Global health experts are increasingly concerned that too few new antibiotics are being developed for children, at a moment when antimicrobial resistance (AMR) already causes large numbers of deaths. The 2026 Antimicrobial Resistance Benchmark, released on 10 March by the Access to Medicine Foundation, shows that the number of candidate antimicrobial drugs in the pipelines of large companies has fallen by 35% since 2021. The report stresses a particular shortfall of child-friendly formulations: only 14% of medicines under development are for children under five, and in Sub-Saharan Africa seventeen countries have no children's antibiotics available from the companies assessed.
The Benchmark examined 25 companies and found seven drugs in late-stage development aimed at infections that show resistance to current antibiotics, such as gonorrhea, urinary tract infections and drug-resistant tuberculosis. UK-based GSK is involved in three of those late-stage drugs, including the already approved UTI antibiotic gepotidacin; other developers named are Venatorx and Innoviva. Although all companies say they have plans for registration, early-access programmes and post-trial access, the Foundation calculates that only two of the seven upcoming antimicrobials—from Innoviva and Otsuka—are likely to be affordable in low- and middle-income countries.
John-Arne Røttingen of Wellcome warned that chronic underinvestment, weak development pipelines and declining private-sector interest mean communities affected by drug-resistant infections suffer. The report cautions that gaps in access planning could leave millions in LMICs with delayed treatment or no access at all. Experts recommend stronger incentives and clearer access plans: Martijn Van Gerven suggests revenue guarantee schemes to make antibiotic development viable, while Røttingen says the subscription model must work globally. Observers also point to local manufacturing, partnerships and volume guarantees as ways to lower prices and improve sustained access; the Benchmark additionally assessed ten generics manufacturers, including Abbott, Hikma and Sandoz, and found varied tracking of patient reach, with Sandoz and Viatris tracking all their medicines.
Difficult words
- antimicrobial resistance — when germs no longer respond to medicines
- formulation — a medicine's physical form for giving doseformulations
- pipeline — the development stages for new drugspipelines
- late-stage development — final trial phase before a drug is approved
- affordable — not too expensive for many countries
- subscription model — a payment system that guarantees access over time
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How could revenue guarantee schemes or the subscription model help increase access to antibiotics in low- and middle-income countries? Give reasons from the article.
- What problems might result when only 14% of new medicines in development are for children under five?
- How could local manufacturing, partnerships and volume guarantees lower prices and improve sustained access to medicines in the countries mentioned?
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