Working Group Report on Antibiotic Delinkage

Antibiotics are powerful drugs that prevent many deaths each year.

Modern medicine relies on them as a safety net. They are a precious global resource that must be managed on a sustainable ecological basis.

Many stakeholders believe that an antibiotic crisis is fast approaching or may already be upon us.

Owing to the long lead times for antibiotic research and development (R&D), society must act a decade before the need becomes immediately urgent.

A central proposition in this report is that it is desirable to develop new business models where the return for investment in R&D on antibiotics is not dependent on the volume of sales, an approach generally known as "delinkage." There is a need to incentivize investment in R&D without also incentivizing sales volumes, which may lead to the over-marketing of antibiotics, the acceleration of the development of resistance, and the undermining of stewardship and conservation measures necessary to limit the growth of resistance. The report therefore considers the ways in which delinked models could be implemented and the myriad of different challenges involved in moving toward new business models that require global reach to address what is a global problem.