Antimicrobial resistance is one of the most serious threats to global health. An antimicrobial resistance experiment underway.
Source: DFID – UK Department for International Development
The discovery of penicillin in 1928 marked the beginning of a new era in humanity’s fight against bacterial disease. During the golden age of antibiotics, successive new drugs made once-fatal infections treatable, strengthening the belief that humans had gained the upper hand over bacteria.
However, that confidence is now being quietly eroded. As resistant bacteria emerge and spread, antimicrobial resistance (AMR) is making existing treatments less effective and posing a growing threat to global health.
A recent analysis published in The Lancet in 2024 estimated that, as of 2021, deaths directly caused by bacterial AMR numbered about 1.14 million and associated deaths about 4.71 million, and projected that, if current trends continue, by 2050 direct deaths could rise to about 1.91 million and associated deaths to about 8.22 million.
The 79th World Health Assembly (WHA79), held in Geneva, Switzerland
Source: WHO X (formerly Twitter)
The need for urgent global action on AMR was also evident at WHA79, held this May in Geneva, Switzerland. Member States adopted the updated Global Action Plan on Antimicrobial Resistance 2026–2036, which sets the direction for the global response over the next decade, and reaffirmed the goal of reducing AMR-related human deaths by 10% by 2030. The comprehensive revision reflected growing recognition that AMR has continued to worsen rapidly despite the adoption of the first Global Action Plan on AMR in 2015.
Antimicrobial Resistance: Crossing Species and Borders to Threaten Humanity’s Future
There are several reasons why AMR has quietly but rapidly become a serious threat to global health.
One of the most important is that the development of new antibiotics has stalled. Since the late 1980s, few clinically meaningful new classes of antibiotics have emerged. Antibiotics are generally used for short periods, and because their use must be restricted to slow the development of resistance, they offer limited commercial appeal for pharmaceutical companies. While commercial interest has declined, resistant bacteria have continued to evolve.
Timeline of the discovery of different antibiotic classes in clinical use
Source: ReAct Group. Timeline of the discovery of different antibiotic classes in clinical use (© ReAct Group, 2015), adapted from Silver LL. Challenges of Antibacterial Discovery. Clinical Microbiology Reviews. 2011;24(1):71–109.
Antimicrobial resistance also crosses species and borders. Antibiotics used in livestock, fungicides used on crops, and pharmaceutical residues in wastewater and rivers can create environments where resistance genes emerge, persist, or spread. Resistant bacteria that arise from the misuse and overuse of antibiotics in one country can spread to other regions through travel, trade, food distribution, and environmental pathways.
Newborns are among the populations most vulnerable to AMR. According to the Global Antibiotic Research and Development Partnership (GARDP), about 214,000 newborns worldwide die each year from antibiotic-resistant infections. This is because sepsis can be fatal in newborns, whose immune systems are not yet fully developed, and once first-line antibiotics fail, alternative treatment options are very limited.
The RIGHT Foundation: Supporting R&D That Responds to Priorities
To respond to these threats, the World Health Organization (WHO) updated its Bacterial Priority Pathogens List (BPPL) in 2024 for the first time in seven years. The updated list classifies bacterial pathogens posing major public-health threats due to AMR into three priority tiers: Critical, High, and Medium. It also highlights areas where action is most urgently needed, including new drug development, diagnostics, infection prevention, and stronger surveillance systems.
List of WHO BPPs of public health importance, 2024 update
Source: WHO Bacterial Priority Pathogens List, 2024
The most urgent Critical priority group includes carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Enterobacterales, and third-generation cephalosporin-resistant Enterobacterales. Enterobacterales include major neonatal sepsis-causing bacteria such as Klebsiella pneumoniae and E. coli. In low- and middle-income countries, these Gram-negative bacteria account for a substantial share of neonatal sepsis cases, and the spread of antimicrobial resistance is closely linked to preventable newborn deaths each year.
The High priority group includes pathogens such as antibiotic-resistant Neisseria gonorrhoeae and fluoroquinolone-resistant Salmonella Typhi. Resistance to existing first-line or core treatments for these pathogens is spreading, steadily narrowing available treatment options.
The Foundation supports two project that aligned with the priorities set out in the WHO BPPL.
The first project is the “Novel Antibiotic Combinations to Address AMR Burden in Neonatal Sepsis.” The Foundation is providing KRW 4 billion in funding for this project, which is being carried out jointly by the nonprofit GARDP and Jeil Pharmaceutical.
The project uses an innovative approach to identify new combinations of three previously approved antibiotics (flomoxef, fosfomycin, and amikacin) and to evaluate their safety and efficacy. The combination therapy targets resistant Enterobacterales categorized in the BPPL’s Critical priority group. Building on Jeil Pharmaceutical’s proprietary flomoxef active pharmaceutical ingredient technology, the project aims to develop the manufacturing process and strengthen manufacturing capacity. Ultimately, the goal is to make the treatment available to newborns worldwide following WHO prequalification (PQ) and national registration in individual countries.
The second project focuses on the development of a point-of-care molecular diagnostic technology that can detect chlamydia, gonococcus, and antibiotic-resistant gonococcus in a single test. In collaboration with SD Biosensor, the Foundation is developing a technology that uses the STANDARD™ M10 molecular diagnostic platform to simultaneously identify all three targets.
SD Biosensor’s molecular diagnostic platform STANDARD™ M10
Gonococcus is a representative resistant pathogen included in the High group of the WHO BPPL High priority group. As resistance to the main antibiotics used to treat gonorrhea spreads, quickly determining which antibiotic will be effective for a patient is becoming increasingly important.
The core of this project lies in bringing diagnostic testing closer to the point of care. If chlamydia infection, gonococcal infection, and the presence of antibiotic resistance can all be checked at once, patients can receive appropriate treatment more quickly, and clinicians can choose antibiotics more carefully.
[AMR Projects Supported by the RIGHT Foundation]