By: Oliver Nugent Smith

We often speak about the exceptional advancements in healthcare, yet there is a quiet fight against the growing resistance of bacteria to the modern medicines we are all familiar with. Antimicrobial resistance (AMR) is already linked to an estimated 1.1–1.4 million deaths annually, and the World Health Organization lists it as a top threat to global health and development. Contrary to the rapid, dramatic outbreaks we are familiar with today, such as Ebola and COVID-19, this is a problem developing quietly, posing a critical threat to public health, modern medicine, and the global economy.

The Scale of the Threat

Bacteria reproduce extremely quickly – sometimes every 20 minutes – so evolution by natural selection takes place on a compressed timescale. When antibiotics are used, most bacteria die, yet those with a mutation that brings resistance to the medicine can live on and multiply. Over time, over millions of generations, resistant strains grow and dominate. These ‘superbugs’ could be responsible for more than 10 million deaths each year by 2050 – more than cancer causes today. The most concerning bacterial strains are Gram-negative ones, such as carbapenem-resistant E. coli, which are especially hard to treat due to their tough outer membrane and efflux pumps, actively working to expel any drug that makes its way in.

A striking example of this threat: researchers at the University of East Anglia traced the genetic history of the current hospital superbug, Acinetobacter baumannii, back to the 1970s, finding it accumulated resistant genes over decades before acquiring a gene called oxa23 in 2005, supercharging its resistance.

The problem fuels itself

To prevent the evolution of bacteria, new antibiotics, once approved, are used sparingly by doctors and are kept in reserve for worst-case scenarios. While this is effective medical practice, it makes antibiotics an economically unattractive endeavour for pharmaceutical firms, as opposed to other drugs, such as those used to treat chronic illnesses like diabetes.

A 2026 industry benchmark report revealed a 35% decrease in the number of antibiotic pipeline projects from large research-based pharmaceutical companies, even while the resistance threat keeps growing. This lack of investment means superbugs will grow increasingly powerful, as the gap between bacterial resistance and the strength of our antibiotics continues to widen. What’s worth noting is that this is not unique to 2026; there have been repeated warnings for years that the market failure around antibiotics requires a policy fix, such as guaranteed purchase schemes.

New tools are appearing

Traditional antibiotic discovery has somewhat stalled. Most classes of antibiotics used today were discovered decades ago, and finding new antibiotics has become increasingly more challenging. Therefore, researchers are turning to approaches that tackle the problem of resistance itself. One of the most prominent approaches is CRISPR gene-editing. A key example of this technology was developed at the University of California San Diego. Researchers, led by Ethan Bier, built a tool called pPro-MobV, a specially engineered plasmid – or loop of DNA – that spreads itself between bacterial populations and effectively strips the resistance genes out, restoring the power of antibiotics that had previously stopped working.

An alternative approach, bacteriophage therapy, sidesteps antibiotics altogether by using bacteriophages – viruses that infect and kill only very specific bacteria, without harming human cells – and is now in human trials. The biotech company Locus Biosciences is currently running a Phase II trial testing a CRISPR-enhanced phage treatment in patients with recurring urinary tract infections, while Danish company SNIPR Biome has begun dosing patients with a phage-based treatment targeting drug-resistant E. coli responsible for a large share of dangerous bloodstream infections.

A third, AI-assisted drug breakthrough, works differently. Machine learning models are being used to process enormous quantities of candidate chemical compounds quicker than any traditional method, and to predict which bacteria are likely to develop resistance to a drug before it is even approved. Together, these approaches prove how medicine is aiming to attack antibiotic resistance from many angles.

What does the future look like?

Despite the development of new tools, most experts agree the response to antibiotic resistance will not succeed through science alone – requiring greater coordination between governments, healthcare systems, pharmaceutical companies, and patients. Each of these contributes to solving the problem.

Governments must set shared targets and distribute funding: the WHO has collated data from over 100 countries through a global surveillance system, so that resistance trends can be tracked and responded to. Pharmaceutical and biotech firms hold the manufacturing capabilities and brainpower to produce new treatments, yet economic incentives do not directly point them towards the development of antibiotics, reinforcing the importance of effective governance. Hospitals and individual clinicians are the final link, ensuring antibiotics are prescribed sensibly and sustainably, giving antibiotics only when necessary and making sure patients complete their full course.

The fight against antibiotic resistance is not simply down to the actions of top scientists, but the collaborative efforts of all the groups listed above.