WHO flags surge in drug-resistant bacteria, warns of innovation crisis

Across the world, doctors are sounding the alarm: drug-resistant bacteria are spreading faster than new treatments and diagnostic tools can keep up. The World Health Organisation (WHO) says the rise of antimicrobial resistance (AMR), when bacteria, viruses, and other microbes no longer respond to medicines is among the top threats to public health, claiming over a million lives annually.

 

Yet despite the growing threat, the pipeline of new antibacterial treatments is shrinking and struggling to innovate.

 

Antibacterial pipeline faces dual crisis

 

WHO’s newly released report, Analysis of Antibacterial Agents in Clinical and Preclinical Development 2025, reveals worrying trends:

 

 

• Number of antibacterials in clinical development dropped from 97 in 2023 to 90 in 2025
• Among these 50 are traditional antibiotics; 40 are non-traditional (bacteriophages, antibodies, microbiome-modulating agents)

 

The pipeline also suffers from a dual crisis of 'scarcity and lack of innovation'. Only 15 of the 90 antibacterials are considered innovative, and for 10 of these, data are insufficient to confirm the absence of cross-resistance.

 

Of the 50 traditional antibiotics, 45 (90 per cent ) target priority pathogens, including 18 (40 per cent) focused on drug-resistant Mycobacterium tuberculosis. Since 2017, 17 new antibacterial agents have gained market authorisation, but only two represent entirely new chemical classes.

 

Beyond the lack of new and innovative drugs, significant gaps remain in the types of treatments available. 

Gaps in treatments

 

According to WHO, serious gaps remain in paediatric formulations, oral treatments for outpatients, and combination strategies with non-traditional agents.

 

The preclinical pipeline includes 232 programmes across 148 organisations, but 90 per cent are small firms with fewer than 50 employees, highlighting the fragility of the global R&D ecosystem. The focus remains heavily on Gram-negative bacteria, where innovation is most needed.

 

Diagnostics at the frontline lag behind

 

WHO’s other report, Landscape Analysis of Diagnostics for Bacterial Priority Pathogens, highlights critical gaps in diagnostic tools, particularly in low-resource settings. Key shortcomings include:

 

• No multiplex platforms in intermediate referral labs to detect bloodstream infections directly from whole blood
• Limited access to biomarker tests like C-reactive protein and procalcitonin to distinguish bacterial from viral infections
• Scarcity of simple, point-of-care diagnostic tools for primary and secondary care facilities

 

WHO stresses the urgent need for affordable, robust, and easy-to-use diagnostic platforms, including sample-in/result-out systems compatible with multiple specimen types such as blood, urine, stool, and respiratory samples. 

 

WHO calls for greater investment and collaboration

 

“Antimicrobial resistance is escalating, but the pipeline of new treatments and diagnostics is insufficient to tackle the spread of drug-resistant bacterial infections. Without more investment in R&D, together with dedicated efforts to ensure that new and existing products reach the people who most need them, drug-resistant infections will continue to spread," said Dr Yukiko Nakatani, WHO Assistant Director-General for Health Systems.

 

WHO urges developers to publish antibacterial data to foster collaboration, attract investment, and accelerate innovation. The organisation also calls for new funding models to support the small and medium-sized enterprises driving antibacterial and diagnostic research.