MANILA, PHILIPPINES [TAC] – The World Health Organization (WHO) warned that efforts to address antimicrobial resistance (AMR) are falling behind schedule as evidence by the dearth in the development of new drugs and diagnostics for bacterial infections.
According to the WHO’s 2025 report, there are only 90 antibacterial agents in development, which is less than the number of agents in development in 2023.
The WHO also affirms that the majority of the agents in development are not very innovative or effective against prioritized drug-resistant bacteria. Small biotech firms drive most research, making the ecosystem fragile.
There are also significant gaps in access to quick, inexpensive diagnostics, particularly in low- and middle-income countries. Simple point-of-care diagnostics, biomarker testing to differentiate between bacterial and viral illnesses, and bloodstream infection detection devices are among the main shortages.
WHO urges immediate international investment to advance diagnostics innovation, antibiotic research and development, and fair access to life-saving therapies.
Critical gaps at care frontlines
According to the new WHO report, the number of antibacterials in the clinical pipeline decreased from 97 in 2023 to 90 in 2025. Of these, 50 are traditional antibacterial agents and 40 are non-traditional approaches such as bacteriophages, antibodies, and microbiome-modulating agents.
Among the 90 antibacterials in development, only 15 qualify as innovative. For 10 of these, available data are insufficient to confirm the absence of cross-resistance, meaning that resistance to one antibacterial could also reduce effectiveness against another treatment.
Furthermore, only 5 of the antibacterials are effective against at least one of the WHO “critical” bacteria – critical being the BPPL’s top risk category, over ‘high’ and ‘medium’ priority. Of the 50 traditional antibiotics, 45 (90%) target priority pathogens, including 18 (40%) focused on drug-resistant Mycobacterium tuberculosis.
Gaps persist in specific areas, including pediatric formulations, oral treatments for outpatient use, and solutions to address escalating resistance such as combination strategies with non-traditional agents.
Since July 2017, 17 new antibacterial agents against priority bacterial pathogens have obtained marketing authorization, but only two represent a new chemical class.
The preclinical pipeline remains active, with 232 programs across 148 groups worldwide, though 90% of companies involved are small firms with fewer than 50 employees which highlights the fragility of the R&D ecosystem. The focus remains heavily on Gram-negative bacteria, where innovation is most urgently needed.
WHO urges developers to publish data on antibacterial activity to foster collaboration, attract investment, and accelerate innovation.“Antimicrobial resistance is escalating, but the pipeline of new treatments and diagnostics is insufficient to tackle the spread of drug-resistant bacterial infections,” said Dr Yukiko Nakatani, WHO assistant director-general for health systems. “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.”
