Drug-resistant infections: transforming the global response

Drug-resistant infections kill hundreds of thousands of people every year, in all parts of the world. This burden is disproportionately higher in low- and middle-income countries.

If we act now, we can turn the tide on antimicrobial resistance (AMR), save millions of lives and safeguard the medical progress of the past hundred years for future generations. If we don’t, then routine medical procedures and operations will become dangerous or stop being effective, common infections will become untreatable, and many lives will be lost.

Through our work, we want to:

• catalyse the development and uptake of key interventions like new antibiotics, improved diagnostic tools and better data to prevent, treat and control drug-resistant infections 
• work for the communities most affected by this threat. While global efforts to tackle drug resistance remain crucial, it’s more important than ever to make sure that countries, particularly low- and middle-income ones, are able to respond effectively at a national level.
• make sure new antibiotics and diagnostic tools are available in low-resource settings, and the countries that stand to benefit the most from tackling AMR have the necessary data to implement country-specific, country-led and country-owned interventions. 

We’re working to achieve three key objectives. Building a strengthened evidence base underpins each of these.

Objective 1: Advancing a sustainable pipeline of antibiotics, so that new antibiotics are available around the world

The problem 

The development of new therapeutics, particularly antibiotics, is crucial to mitigate the effects of antimicrobial resistance. But the environment for developing antibiotics is challenging, with market failures inhibiting private sector development of these essential drugs. 

What we have done so far 

To improve the pipeline of antibiotics, we have:

• funded CARB-X, a public-private partnership launched in 2016 to help accelerate antibacterial research and fill the current shortage of funding. It has invested $361 million in 92 projects across 12 countries since its inception. We've committed to providing up to $70 million in additional funding over three years to build on this success.
• supported the Global Antibiotic Research and Development Partnership which is working to develop and deliver new or improved antibiotic treatments. The first trials are for new treatments for neonatal sepsis and gonorrhoea.
• led policy discussions about how governments and industry can work together to sustainably increase antibiotic discovery and development; we also contributed to discussions in forums like the G20 and the Global AMR R&D Hub, and supported the exploration of new, fairer ways to pay for antibiotics in countries like the UK and the US.

Next, we want to catalyse the development and update of key tools like new antibiotics, interventions to enable the appropriate use of antibiotics, and better data to prevent, treat and control drug-resistant infections. 

Objective 2: Encouraging appropriate use of antibiotics, so that drug resistance slows down

The problem

Access to antibiotics remains an issue in many countries, where it is often a greater concern than drug-resistant infections. Meanwhile, antimicrobial treatments are frequently misused – taken for infections or conditions that cannot be treated with antimicrobials, in improper dosage, or for the wrong treatment duration.

This behaviour leads to a rise in antimicrobial resistance. Diagnostics can help to guide appropriate use of antibiotics and, at the same time, improve patient outcomes, facilitate development of new drugs, and enhance the surveillance of AMR. But not enough new diagnostic products are in development, due to market failures and other barriers.

What we have done so far

To improve the development and use of diagnostics, and build evidence around how to make better use of existing antibiotics, we have:

• supported Value-Dx, a consortium including Wellcome and industry that aims to understand, demonstrate, and quantify the value of diagnostics and the obstacles to their adoption and use
• supported a project of the World Health Organization (WHO) to map the landscape of in vitro diagnostics for AMR and develop an understanding of what’s needed for high-priority diagnostics
• supported the development of a research roadmap to build understanding of how to use antibiotics most effectively
• supported the WHO expert group on behaviour change and AMR to determine how key behaviour change methodologies and insights could support implementation of WHO products for antimicrobial resistance.

Objective 3: Mobilising national action on drug-resistant infections, so that countries can effectively respond at a national level

The problem

Drug resistance will only be effectively managed if everyone acts to reduce it – that’s why national measures are so important. By now, all countries have set National Action Plans, but these still need to be implemented. 

Until recently, we have worked on advancing global governance structures. Next, we plan to redirect our efforts from top-down global mobilisation to strengthening national responses.

What we have done so far

Following the 2016 UN resolution to tackle drug-resistant infections, we have:

• co-hosted a Call to Action in Ghana in 2018; this followed our 2017 event which brought together more than 200 participants from around the world and generated more than 100 commitments to act on drug resistance.
• worked with the WHO to support the work of the Interagency Coordination Group on Antimicrobial Resistance, an ad-hoc group of global organisations and experts tasked with delivering a report and recommendations to the UN Secretary General 
• co-founded the Global Antimicrobial Resistance (AMR) R&D Hub to act as the global knowledge centre about solutions for AMR, including the discovery and development of urgently needed antimicrobial drugs
• brought together experts to focus on the impact of antimicrobial resistance on the environment [PDF 317KB].

Building the evidence base

We have strengthened the evidence base underpinning these objectives by:

• launching the Surveillance and Epidemiology of Drug-resistant Infections Consortium (SEDRIC), an international think-tank which supports the improvement of surveillance systems for resistant infections. Since 2018, SEDRIC has published recommendations on barriers to capturing and sharing data on antimicrobial resistance and developed an interactive tool to map research projects.
• looking at how existing data on antimicrobial resistance can be used more effectively by:
  • working with partners to integrate the mapping of the burden of antimicrobial resistance into the Global Burden of Disease Index 
  • developing the AMR register with Vivli to create an open data sharing platform to make better use of antibiotic surveillance data by the pharmaceutical industry. This will build on the pilot phase which is already complete.
• launching the Wellcome Data Re-use Prize to develop new tools to map the spread and impact of drug-resistant infections  
• analysing the impact of antimicrobial resistance legislation and policies. For example, we looked at how the ban on antimicrobials in animal production in California has affected antimicrobial resistance and human health. 

More news

Read more articles on drug-resistant infections

An antimicrobial resistance learning framework for children and young people

This learning framework is a downloadable resource for educators, health and research professionals to help develop young peoples’ understanding of antimicrobial resistance and positive actions they can take to mitigate it. Commissioned by Wellcome and developed by a team from the Oxford Tropical Network in partnership with young people in Kenya, Vietnam, Thailand and Nepal.

Understanding the Antibiotic Manufacturing Ecosystem: A view of global supply chains, pressure points, and implications for antimicrobial resistance response [PDF 7.3MB]

This report, commissioned by Wellcome and produced by Boston Consulting Group, brings together data to map global antibiotic supply chains with economic analysis to explore the viability of measures to limit antibiotic discharge in manufacturing effluent.

Call to Action on Antimicrobial Resistance 2021 Report

Key outcomes from the third Call to Action on Antimicrobial Resistance Conference held virtually, co-hosted by the governments of Denmark, Colombia, Ghana, Indonesia, Thailand and Zambia, with the International Centre for Antimicrobial Resistance Solutions (ICARS), Fleming Fund, UN Foundation, UNICEF, Wellcome Trust and the World Bank.

Stewardship and Access Plan Development Guide [PDF 568KB]

Guidance to support product developers meet the stewardship and access obligations for CARB-X-funded diagnostics, vaccines and treatments. 

Clinical trial networks for AMR research [PDF 272KB]

This report explores how we can enhance collaboration between clinical trial networks for antimicrobial resistance.

The growing crisis in antibiotic R&D: opportunities for G20 member action to support sustainable innovation [PDF 135KB]

A discussion paper by Wellcome about the challenges in antibiotic research and development.

Reframing Resistance. How to communicate about antimicrobial resistance effectively

Wellcome's report and practical toolkit aims to guide experts, communicators and practitioners to communicate with impact, so that the public understands and supports action on drug-resistant infections.  

Response to the Open Consultation on the Terms of Reference of the Independent Panel for Evidence on Action Against Antimicrobial Resistance [PDF 108KB]

Following the report of the Interagency Coordination Group on Antimicrobial Resistance to the Secretary-General of the United Nations, the Food and Agriculture Organization, the World Organisation for Animal Health and the World Health Organization have been working on setting up an Independent Panel for Evidence on Action Against AMR. They issued draft Terms of Reference for the panel in an open consultation which Wellcome responded to.

Response to the Indian Government on the open consultation for proposed Environment (Protection) Amendment Rules 2020 [PDF 141KB]

The Indian Ministry of Environment, Forest and Climate Change issued the draft notification Environment Protection Amendment Rules 2020, setting out proposed national standards for levels of antimicrobials released in pharmaceutical manufacturing effluent. Wellcome responded to the open consultation on this notification.

Response to the Open Consultation on Proposals Received for the 2020 Comprehensive Review of the Global Indicator Framework [PDF 103KB]

We respond to the Open Consultation on Proposals Received for the 2020 Comprehensive Review of the Global Indicator Framework, specifically in relation to inclusion of an antimicrobial resistance-specific indicator within the Sustainable Development Goals.

Call to Action on Antimicrobial Resistance 2018 Report [PDF 1.4MB]

Key outcomes from the second Call to Action on Antimicrobial Resistance held in Ghana, co-hosted by the Governments of Ghana, Thailand and the UK, along with the World Bank, UN Foundation and Wellcome.

The Ghana Declaration, Call to Action on Antimicrobial Resistance [PDF 927KB]

The Ghana Declaration signed by the co-hosts of the Call to Action on Antimicrobial Resistance, together with civil society leaders, heads of private sector companies and the World Health Organization, the Food and Agriculture Organization and the World Organisation for Animal Health.

Wellcome response to IACG draft recommendations [PDF 598KB]

We respond to the draft recommendations of the Ad hoc Interagency Coordination Group on Antimicrobial Resistance.

Addressing antimicrobial resistance in the environment [PDF 1.9MB]

This scientific white paper looks at the evidence about how antimicrobial resistance in the environment is impacting human health, and at how the risks can be addressed.

It summarises discussions from the International Environmental AMR forum, held in April 2018. Read the executive summary [PDF 638KB] for the key messages.

CARB-X annual reports

The progress CARB-X has made towards accelerating antibacterial research since it was established in 2016. 

Vaccines for antimicrobial resistance

This report, commissioned by Wellcome and produced by Boston Consulting Group, looks at the opportunities and challenges around developing vaccines to combat antimicrobial resistance.

Antimicrobial resistance inquiry [PDF 89KB]

The evidence we submitted to the Health and Social Care Committee Antimicrobial resistance inquiry.  

Antimicrobial resistance surveillance: sharing industry data [PDF 1.1MB]

Recommendations from a pilot project to openly publish human antimicrobial resistance surveillance data generated and collected by the pharmaceutical industry. The project was led by the Open Data Institute and funded by Wellcome.

Call to Action on Antimicrobial Resistance [PDF 1.9MB]

The key outcomes from the Call to Action on Antimicrobial Resistance event, organised by Wellcome in partnership with the UK, Ghanaian and Thai governments and the UN Foundation.

The event focused on the critical gaps in tackling the spread of drug-resistant infections and sought commitments to concerted and tangible actions.

SEDRIC, one year on [PDF 371KB]

A reflection on the activities and accomplishments of the Surveillance and Epidemiology of Drug-Resistant Infections Consortium (SEDRIC) in its first year, and plans for the next 12 months.

More reports 

See all of our reports on drug-resistant infections. 

To contact someone in the team, email drugresistantinfections@wellcome.org.

See who's in our infectious disease team and on our strategic advisory board.