Rethinking Antimicrobial Innovation: A Policy Blueprint for Sustainable Discovery and Development Incentives

Executive Summary Antimicrobial resistance (AMR) is outpacing today’s innovation model. We recommend two pillars to reset the pipeline with a public-health lens: Strengthen early-stage science and bridge the preclinical-to-clinical gap, and Deploy equitable pull incentives that reward success without widening access inequalities. We frame both pillars in a One Health, data-driven approach that uses modern AI—specifically foundation models (e.g., large language models) and multimodal learning—to integrate signals across human, animal, and environmental domains. We recommend two immediate priorities: Europe must invest in early science and bridge the preclinical-to-clinical gap. Europe must design pull incentives tied to equitable access. To succeed, these tools must be embedded in a One Health framework and supported by modern AI. Foundation-model AI (large language models and multimodal systems) can accelerate discovery and trial design—but only if fed with curated, high-quality data from human, veterinary, and environmental sources. Key actions for the EU Presidency and Commission: Establishing a coordinated EU-wide funding framework that combines targeted push and pull tools, leveraging distributed expertise rather than a centralised facility. Scaling public funding via Horizon Europe, IHI, and a dedicated AMR instrument. Building on models like CARB-X and the AMR Action Fund, public R&D funding in Europe should be explicitly centered on One Health based antimicrobial stewardship plans. Expanding civil society’s role in education, accountability, and uptake. Advance advocacy through targeted stakeholder coalitions, including civil society, academic networks, and patients’ organizations, to shape legislative implementation and ensure incentive models remain aligned with public health outcomes Embed technical guardrails in all stages of policy development for AMR R&D This package gives Europe an actionable way to lead globally: clear investment signals, practical incentives, and accountable equity safeguards.