IPM Take
The sharp message is that AMR cannot be solved by asking for new antibiotics alone. The Benchmark shows a whole-chain failure risk: thin R&D, fragile access planning, stewardship gaps and manufacturing responsibilities that still vary across companies. Precision infectious disease policy needs both innovation and governance. A new antimicrobial has limited public-health value if it is unavailable in low and middle income countries, used without stewardship, or produced through supply chains that worsen resistance risk.
Executive Summary
The Access to Medicine Foundation’s 2026 AMR Benchmark evaluates 25 pharmaceutical companies active in anti-infectives, including seven large research-based companies, ten generic medicine manufacturers and eight small and medium-sized enterprises. The Benchmark assesses companies across R&D, responsible manufacturing, and appropriate access and stewardship, with different assessment scopes depending on company type. It identifies hopeful examples of progress, but warns that industry-wide efforts are being outpaced by drug resistance, with antimicrobial R&D decline especially concerning and existing antimicrobial access still lacking across low and middle income countries.
Why it matters
- Policymakers: Need to connect AMR incentives with access, stewardship and manufacturing standards, not only pipeline expansion.
- Industry / innovation partners: Must show stronger responsibility across the antimicrobial lifecycle, from development to access planning, responsible promotion and supply-chain controls.
- Payers / public authorities: Should prepare models that reward innovation while protecting stewardship and ensuring access where resistant infections carry the greatest burden.
Previously, the AMR debate often focused on the need for new antibiotics. That remains essential, but the 2026 Benchmark shows that the problem is wider.
What has changed is the clearer view of company performance across the full antimicrobial lifecycle. The Benchmark assesses where companies are acting on R&D, responsible manufacturing, access and stewardship. Large research-based companies are assessed across all three areas, generic manufacturers across responsible manufacturing and appropriate access and stewardship, while SMEs are assessed only on R&D.
The affected population is global, but the access burden is especially sharp in low and middle income countries, where both drug-resistant infections and treatment gaps are severe. The Benchmark highlights that even existing antimicrobials are not consistently available across these settings, while the decrease in antimicrobial R&D remains particularly concerning for future preparedness.
For IPM, the implication is direct: AMR preparedness must link R&D incentives with access plans, stewardship, supply reliability and responsible manufacturing. Otherwise, new antimicrobials may arrive too slowly, reach too few patients, or be used in ways that weaken their future effectiveness.
