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      Accelerating global innovation to address antibacterial resistance: introducing CARB-X.

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          Abstract

          A global response to the chronic shortfall in antibiotic innovation is urgently needed to combat antimicrobial resistance. Here, we introduce CARB-X, a new global public-private partnership that will invest more than US$350 million in the next 5 years to accelerate the progression of a diverse portfolio of innovative antibacterial products into clinical trials.

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          Antibiotic resistance-the need for global solutions.

          The causes of antibiotic resistance are complex and include human behaviour at many levels of society; the consequences affect everybody in the world. Similarities with climate change are evident. Many efforts have been made to describe the many different facets of antibiotic resistance and the interventions needed to meet the challenge. However, coordinated action is largely absent, especially at the political level, both nationally and internationally. Antibiotics paved the way for unprecedented medical and societal developments, and are today indispensible in all health systems. Achievements in modern medicine, such as major surgery, organ transplantation, treatment of preterm babies, and cancer chemotherapy, which we today take for granted, would not be possible without access to effective treatment for bacterial infections. Within just a few years, we might be faced with dire setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions are immediately taken. Here, we describe the global situation of antibiotic resistance, its major causes and consequences, and identify key areas in which action is urgently needed. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            Antibiotic reimbursement in a model delinked from sales: a benchmark-based worldwide approach.

            Despite the life-saving ability of antibiotics and their importance as a key enabler of all of modern health care, their effectiveness is now threatened by a rising tide of resistance. Unfortunately, the antibiotic pipeline does not match health needs because of challenges in discovery and development, as well as the poor economics of antibiotics. Discovery and development are being addressed by a range of public-private partnerships; however, correcting the poor economics of antibiotics will need an overhaul of the present business model on a worldwide scale. Discussions are now converging on delinking reward from antibiotic sales through prizes, milestone payments, or insurance-like models in which innovation is rewarded with a fixed series of payments of a predictable size. Rewarding all drugs with the same payments could create perverse incentives to produce drugs that provide the least possible innovation. Thus, we propose a payment model using a graded array of benchmarked rewards designed to encourage the development of antibiotics with the greatest societal value, together with appropriate worldwide access to antibiotics to maximise human health.
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              Author and article information

              Journal
              Nat Rev Drug Discov
              Nature reviews. Drug discovery
              Springer Nature
              1474-1784
              1474-1776
              September 2016
              : 15
              : 9
              Affiliations
              [1 ] Boston University School of Law, Boston, Massachusetts 02215, USA.
              [2 ] Chatham House, London SW1Y 4LE, UK.
              [3 ] AstraZeneca Pharmaceuticals, Waltham, Massachusetts 02451, USA.
              [4 ] University of Texas Medical School-Houston, Houston, Texas 77225, USA.
              [5 ] Wellcome Trust, London NW1 2BE, UK.
              [6 ] AMR Centre, Alderley Park, Manchester SK10 4TG, UK.
              [7 ] Mass Bio, Cambridge, Massachusetts 02139, USA.
              [8 ] California Life Sciences Institute, South San Francisco, California 94080, USA.
              [9 ] Broad Institute, Cambridge, Massachusetts 02142, USA.
              [10 ] Harvard Medical School, Boston, Massachusetts 02215, USA.
              [11 ] Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
              [12 ] National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892, USA.
              [13 ] Biomedical Advanced Research and Development Authority, Washington, DC 20201, USA.
              Article
              nrd.2016.155
              10.1038/nrd.2016.155
              27469032
              d9522520-324b-4aee-9e29-5a8dc5e41314
              History

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