The research and development pipeline for options to tackle antimicrobial resistance (AMR) remains "worryingly thin" and industry investment has lost momentum, warns a new report tracking developments in this area.
Despite this, the Antimicrobial Resistance Benchmark Report 2026, which is compiled by the Access to Medicine Foundation identifies “hopeful spots of progress from companies still engaged in the antimicrobial space, but notes that industry efforts "are being outpaced by drug resistance.”
Since 2018 the report has been tracking how pharmaceutical companies active in the antimicrobial sector are taking action to combat drug resistance and ensure appropriate access their products in low-and middle-income countries.
The 2026 report evaluates the efforts of 25 pharmaceutical companies, focusing on seven large research-based companies, ten generic medicine manufacturers and eight small and medium sized enterprises (SMEs). The report says that the inclusion of SMEs reflects the “immense importance” of these players in stepping up research and development in AMR, while the “exodus of large research-based companies in this space continues.” The report also looks at what companies are doing to address AMR across their marketed products, across responsible manufacturing, and appropriate access and stewardship.
The report highlights that among the seven large research-based companies, these being GSK, Johnson & Johnson, Merck & Co, Otsuka Pharmaceutical, Pfizer, Sanofi and Shionogi there is a continued contraction of pipelines, with a 35% decline in the number of projects in development in the past five years. "This makes the current efforts of companies still engaged in this space all the more vital," the report says.
Despite the decline, the report does note that there are “seven innovative projects in late-stage development that can already have significant impact against drug resistant infections.” These projects are being carried out by GSK, Otsuka and Shionogi, as well as four SMEs, these being BioVersys, F2G, Innoviva and Venatorx.
Of the large research-based companies the report says that “GSK has by far the largest antimicrobial pipeline, with 30 projects in development. These span both preventative vaccines and antibacterial therapeutics and include three innovative candidates. Shiongi and Pfizer follow, with eight projects each". The eight SMEs are driving innovation for critical- and high-priority pathogens, the report says.
With GSK recently securing approval of the first new oral antibiotic class for uncomplicated urinary tract infections in nearly 30 years, as well as establishing six new research programmes with the Fleming Initiative, the company welcomed the recognition for its ongoing work.
Tony Wood, chief scientific officer at GSK said: “GSK is using cutting edge technology to bring much needed innovation to patients, including a new first-in-class antibiotic last year, While this is welcome progress, it is not enough, and today’s report underlines the need for governments and industry to work together to improve economic incentivising of R&D and implement better access stewardship models.”
While these significant developments are welcomed, the benchmark report cautions that: “Despite these promising projects, development of antimicrobials with innovative characteristics that can overcome resistance where older drugs fail remains sparse.” It points to GSK, Otsuka and Shionogi as still actively pursuing this goal, while the pipelines of the other four large research-based companies - Johnson & Johnson, MSD, Pfizer and Sanofi - focus on either vaccines and/or adaptive R&D which offer primarily expanded indication or incremental improvements.
Jayasree Iyer, CEO of the Access to Medicine Foundation said: “The scarcity of projects in development makes it vital that medicines which do reach the market are accessible to the people who need them most – especially in low-and middle-income countries, where serious access gaps persist.”
Further reading:
- What is AMR? Here’s what you need to know about antimicrobial resistance
- Supercomputers vs superbugs: GSK and Fleming Initiative target AMR
- AMR: Researchers test bacteriophages to tackle antimicrobial resistance
- Antimicrobial resistance: How microplastics can increase the spread of AMR
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