The World Health Organization (WHO) has published updated reports focused on the progress of antibacterial treatments in development and available diagnostic tools intended to detect and identify bacteria marked as high-risk on the WHO bacterial priority pathogens list (BPPL). These reports aim to shape antibacterial research and innovation to better confront the increasing challenge of antimicrobial resistance (AMR).

Limited Progress in Antibacterial Development

The latest edition of WHO’s "Analysis of Antibacterial Agents in Clinical and Preclinical Development: Overview and Analysis 2025," first introduced in 2017, evaluates ongoing research and development efforts against WHO’s list of high-priority drug-resistant bacteria. The data from 2025 shows a drop in antibacterial candidates under development—from 97 in 2023 to 90. Out of these, 50 are conventional antibacterial drugs, while 40 represent alternative methods like bacteriophages, antibodies, and microbiome-based therapies.

This pipeline is facing two main problems: there are too few candidates, and the level of innovation remains low. Of the 90 drugs in progress, just 15 are considered innovative. Data limitations for 10 of these means it’s unclear if they avoid cross-resistance—when resistance to one treatment reduces the effectiveness of another. Only five of the treatments are effective against at least one of the top-tier “critical” bacteria on WHO’s list.

Among the 50 traditional antibacterials, 45 target bacteria on the priority list. Eighteen focus on treatment-resistant Mycobacterium tuberculosis. However, important gaps remain, such as formulations for children, oral options for non-hospitalized patients, and combination treatments using non-traditional agents. Since July 2017, 17 new antibacterial drugs targeting priority pathogens have been approved, with just two introducing a new chemical class.

Preclinical development is still active, with 232 programmes underway across 148 organizations. However, 90% of these are run by small companies with fewer than 50 employees, making the overall R&D landscape vulnerable. Research continues to center around Gram-negative bacteria, due to the urgent need for innovation in that area.

The WHO encourages developers to release antibacterial effectiveness data to promote collaboration, investment, and acceleration of new discoveries.

Diagnostic Tools: Gaps at the Point of Care

Effective diagnostics are critical to controlling AMR, particularly in lower-income countries. WHO’s “Landscape Analysis of Commercially Available and Pipeline In Vitro Diagnostics for Bacterial Priority Pathogens” outlines current and emerging tools designed to identify BPPL pathogens and assess antibiotic resistance through phenotypic or genotypic testing methods.

The report highlights several ongoing weaknesses, including:

• A lack of multiplex platforms that can detect bloodstream infections directly from whole blood in mid-tier (level II) laboratories, without requiring a culture process;

• Poor availability of biomarker-based tests like C-reactive protein and procalcitonin, which help distinguish between bacterial and viral infections; and

• A shortage of easy-to-use diagnostic tools for clinics and hospitals with limited resources.

These shortcomings hit hardest in low-resource areas, where most patients seek care at the primary level. WHO emphasizes the immediate need for simple, accurate, and cost-effective diagnostic solutions. This includes systems that can deliver results directly from various sample types—such as blood, urine, stool, or respiratory material—in a streamlined “sample-in/result-out” manner.

“Antimicrobial resistance continues to rise, while the current development pipeline of new treatments and diagnostic tools is inadequate to contain the spread of resistant bacterial infections,” stated Dr. Yukiko Nakatani, WHO’s Assistant Director-General for Health Systems. “Without stronger support for research and development, and targeted efforts to make these tools accessible where they’re most needed, we risk losing further ground.”

WHO is especially calling for increased investment in technologies suitable for use in low-resource settings that avoid the need for complex culture methods and are adaptable to frontline healthcare environments.

The two reports presented today are meant to inform future innovation and funding decisions across both the antibacterial drug and diagnostic sectors. Reinforcing this pipeline will require integrated action—spanning discovery, development, access-aware product design, and innovative financing strategies—particularly supporting the smaller enterprises at the forefront of these R&D efforts.