AMR Benchmark Finds Progress Against Superbugs but Urges Faster Action to Strengthen Access and Health Systems

Five years after the release of its previous Antimicrobial Resistance (AMR) Benchmark, the Access to Medicine Foundation has in its 2026 report identified pockets of progress in pharmaceutical companies’ efforts to tackle deadly superbugs. However, the report warns that drug resistance is still advancing faster than the global response, underscoring the urgent need to expand innovation, improve access to antibiotics and apply effective strategies across more medicines and more countries. For Africa, where infectious diseases remain widespread and access to treatment is uneven, the findings highlight the growing urgency for stronger health systems, better access to medicines and accelerated implementation of national AMR action plans to prevent the continent from bearing a disproportionate share of the crisis. Chiemelie Ezeobi reports 

The global fight against drug resistant infections has recorded pockets of progress from some pharmaceutical companies, but experts warn that time is running out as antimicrobial resistance (AMR) continues to outpace global efforts to contain it.

Five years after the release of its previous report, the 2026 Antimicrobial Resistance Benchmark by the Access to Medicine Foundation highlights promising initiatives by several pharmaceutical companies to develop new treatments and improve access to existing antibiotics. However, the report also underscores a worrying decline in overall industry performance since the 2021 Benchmark.

The stakes are high. More than one million people die each year as a direct result of drug resistant infections, while antimicrobial resistance contributes to more than four million deaths globally. By 2050, projections show that direct deaths from AMR could rise to nearly two million annually, while total deaths linked to the crisis could exceed eight million.

For Africa, where infectious diseases remain prevalent and health systems often face funding and infrastructure challenges, the consequences could be particularly severe if urgent action is not taken. 

Despite the alarming outlook, the report emphasises that AMR is not an insurmountable challenge. “We can tilt the battle against superbugs in humanity’s favour. Our findings show practical approaches that can ramp up progress on all fronts,” said Jayasree K. Iyer, CEO of the Access to Medicine Foundation.

Thin Pipeline of New Antibiotics Raises Alarm

One of the biggest challenges in the fight against AMR remains the lack of new antimicrobial medicines being developed.

The 2026 Benchmark assessed the efforts of 25 pharmaceutical companies, comprising seven large research based companies, ten generic medicine manufacturers and eight small and medium sized enterprises (SMEs).

Although the pharmaceutical industry plays a central role in addressing antimicrobial resistance, the report reveals that the antimicrobial pipelines of large research based companies have declined by 35 per cent since the previous Benchmark.

This decline has left smaller biotechnology companies increasingly responsible for innovation in the field. The eight SMEs included in the Benchmark now account for almost a quarter of all antimicrobial pipeline projects currently under development.

Despite limited resources and global reach, these companies are helping to sustain research into new antibiotics while several large pharmaceutical companies scale back investments in infectious disease research.

Still, the report identifies seven late stage antimicrobial projects with genuine innovation and the potential to overcome resistance. These projects come from large research based companies GSK, Otsuka and Shionogi, as well as SMEs BioVersys, F2G, Innoviva and Venatorx.

Some of these medicines have recently secured regulatory approval, offering a measure of hope in the global fight against superbugs.

Breakthrough Treatments Offer Glimmers of Hope

One of the most notable innovations highlighted in the Benchmark is GSK’s gepotidacin, a new antibiotic targeting uncomplicated urinary tract infections (UTIs).

UTIs are among the most common bacterial infections globally, with approximately 150 million people developing a UTI every year. Studies also show that between 50 and 60 per cent of women worldwide will experience a UTI during their lifetime.

Gepotidacin represents the first new oral antibiotic class for uncomplicated UTIs in nearly 30 years. During the Benchmark’s analysis period, the drug was approved for treating uncomplicated UTIs and uncomplicated gonorrhoea. Its approval coincided with Innoviva’s zoliflodacin, marking the first introduction of new oral treatment options for gonorrhoea in decades.

The breakthrough is particularly significant because gonorrhoea affects around 82 million people annually and has developed resistance to nearly every antibiotic class used to treat it.

These advances demonstrate that it is possible to turn the tide against drug resistant infections. However, experts warn that the pace of innovation must accelerate to keep up with growing resistance.

Access Gaps Leave African Children Vulnerable

Beyond the challenge of developing new antibiotics lies another urgent problem: access to existing treatments. The Benchmark finds that the availability of antibiotics in low and middle income countries (LMICs) is often inadequate, especially when it comes to medicines suitable for children.

Children are more vulnerable to infections, yet child friendly formulations of antibiotics can take years to be approved after new medicines are introduced.

As a result, many children receive suboptimal treatment, increasing the likelihood that infections persist and resistant bacteria emerge.

Among companies with paediatric formulations on the market, five stand out for registering these medicines more widely than their peers. These companies are Aurobindo, GSK, Hikma, Sandoz and Teva.

On average, they register their child friendly formulations in about 50 to 70 per cent of the LMICs where they register their other off patent antimicrobial medicines.

However, major gaps remain across Africa given that In 17 countries in sub Saharan Africa, the Benchmark found that no child friendly versions of the analysed antibiotic products had been registered by any of the companies assessed.

African Governments Must Strengthen National AMR Plans

Experts say Africa must urgently strengthen policies and health system responses to avoid falling further behind in the fight against antimicrobial resistance.

“African governments and health systems should prioritise the implementation of national AMR action plans. That includes identifying sustainable financing mechanisms to fund these plans and ensuring strong collaboration across sectors, following the One Health approach, particularly with the animal health and environmental sectors.”

The One Health approach recognises the close links between human health, animal health and environmental factors in the emergence and spread of antimicrobial resistance.

In many African countries, antibiotics are widely used in agriculture and livestock production, increasing the risk that resistant bacteria develop and spread between animals, humans and the environment.

Early Collaboration Needed to Bring New Medicines to Africa

As promising antimicrobial products begin to emerge from research pipelines, experts say early collaboration between pharmaceutical companies, governments and health systems will be essential.

“As many projects are now coming out of the pipeline, especially the innovative and promising ones we have highlighted in the report, it will be important to start collaborations earlier. Early engagement can help ensure that new products are successfully integrated into markets.

“This means companies must think ahead about procurement pathways, reimbursement mechanisms, and market shaping strategies that will allow these products to be sustainably adopted into health systems.”

Without such planning, there is a risk that new antibiotics will reach wealthier markets first, leaving many low income regions, including parts of Africa, without access to life saving treatments.

Coordinated Action Needed Across the Pharmaceutical Value Chain

The Benchmark also highlights some progress in areas such as responsible antibiotic manufacturing and improved monitoring of how medicines reach patients.

For the first time, the report assessed how generic medicine manufacturers track patient reach. Six of the ten generic companies evaluated were found to monitor patient reach across almost all the antibiotic and antifungal products analysed.

Nevertheless, overall industry performance across both large research based companies and generic manufacturers has declined since the 2021 Benchmark.

Although companies such as GSK and Aurobindo remain leading performers compared with their peers, and Japan’s Shionogi shows the strongest progress across several areas, experts say far more action is needed.

“From R&D through manufacturing, to access and stewardship and measuring real world patient reach, the Benchmark illustrates the potential for companies to develop more comprehensive approaches. But we need intensified, industry wide action,” said Claudia Martínez, Director of Research at the Access to Medicine Foundation.

By highlighting where companies are performing strongly and where progress must accelerate, the AMR Benchmark seeks to guide the pharmaceutical industry, governments and global health partners in ensuring the sustainable development, supply and responsible use of antibiotics.

For Africa, the message is clear: without stronger policies, better access to medicines and improved health systems, the continent risks facing the worst consequences of the growing global superbug crisis.