises (n = 104, 71% of all institutions that submitted data).
• This is the first review of the preclinical pipeline that makes all of the drug development projects and institutions available through a public database.

All of the preclinical antibacterial pipeline data at the product level is available and downloadable on the WHO Global Observatory on Health R&D.