A landmark global analysis estimates that antimicrobial resistance directly caused 1.27 million deaths in 2023 and contributed to 4.95 million deaths, surpassing HIV and malaria as a cause of global mortality. The pathogens of greatest concern include carbapenem-resistant Enterobacteriaceae, multidrug-resistant tuberculosis, and methicillin-resistant Staphylococcus aureus, all of which have developed resistance to most or all available antibiotics.
The response to the crisis is hampered by economic disincentives that have caused major pharmaceutical companies to exit antibiotic development. New antibiotics are not profitable under current market models because they are used sparingly to preserve effectiveness, generating insufficient revenue to justify the two billion dollar average development cost. Governments are exploring push and pull incentives including market entry rewards to restart the antibiotic development pipeline.
