Efforts to combat antimicrobial resistance (AMR) are falling behind, with the global antibiotic pipeline shrinking by 35 percent over the past five years, according to a new industry report. The decline comes as drug-resistant infections continue to rise worldwide, threatening millions of lives.
“Without significant change, AMR will cause a devastating rise in deaths from preventable infections over the next two decades, with vulnerable populations living in poorer countries hit the hardest,” the report warned.
The analysis reviewed research and development (R&D) efforts from 15 companies, including seven large multinational firms such as GSK, Pfizer, Shionogi, MSD, and Otsuka, as well as eight small and medium enterprises. Among the major players, GSK leads the pack with 30 drugs in development, covering preventive vaccines and antibacterial therapeutics, including three innovative medicines. Japan’s Shionogi has overtaken Pfizer, which held second place in 2021. The report noted that performance across companies remains uneven, with no firm fully meeting its potential in the fight against AMR.
AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines. While the process can happen naturally through genetic changes, human factors such as overuse and misuse of antibiotics have accelerated resistance. By late 2025, one in six lab-confirmed bacterial infections was resistant to standard treatments, according to the World Health Organization. In the European Union alone, AMR causes more than 35,000 deaths each year, and global projections estimate 39 million deaths from bacterial resistance between 2025 and 2050.
Children, particularly those in low- and middle-income countries, are among the most vulnerable. Yet, the report found only five pediatric drugs in development, with just 13 percent of pipeline projects targeting children under five. Of all new antibiotics introduced since 2000, only 10 percent carry a pediatric label, leaving gaps in child-friendly formulations that can take years to gain approval.
On a hopeful note, seven innovative late-stage projects show significant potential against drug-resistant infections. Three are being developed by large companies – GSK, Otsuka, and Shionogi – while four involve smaller firms including BioVersys, F2G, Innoviva, and Venatorx.
Despite these developments, the report cautioned that the pace and scale of antibiotic innovation remain insufficient. “Industry efforts cannot advance at the pace and scale required without global and country-level reform – especially in procurement, financing, and regulation,” it said. Until funding and policies match the scale of the AMR threat, responses will remain reactive, leaving millions at risk.
