Antibiotics are the foundation of modern medicine. From simple surgeries and dental procedures to cancer treatment, antibiotics support health systems’ ability to deliver safe care to patients.

AMR is one of the most pressing threats to global health, jeopardizing many of the advances in medical treatment that depend on the availability of effective and safe antibiotics.

The World Bank estimates that drug-resistant infections have the potential to cause a level of economic damage similar to that caused by the 2008 financial crisis.

But, despite being almost 10 years on from the WHO Global Action Plan (GAP) on AMR, there is still a long way to go to meet its proposed objectives.

AMR is associated with close to 5 million deaths globally per year and directly responsible for nearly 1.3 million deaths, at a time when, because of lack of a functional market, the antibiotics pipeline is close to dry.

We need to accelerate the creation of a dynamic and sustainable innovation ecosystem to enable R&D for new antibiotics.

Research into new antibiotics is a long-haul journey. According to the WHO, it takes 10–15 years to progress an antibiotic candidate from the preclinical to the clinical stages.

For antibiotics in existing classes, on average, only one of every 15 drugs in preclinical development will reach patients. With new classes of antibiotics, only one in 30 candidates will reach patients. Many that have successfully made it to market in the last decade continue to face difficulties.

New antibiotics need to be used appropriately to preserve their effectiveness and slow the development of resistance. While new antibiotics would be used only rarely, they’re still needed when nothing else works. This makes constant innovation a necessity.

But, to enable this, policy reforms are needed to correct the broken market and unlock sustainable investment into antibiotic R&D.

The innovative pharmaceutical industry has long played its part in fighting the threat of AMR, but more needs to be done.

Critically, the clinical antibiotic pipeline needs to be replenished and more antibiotics brought to market.

Good stewardship is essential to maintain the effectiveness of new and existing antibiotics. It’s vital that patients have access to the right antibiotic at the right time so that last-line reserve antibiotics are only used in the appropriate circumstances.

As part of coordinated efforts on infection prevention, control, and stewardship, preventative measures such as vaccines must be fully leveraged.

But the innovative pharmaceutical industry cannot work alone in making sure the threat of AMR is kept at bay. Urgent policy reforms are needed to revitalize antibiotic R&D.

Currently, society and healthcare systems place a low value on antibiotics despite the public health risks of AMR, sending a clear signal that investing in them is not a priority.

The world’s leading economies must implement new market incentives that reward successful antibiotic development beyond the volume of sales.

Globally, the incentive must be sufficiently sized to attract robust and sustainable investment in R&D by delivering an appropriate return on investment that can in turn support further R&D. Countries also need to rethink how they value and reimburse for antibiotics so they’re available on the market and can be prescribed to patients when needed.

In this way, we have the potential to create a healthy, sustainable innovation ecosystem that supports R&D for new antibiotics and other antimicrobials for prioritized pathogens and keeps up with growing resistance to existing antibiotics.