Emily Wheeler
Research & Science Working Group Chair, AMR Industry Alliance; Vice President of Infectious Disease Policy at the Biotechnology Innovation Organization (BIO)
Without market incentives, talent loss and a declining pipeline will leave the world unprepared for the next wave of resistant infections.
In 2019, antimicrobial resistance (AMR) caused 1.27 million deaths and contributed to another 5 million deaths worldwide.[1] Left unchecked, those numbers are projected to rise by 70% by 2050.[2] This isn’t a distant public health issue; it’s an urgent problem today and a direct threat to modern medicine itself. Without effective antimicrobials, routine surgeries, chemotherapy and even childbirth become perilous. Yet, research and development continue to lag far behind the urgency of our crisis.
Deadly consequences for evaporating pipeline
The workforce behind antimicrobial innovation is vanishing as a result of unique threats to the antimicrobial ecosystem. Today, only around 3,000 researchers worldwide are focused on AMR, compared to 46,000 in cancer and 5,000 in HIV/AIDS.[3] That’s not just a shortage; it’s a brain drain with deadly consequences.
The innovation pipeline reflects the same imbalance. In 2022, there were 35 times more cancer publications than on priority bacteria.3 Cancer patents outpaced antibiotic patents by 20 to 1.3 The result, as our research shows, is a dwindling pipeline that cannot keep pace with the scale of the threat.
Without effective antimicrobials, routine surgeries, chemotherapy and even childbirth become perilous
New antibiotics must only be used when necessary
The problem isn’t science – it’s economics. New antibiotics need to be used appropriately, used only when necessary to slow resistance. That makes traditional volume-based incentives ineffective. Put simply: the market for antimicrobials is broken. Without intervention, investment will continue to evaporate, leaving healthcare professionals without options to treat patients.
New market incentives for antimicrobials are needed now
We cannot wait for this crisis to worsen. Policymakers must create new market incentives to bring antimicrobials back into the innovation spotlight. Otherwise, once-treatable infections will again become death sentences.
[1] WHO. 2023. Antimicrobial Resistance. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
[2] GBD 2021 Antimicrobial Resistance Collaborators. 2024. Global burden of bacterial antimicrobial resistance 1990–2021: a systematic analysis with forecasts to 2050. The Lancet.
[3] AMR Industry Alliance. 2024. Leaving the Lab: Tracking the Decline in AMR R&D Professionals.
