A new report from the Access to Medicine Foundation calls for urgent changes in research and development (R&D) to ensure new antibiotics and antifungals reach patients facing drug-resistant infections. The report examines five late-stage antimicrobial projects targeting severe drug-resistant pathogens, revealing that structured advance planning for access and stewardship is not yet standard among companies.
Four out of five companies—GSK, Pfizer, Innoviva, and Venatorx—are conducting clinical trials involving children, aiming to improve access for paediatric patients. Despite these efforts, only five low- and middle-income countries (LMICs)—China, India, Mexico, South Africa, and Thailand—have concrete commitments for drug registration. Many of the remaining 108 LMICs with high burdens of targeted diseases lack such commitments.
The report underscores the need for partnerships and licensing agreements to enhance access in LMICs. SMEs have pursued wider access through collaborations, like those with the Global Antibiotic Research and Development Partnership (GARDP). However, the report finds that companies are underutilizing existing tools and strategies to advance their access and stewardship plans.
Jayasree K. Iyer, CEO of the Access to Medicine Foundation, emphasises the critical nature of enabling access to these new treatments, “The difference between us winning or losing this race depends on how companies enable access to people living on the frontlines of drug resistance.”
The report suggests pharma companies to prioritise affordability, responsible use, and accessibility to make progress in the fight against antimicrobial resistance.
Further the report suggests, that for sustainable solutions to take hold, it is vital that comprehensive and detailed access and stewardship plans are embedded in companies’ antimicrobial innovation, specifically strategies that target populations and countries that face the highest burden of drug resistance. To strengthen their efforts and increase their reach, companies can seek out partnerships for co-development, as well as licencing agreements to ensure newly developed drugs are made available to those who need them most. With the SAP Guide being fit for purpose and signed off by multiple key stakeholders in the AMR space, companies have an opportunity to utilise it to help plan effectively for access and stewardship –particularly by implementing its recommendations earlier in the development phase – without jeopardising the progress towards market approval.

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