Hosted on 28 May 2026 by the AMR Multi-Stakeholder Partnership Platform (AMR MSPP) as part of its Dialogue Series and organized by the Milken Institute, the webinar “What Innovative Models for Financing Antimicrobial Development?” explored one of the most persistent challenges in global health: how to finance the development of new antimicrobials in a market where traditional investment incentives do not work.
The discussion brought together perspectives from finance, philanthropy, development banking, global health policy, and antimicrobial research. Across the session, speakers examined why the current model continues to fall short and what kinds of financing approaches could help rebuild a sustainable pipeline for antibiotics, vaccines, diagnostics, and other tools needed to respond to antimicrobial resistance.
Caitlin MacLean, Managing Director of Catalytic Capital at the Milken Institute and moderator of the session, opened by presenting antimicrobial resistance (AMR) as both a public health crisis and a market failure. Because new antimicrobials must be used carefully to preserve their effectiveness, their commercial potential is limited even when their clinical value is high. This makes antimicrobial development difficult to finance as it requires major upfront investment, long timelines, and tolerance for uncertain returns. The Milken Institute’s Financial Innovations Lab Report, launched in 2022, proposed two models to help address this gap. The first is a blended capital fund, combining concessional capital with private investment to lower financing costs and give developers more flexibility through mid- and late-stage development. The second reframes antibiotics as health infrastructure, using AMR-focused bonds or pooled loan funds to provide longer-term financing better suited to the timelines of development, stewardship, market access, and education.
The panel noted that progress has been made. Kevin Outterson, Executive Director of CARB-X and Professor of Law at Boston University, pointed to the growth of push-funding mechanisms such as CARB-X, GARDP, and the AMR Action Fund, which have helped reduce early-stage scientific and technical risk. Recent renewed interest from major pharmaceutical companies, particularly in bacterial vaccines, was also cited as a positive sign.
At the same time, Henry Skinner, Chief Executive Officer of the AMR Action Fund, emphasized that private investors remain cautious. Several small antibiotic-focused biotechnology companies have struggled even after regulatory approval, showing that approval alone does not ensure commercial viability. Without reliable revenue, companies may be unable to launch products, complete post-approval obligations, expand indications, or support access in additional markets.
This is why pull incentives—rewards for a product that reaches the market, rather than the push funding that underwrites the research itself—remain essential. Chief among them is the subscription model, in which a government pays a fixed annual fee for access to an antibiotic regardless of how much is used. In the United States, the PASTEUR Act would create exactly such a scheme; most recently reintroduced in 2026, it is the main vehicle for these efforts, and the European Union and other countries are weighing comparable measures to support innovation or secure access. Together these could give developers more predictable returns.
However, speakers stressed that these incentives must be credible, sustained, and global, because the burden of drug-resistant infections reaches beyond high-income markets.
Alexandre Dajkovic, Senior Life Sciences Expert at the European Investment Bank, explained how public mandates can help absorb risk and crowd in private capital. Through European Commission-backed mechanisms and InvestEU-related programs, the EIB can support higher-risk biotech and AMR investments that may otherwise be unattractive to traditional investors. Still, these deals often depend on other investors joining, highlighting the need for coordinated financing structures.
Mona Basso, independent strategic advisor and formerly of Palladium, described blended finance as a useful tool, but not a standalone solution. By layering concessional, impact, and commercial capital, it can allow investors with different risk appetites to participate. Similar models have been used in climate, infrastructure, water and sanitation, and women’s health, but AMR will require approaches tailored to each stage of the product life cycle.
Jeremy Knox, Head of Policy for Infectious Disease at the Wellcome Trust, underlined the need for different actors at different points in the pipeline. Philanthropy can support early-stage research, where risks are often too high for private capital, but later-stage development and market-shaping mechanisms require government action, especially through durable pull incentives.
The conversation also looked beyond drug development. Speakers highlighted the need to engage insurers and reinsurers, generic manufacturers, animal health, food and agriculture, regional development banks, infrastructure investors, climate finance, gender-lens investors, and aging-related investment platforms. These sectors all have an interest in reducing the burden of AMR, from protecting supply chains to strengthening health systems and manufacturing resilience.
Diagnostics, surveillance, stewardship, and public awareness were also identified as essential. New antimicrobials will have an impact only if health systems can identify the right patients, guide appropriate treatment, and preserve effectiveness over time. Artificial intelligence may support drug discovery, surveillance, and evidence generation, but it cannot replace laboratory validation, clinical trials, manufacturing, regulation, or responsible data governance.
The webinar made clear that no single instrument will solve the antimicrobial financing challenge. Funds, bonds, pull incentives, philanthropy, public mandates, and policy reform all have a role to play. Ultimately, the financing question is not only what a new antibiotic earns, but what its absence costs. Much of modern medicine — routine surgery, cancer treatment, organ transplants — depends on being able to control infection. And valuing these drugs by sales alone, without sustainable investment, makes it increasingly difficult to protect the medical advances made.
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Watch the Webinar recording below