The increasing number of bacterial infections globally that do not respond to any available antibiotics indicates a need to invest in—and ensure access to—new antibiotics, vaccines, and diagnostics. The traditional model of drug development, which depends on substantial revenues to motivate investment, is no longer economically viable without push and pull incentives. Moreover, drugs developed through these mechanisms are unlikely to be affordable for all patients in need, particularly in low-income and middle-income countries. New, publicly funded models based on public–private partnerships could support investment in antibiotics and novel alternatives, and lower patients’ out-of-pocket costs, making drugs more accessible. Cost reductions can be achieved with public goods, such as clinical trial networks and platform-based quality assurance, manufacturing, and product development support. Preserving antibiotic effectiveness relies on accurate and timely diagnosis; however scaling up diagnostics faces technological, economic, and behavioural challenges.

 

Authors

Prof Ramanan Laxminarayan, PhD, Isabella Impalli, BSE, Radha Rangarajan, PhD, Jennifer Cohn, MD, Kavi Ramjeet, PhD, Betsy Wonderly Trainor, BSc, Prof Steffanie Strathdee, PhD, Nithima Sumpradit, PhD, Daniel Berman, MIA, Prof Heiman Wertheim, PhD, Prof Kevin Outterson, JD, Padmini Srikantiah, MD, Ursula Theuretzbacher, PhD

 

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