Antimicrobial resistance (AMR) caused 4.7M deaths globally in 2021 and could lead to 8.2M annually by 2050 without action. Yet antibiotic R&D faces hurdles: 12–15-year timelines, high costs, low recruitment, complex trial designs, and rapid post-approval resistance. Innovation is emerging through next-generation sequencing, AI, CRISPR, phage therapy, and antibiotic adjuvants. Global initiatives like CARB-X, with $900M+ funding, support early-stage projects, with 104 funded to date. Novel financing, such as the UK’s Subscription Model, incentivizes sustainable antibiotic development by rewarding value over volume.

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