Antimicrobial resistance (AMR) to drugs, a natural and unavoidable consequence of treating infectious diseases, is a growing global public health threat. The EU Commission is to develop comprehensive proposals by the end of 2012 for addressing the situation. This Paper is meant to provide input into those policy discussions.

The paper reviews AMR’s implications for the burden of disease, the causes of AMR, the current state of the antibiotic development pipeline and the reasons antibiotic R&D has been de-emphasised by biopharmaceutical companies.

Four key sets of factors are identified that provide serious disincentives for R&D.  The authors develop a model to assess the push, pull and hybrid approaches that may be applied to reinvigorate the development of new products.  Since AMR is global in scope and involves many stakeholders, the authors urge a comprehensive approach that reaches across countries and involves a broad range of interests.