AMR benchmark warns drug resistance outpacing pharma efforts

Five years after the release of its previous Antimicrobial Resistance (AMR) Benchmark, the Access to Medicine Foundation has identified encouraging progress in pharmaceutical companies’ efforts to tackle drug-resistant infections. However, the latest report warns that antimicrobial resistance continues to spread faster than the industry’s response, posing a growing threat to global health.

The 2026 AMR Benchmark highlights several promising developments, including seven innovative late-stage drug projects targeting some of the world’s most dangerous drug-resistant pathogens. These projects are being developed by pharmaceutical companies including GSK, Otsuka, Shionogi, BioVersys, F2G, Innoviva and Venatorx.Recent regulatory approvals for some of these medicines offer hope that new treatment options may soon reach patients. Yet the report notes that the overall pipeline of new antimicrobial medicines remains alarmingly thin, even as resistance to existing drugs accelerates worldwide.

According to the study, more than one million people die each year directly from drug-resistant infections, while antimicrobial resistance contributes to over four million deaths annually. If current trends continue, deaths linked to AMR could rise to nearly two million direct deaths and more than eight million indirect deaths annually by 2050. Despite the grim outlook, experts say the crisis is not insurmountable.“We can tilt the battle against superbugs in humanity’s favour,” said Jayasree K Iyer, CEO of the Access to Medicine Foundation.

“Our findings show practical approaches that can ramp up progress on all fronts.”The report identifies a 35 per cent decline in antimicrobial research pipelines among large research-based pharmaceutical companies compared with the previous benchmark.At the same time, smaller biotechnology firms are increasingly playing a crucial role in keeping innovation alive. The 2026 benchmark assessed 25 pharmaceutical companies, including seven large research-based firms, ten generic medicine manufacturers and eight small- and medium-sized enterprises (SMEs).Notably, SMEs now account for almost a quarter of all antimicrobial pipeline projects, although many face challenges such as limited funding and global market access.Among the notable developments highlighted in the report is gepotidacin, developed by GSK, which targets uncomplicated urinary tract infections (UTIs).

The drug represents the first new oral antibiotic class for UTIs in nearly 30 years.Another promising drug, zoliflodacin, developed by Innoviva, offers a new oral treatment for gonorrhoea, a disease that infects around 82 million people annually and has become resistant to most existing antibiotics.While new medicines are crucial, the report stresses that improving access to existing antibiotics — particularly child-friendly formulations—is equally urgent.Children under five, especially those living in low- and middle-income countries, remain among the most vulnerable to drug-resistant infections.Five companies — Aurobindo, GSK, Hikma, Sandoz and Teva — were recognised for registering child-friendly antibiotic formulations more widely than their peers.

However, access gaps remain severe in 17 countries in sub-Saharan Africa, where no paediatric versions of many essential antibiotics have been registered.The benchmark also evaluates how pharmaceutical companies address antimicrobial resistance across their value chains, including research, manufacturing, and responsible antibiotic use.Some progress has been observed in monitoring patient access and managing antibiotic production to reduce environmental risks.

However, overall performance among both large pharmaceutical firms and generic medicine manufacturers has declined since the 2021 AMR Benchmark.Experts say addressing the crisis will require coordinated action from governments, industry, researchers and international organisations.“Chronic underinvestment, weak development pipelines and declining interest from the private sector mean communities affected by drug-resistant infections suffer,” said John-Arne Røttingen, CEO of Wellcome. “The solution lies in diverse partnerships that bring together pharmaceutical companies, researchers, public funders and new payment models to drive urgently needed innovation.

”The report concludes that antimicrobial resistance demands urgent, coordinated global action, with pharmaceutical companies playing a central role in research, responsible manufacturing, improved access and monitoring patient reach.“From R&D through manufacturing to access and stewardship, the Benchmark illustrates the potential for companies to develop more comprehensive approaches,” said Claudia Martínez, Director of Research at the Access to Medicine Foundation. “But intensified, industry-wide action is needed.

”By identifying areas where companies perform well and where improvements are required, the benchmark aims to guide global efforts to ensure the sustainable development, supply and responsible use of antibiotics in the years ahead.