“A European antimicrobial development institute would foster collaboration and accelerate discovery”

Antibiotic resistance is a silent and growing threat. It is responsible for more than 1.27 million deaths per year worldwide (in 2019), surpassing the number of victims of HIV or malaria. By 2050, an additional 39 million deaths are expected and healthcare costs are expected to reach $1 trillion annually [approximately €866 billion] . This crisis is jeopardizing the entire spectrum of modern medicine, from surgery to chemotherapy.

Yet, despite this urgency, no new class of antibiotics has reached the market in fifty years. This paradox stems not from a lack of promising scientific discoveries, but from an inherently unfavorable economic model.

Since the withdrawal of major pharmaceutical groups from this field, university researchers have identified innovative avenues, and startups are being created to transform them into drugs. However, these small organizations face colossal obstacles. First, the cost of multidisciplinary expertise. Developing a drug requires a variety of skills (chemistry, pharmacology, toxicology, etc.) that a startup cannot internalize. Second, the difficulty of obtaining financing. The millions needed for trials are difficult to raise. Investors are wary of antibiotics. They are prescribed for short periods of time and aim for a permanent cure, limiting sales potential. Moreover, authorities could restrict their use to preserve them for a pandemic, further hampering commercialization.

This "volume-sales" model is not suitable for antibiotics. Downstream solutions, known as "pull," exist—such as market entry rewards or subscription models. The Antimicrobial Products Subscription Model, implemented by the British public healthcare system to remunerate laboratories not based on the volume of antibiotics sold but with a fixed amount, is one example. But the global deployment of these mechanisms is slow and does not attract sufficient investors.

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