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The AMR
Innovation
Challenge

01 THE THREAT OF AMR

Our world faces a silent,

slow-moving global
threat that kills
around 700,000
people each year due to
the uncontrolled rise of
superbugs resistant to
antibiotics. These
superbugs can affect
anyone, of any age, in
any country. AMR is a
universal issue that
impacts us all – we are all
at risk.
This looming global crisis has the potential
to be as large or even larger than COVID-19
in terms of deaths and economic costs.

AMR
undermines
every aspect
of modern
medicine

We rely on the availability of effective

antibiotics to be able to do everything from
wisdom tooth extractions to organ
transplantation to cancer chemotherapy.

Superbugs could set medicine back to the

19th century, before the discovery of
penicillin, when simple infections could kill.

Now is the
time for
action

Though AMR is a long-established and slow-

moving threat, it is no less dangerous than
the COVID-19 pandemic impacting the
world today.

As we’ve seen with COVID-19, we are all still

vulnerable to infectious diseases – and we've
seen the huge economic and public health
costs from a lack of preparedness.
Ultimately, being prepared is more cost-
effective in the long run.

Whereas COVID-19 was not known until

early January 2020, AMR is a threat we know.
It is here now and only increasing. We know
the priority pathogens for which there is an
urgent need for new treatments, and AMR
has been on the political agenda for years.

AMR is a predictable
and preventable crisis.
We have a critical
opportunity to get
ahead of it. We must
not waste it.

Next-generation
antibiotics are vital for
humanity, but – right
now – there are not
enough of these
valuable tools in
development
Given the nature of resistance, we will always
need new antibiotics. However, drug
resistant bacteria are developing faster than
new antibiotics can reach the market.

And today, there are too few antibiotics in

clinical development to meet current and
anticipated needs, according to an
assessment by the Pew Charitable Trusts.
Most of these compounds are being
developed by small biotechnology
companies.

A Breakdown of the Issue:

1
There is no viable antibiotic market
Developing antibiotics is a long, complex
and risky process, and many in
development fail along the way. Once new
antibiotics are approved, they are used
sparingly to preserve effectiveness and
slow the development of further resistance.
While this makes sense for public health, it
doesn’t support the level of investment
needed to maintain a robust antibiotic
pipeline. What’s more, despite the huge
societal costs of AMR, our health care
systems do not recognize the value of new
antibiotics.

2
Late-stage investment is limited
Without a viable antibiotic market, biotech
companies developing new antibiotics are
unable to find financing for clinical
development, meaning important
antibiotics may never overcome the “valley
of death” to reach the patients who need
them. Recent initiatives that provide
funding for early-stage research have
contributed to improving the pre-clinical
antibacterial treatment pipeline. However,
without support and investment in the
more complex, expensive later stages of
development, these compounds will wither
on the vine.

3
The fragile antibiotic pipeline is close to
collapse
There are few new antibiotics in clinical
development. In recent years, a number of
antibiotic-focused biotechs have declared
bankruptcy or exited this space, despite
having successfully developed new
antibiotics, due to the lack of commercial
sustainability, resulting in the loss of
valuable expertise and resources.

We must take action

now to respond to a
pressing global public
health crisis and
create a sustainable
antibiotic market.

Market-based policy
reforms are urgently
needed to drive
sustainable investments
in antibiotic R&D
There is broad agreement that market-
based policy reforms, including
reimbursement reform and new pull
incentives, are needed to create market
conditions that enable sustainable
investment in antibiotic R&D.

Decisive government action is needed to

revitalize the antibiotics market to ensure the
antibiotic pipeline meets the needs of
patients.

No single action is
going to solve this
problem

Policymakers across the globe must enact

market-based reforms to create an
environment where antibiotic R&D can
flourish for decades to come.

A number of different solutions have been

discussed that have the potential to drive
additional R&D investment. These should be
worked up further and implemented or tried
out by governments in different countries.
There isn’t a single solution that will work
everywhere around the world.

Market entry rewards, subscription models,

and other novel incentives, which provide a
certain level of economic return based on
the value a new antibiotic brings not the
volume used, could help drive innovation.

Reforms to the way antibiotics are

reimbursed and valued, reflecting the
unique characteristics of antibiotics, are
needed to enable appropriate access and
stabilize the economics of antibiotic R&D.

Putting the necessary

policy reforms in place
will take time
Until then, it is up to all of us – public and
private sector combined – to take action
now to sustain the current pipeline of
effective new antibiotics to safeguard our
future.

The pharmaceutical industry and leading

global philanthropies and development
banks are stepping up with nearly US$1
billion to bridge the gap and respond to the
AMR threat. The Fund aims to bring 2-4
new antibiotics to market this decade that
will save patient lives. The AMR Action
Fund will bridge innovative candidates in
the pipeline through the most challenging
later stages of drug development, ultimately
providing governments time to make the
necessary policy reforms to enable a
sustainable antibiotic pipeline.

To make this work, all

stakeholders must
come together to
unleash innovation

The AMR Action Fund expects to invest

more than US$1 billion with the support of
future partners, such as:

1
Development banks

2
Philanthropic organizations

3
Multilaterals and strategic partners

4
Other impact funds

Forming this broad alliance of industry and

non-industry stakeholders will allow us to
work together to respond to a pressing
global public health crisis and encourage
governments to create market conditions
that enable sustainable investment in the
pipeline.

Stay connected
Stay up-to-date on our work to bring 2 to 4 new
antibiotics to patients by the end of the decade.
When we have news, we will let you know.

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