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Advancing global antibiotic research, development and access

Nature Medicine volume 30, pages 2432–2443 (2024)Cite this article

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Abstract

The pipeline of new antibiotics is insufficient to keep pace with the growing global burden of drug-resistant infections. Substantial economic challenges discourage private investment in antibiotic research and development (R&D), with a decline in the number of companies and researchers working in the field. Compounding these issues, many countries (from low income to high income) face a growing crisis of antibiotic shortages and inequitable access to existing and emerging treatments. This has led to an increasing role for public and philanthropic funding in supporting antibiotic R&D via the creation of nonprofit public–private partnerships, including Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) and the Global Antibiotic Research and Development Partnership (GARDP), industry support for the AMR Action Fund, and pilot schemes to evaluate and reimburse antibiotics in innovative ways. Now is the time to raise the urgency, ambition and commitments of the world’s leaders to fully support the antibiotic R&D ecosystem, incentivizing all sectors to conduct public health-driven antibiotic R&D and make effective antibiotics accessible to all who need them.

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Fig. 1: Financial problems of antibiotic SME (biotech) companies.
Fig. 2: International push mechanisms covering all phases of antibiotic R&D.
Fig. 3: CARB-X support model.
Fig. 4: Allocation of public and philanthropic investments in R&D of human antibacterial therapeutics globally, by research stage.

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Acknowledgements

We thank D. Graham-Rowe, R. Malpani, N. Ndembi, L. Srot, C. Sweeney, A.-M. Nia and D. Patel for helping to prepare this Review. We thank L. Ogilvie (Global AMR R&D Hub) for generating Fig. 4 and giving permission for its use in this Review. CARB-X is supported by federal funds from the US Department of Health and Human Services, the Administration for Strategic Preparedness and Response, the Biomedical Advanced Research and Development Authority under agreement number 75A50122C00028 and by awards from Wellcome (WT224842), Germany’s Federal Ministry of Education and Research (BMBF), the UK Department of Health and Social Care as part of the Global Antimicrobial Resistance Innovation Fund, the Public Health Agency of Canada, the Bill & Melinda Gates Foundation and the Novo Nordisk Foundation. The US National Institute of Allergy and Infectious Diseases, part of the NIH in Health and Human Services, provides support in the form of in-kind services through access to a suite of preclinical services for product development. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any CARB-X funders. The GARDP is supported by the governments of Canada, Germany, Japan, Monaco, the Netherlands, South Africa, Switzerland, the United Kingdom, the Canton of Geneva and the European Union, as well as Global Health EDCTP3, the RIGHT Foundation and the Wellcome Trust. The GARDP was created by the WHO and the Drugs for Neglected Diseases Initiative in 2016 and was legally registered as the GARDP Foundation in Geneva, Switzerland in 2018. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any GARDP funders. The following companies invest in the AMR Action Fund: Almirall, Amgen, Bayer, Boehringer Ingelheim, Chugai (Roche Group), Daiichi Sankyo, Eisai, Lilly, Boehringer Ingelheim Stiftung, Pfizer, Johnson & Johnson, Lundbeck, the European Investment Bank, GSK, Leo, the Menarini Group, Merck, Novartis, the Novo Nordisk Fonden, Shionogi, Novo Nordisk, Roche, Takeda and UCB. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any AMR Action Fund investors. C.E.M. receives funding from the Wellcome Trust (grant number 222051/Z/20/Z) for her research. J.A. is employed by the IFPMA, which represents the pharmaceutical industry. The content of this Review is solely the responsibility of the authors and does not necessarily represent the official views of the IFPMA, their funders, employers or members.

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Authors and Affiliations

  1. Global Antibiotic Research and Development Partnership (GARDP), Geneva, Switzerland

    Laura J. V. Piddock & Peter Beyer

  2. Africa Centres for Disease Control and Prevention (Africa CDC), Addis Ababa, Ethiopia

    Yewande Alimi

  3. International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), Geneva, Switzerland

    James Anderson

  4. CARB-X, Boston University School of Law, Boston, MA, USA

    Damiano de Felice

  5. Centre for Neonatal and Paediatric Infection, St George’s, University of London, London, UK

    Catrin E. Moore

  6. The Wellcome Trust, London, UK

    John-Arne Røttingen

  7. AMR Action Fund, Boston, MA, USA

    Henry Skinner

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Piddock, L.J.V., Alimi, Y., Anderson, J. et al. Advancing global antibiotic research, development and access. Nat Med 30, 2432–2443 (2024). https://doi.org/10.1038/s41591-024-03218-w

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