Senior Consulting Fellow, Centre on Global Health Security
Associate Fellow, Centre on Global Health Security
Associate Fellow, Centre on Global Health Security

Unni Gopinathan, Medical Intern, Akershus University Hospital; PhD Candidate, Oslo University Hospital/University of Oslo
Chantal Morel, Research Officer, London School of Economics; Scientific Adjunct, University of Geneva Medical School
Anthony So, Professor of the Practice of Public Policy and Global Health; Director of the Program on Global Health and Technology Access, Duke University’s Sanford School of Public Policy and the Duke Global Health Institute

Revenues for pharmaceutical companies need to be delinked from sales of antibiotics to avoid their over-use and avert a public health crisis, according to a new report.

High-level complex of physiologically active antibiotic substance extracted from blastema at the Arctic Innovation Center (AIC) of Ammosov, North-Eastern Federal University (NEFU) in Yakutsk.Photo: Yuri Smityuk/ITAR-TASS Photo/Corbis.High-level complex of physiologically active antibiotic substance extracted from blastema at the Arctic Innovation Center (AIC) of Ammosov, North-Eastern Federal University (NEFU) in Yakutsk. Photo: Yuri Smityuk/ITAR-TASS Photo/Corbis.

This report aims to inform the ongoing discussions and processes on developing a new business model for antibiotics. It is based on the premise that delinkage, seeking to separate the return on investment from antibiotic sales volume, should be the principle underpinning any new business model. It calls on governments to invest significantly in antibiotic R&D by financing a broad menu of incentives across the antibiotic life-cycle, with the highest incentives targeted at the development of antibiotics directed at the greatest health threats arising from antibiotic resistance. Contributions from countries should be coordinated within a globally agreed framework. Finally, global access should, together with conservation, be a priority for any new business model fostering innovation.

Main recommendations

  1. A new business model needs to be developed in which the return on investment in R&D on antibiotics is delinked from the volume of sales.
  2. Increased public financing of a broad menu of incentives across the antibiotic life-cycle is required, targeted at encouraging the development of antibiotics to counter the greatest microbial threats.
  3. The assessment of current and future global threats arising from resistance should be updated periodically in order to identify which classes of product are a priority for incentives.
  4. The delinkage model should prioritize both access and conservation.
  5. Domestic expenditures on the model need to be globally coordinated, including through the establishment of a secretariat, and global participation in the model is the ultimate goal.