Efforts by pharmaceutical companies to combat antimicrobial resistance (AMR) are showing some progress, but remain insufficient as drug-resistant infections continue to outpace innovation, a new report by the Access to Medicine Foundation has found.
The 2026 Antimicrobial Resistance Benchmark, released five years after its previous edition, highlights both encouraging developments and deepening challenges in the global fight against so-called “superbugs.”
According to the report, more than one million people die each year directly due to drug-resistant infections, while AMR contributes to over four million deaths annually. By 2050, these figures could rise to nearly two million direct deaths and more than eight million overall if current trends persist.
Despite the concerning outlook, the report identifies several promising advances. Seven innovative, late-stage drug candidates targeting some of the most dangerous resistant pathogens are currently under development by companies including GSK, Otsuka Pharmaceutical, Shionogi, BioVersys, F2G, Innoviva, and Venatorx Pharmaceuticals.
Some of these treatments have already secured regulatory approval, offering renewed hope in areas where few new antibiotics have emerged in recent decades.
One notable example is gepotidacin, developed by GSK, which represents the first new oral antibiotic class for uncomplicated urinary tract infections in nearly 30 years. Similarly, Innoviva’s zoliflodacin introduces a new oral treatment option for gonorrhoea, a disease that infects an estimated 82 million people annually and has developed resistance to most existing antibiotics.
However, the report warns that these breakthroughs are not enough to offset a broader decline in antimicrobial innovation. The pipeline of new antibiotics from large research-based pharmaceutical companies has shrunk by 35% since 2021, raising concerns about the long-term sustainability of global efforts to combat AMR.
The report also highlights widening gaps in access to existing treatments, particularly in low- and middle-income countries. Children under five are among the most vulnerable, often lacking access to appropriate, child-friendly antibiotic formulations.
While companies such as Aurobindo Pharma, GSK, Hikma Pharmaceuticals, Sandoz, and Teva Pharmaceutical Industries have made progress in expanding access to paediatric medicines, significant gaps remain—particularly across sub-Saharan Africa, where many essential child-friendly antibiotics are still not registered.
Performance across the pharmaceutical industry has also declined overall since the 2021 benchmark, although GSK and Aurobindo continue to lead among their peers. Shionogi was identified as showing the strongest overall progress, while smaller biotech firms were noted for outperforming expectations in research and development despite limited resources.
The report underscores the growing role of small and medium-sized enterprises in sustaining antibiotic innovation, even as larger companies scale back investment in infectious disease research due to high costs and limited financial returns.
Jayasree K Iyer, Chief Executive Officer of the Access to Medicine Foundation, said the findings demonstrate that progress is possible but requires urgent scaling.
“We can tilt the battle against superbugs in humanity’s favour. Our findings show practical approaches that can accelerate progress across the board,” she said.
Experts say tackling AMR will require coordinated action from governments, pharmaceutical companies, and global health institutions. While companies are making some progress in areas such as responsible manufacturing and tracking patient reach, more comprehensive and sustained efforts are needed across the entire value chain.
Claudia Martinez, Director of Research at the Foundation, said the industry must intensify its response.
“From research and development to access and stewardship, there is clear potential for more comprehensive approaches. But what is needed now is stronger, industry-wide action,” she said.
The report concludes that without urgent intervention to boost innovation, improve access, and strengthen global coordination, antimicrobial resistance will remain one of the most significant threats to global public health.