The Next Pandemic: Confronting the Global Threat of Antibiotic Resistance

Executive Summary

Antibiotic Resistance as a Looming Crisis: Antimicrobial resistance (AMR), especially antibiotic resistance in “superbugs,” is emerging as the next potential pandemic-level threat. It already claims an estimated 1.27 million lives annually (2019) and is associated with nearly 5 million deaths worldwide, a toll higher than HIV or malaria. If current trends continue, AMR could be implicated in 8-10 million deaths per year by 2050, posing a catastrophic risk to global health and economies. The CDC and WHO warn that “when antibiotics stop working, every bacteria becomes a deadly bacteria,” turning routine infections into life-threatening conditions.

Scispot and the Biotech Response: Innovative biotech companies and platforms are mobilizing to combat this threat. Scispot, a life sciences software company led by founder Guru Singh, offers an AI-powered, API-first platform for life science labs to accelerate R&D and data-driven decision-making. Such tools are enabling researchers to innovate faster in areas like drug discovery and genomic surveillance. In a recent talk is biotech! podcast, Singh and Ivan Liachko (Founder and CEO of Phase Genomics) highlighted how genomics and AI-powered solutions, from bacteriophage therapies to advanced diagnostics, are at the forefront of the fight against superbugs.

Challenges in Drug Development and Stewardship

The antibiotic development pipeline is distressingly thin. Major pharmaceutical companies have largely exited antibiotic R&D; in 1990, 18 large firms were actively developing antibiotics, but today only 5 remain. New drug approvals have fallen from 3 per year in the 1980s to less than 1 per year in the 2010s, with only 2 truly novel antibiotic classes introduced since 2017. Economic disincentives (low returns on new antibiotics held in reserve) and high failure rates plague development.

Meanwhile, diagnostic gaps and inadequate surveillance mean resistant infections often spread undetected until it’s too late. Overuse and misuse of existing antibiotics in healthcare and agriculture continue to drive resistance. An estimated 30% of outpatient antibiotic prescriptions in the U.S. are unnecessary, and in some countries up to 80% of antibiotics are consumed in livestock farming.

Scientific and Technological Innovations

Despite the challenges, new solutions are emerging:

Genomics & Phage Therapy: Advances in genomics are reviving bacteriophages (viruses that infect bacteria) as precision weapons against superbugs. Phase Genomics, a Seattle-based biotechnology research company founded in 2015, has built a massive phage genome database and identified bacteriophage-derived enzymes called lysins that can selectively destroy bacteria. These “living antibiotics” show promise against resistant strains without harming beneficial microbes. Liachko notes his team can turn a cloudy, bacteria-filled sample “from beer to apple juice” in minutes by adding lysins. Experimental phage therapies have already saved patients in compassionate-use cases, pointing to a future where phage cocktails and engineered viruses could replace or augment chemical antibiotics.

AI-Driven Drug Discovery: Artificial intelligence is accelerating the hunt for new antimicrobials. In 2020, researchers at MIT used a machine-learning model to identify a novel compound, later named halicin, with potent activity against multi-drug-resistant bacteria. This was one of the first antibiotics discovered by AI, and similar computational approaches are screening millions of molecules (including revisiting old drugs) far faster than traditional labs. AI platforms are also optimizing drug design and helping predict bacterial resistance patterns, potentially staying one step ahead of evolving pathogens.

Rapid Diagnostics & Surveillance: New diagnostic tools are shrinking the time needed to detect resistance. Rapid DNA sequencing and PCR-based tests can identify bacterial species and key resistance genes within hours, guiding doctors to effective treatments much faster than conventional cultures. For example, whole-genome sequencing is now used to track hospital outbreaks (identifying transmission chains of MRSA, TB, etc.) and even monitor wastewater for emerging resistance genes. These innovations enable a shift from reactive to proactive containment of superbugs. However, scaling them globally is a challenge, as many low-resource settings still lack basic lab capacity. Improved surveillance networks like WHO’s GLASS are gradually expanding, with 76 countries reporting alarming levels of resistance (median 42% of E. coli infections resistant to common cephalosporins, and 35% of Staph aureus infections being MRSA).

Policy and Economic Initiatives

Recognizing the high stakes, policymakers are mounting a response:

Global Action Plans: The WHO has declared AMR one of the top 10 global health threats and launched a worldwide action plan emphasizing a One Health approach (integrating human, animal, and environmental health). In 2024, world leaders at the UN General Assembly agreed to target a 10% reduction in AMR deaths by 2030 and to boost financing for national action plans.

Incentivizing Antibiotic R&D: Novel “push” and “pull” incentives are being implemented to fix the broken antibiotic market. For example, the UK’s NHS pioneered a “Netflix-style” subscription model that pays pharma companies upfront for access to new antibiotics, de-linking revenue from the volume of pills sold. This gives companies a predictable return on investment in exchange for making new drugs available as a last resort. Similarly, proposals like sizeable market-entry rewards (lump-sum prizes for new approvals) have been recommended. On the push side, public-private partnerships like CARB-X and the AMR Action Fund (nearly $1 billion backed by 20+ pharma firms) are investing in early-stage antibiotic startups, aiming to bring 2-4 new antibiotics to market by 2030. These efforts, alongside regulatory reforms to streamline clinical trials, are critical to replenishing the antibiotic pipeline.

Stewardship and Regulation: Many countries are strengthening antimicrobial stewardship, promoting prudent use of existing drugs. Hospitals are implementing stewardship programs that review antibiotic prescriptions in real time, which have been shown to reduce inappropriate use and improve patient outcomes. In agriculture, regulators are clamping down on routine antibiotic use in healthy animals. The EU and UK have banned the use of antibiotics for growth promotion in livestock, and WHO issued guidelines recommending complete restriction of medically important antibiotics for growth promotion globally. These measures are yielding results: some countries have seen a 13% decline in veterinary antibiotic use in recent years, and farms adopting antibiotic restrictions have seen up to 39% reduction in resistant bacteria in their animals. However, enforcement remains uneven worldwide.

Real-World Impact: Why Urgent Action Matters

The threat of antibiotic resistance is not abstract. It’s already impacting real patients and healthcare systems:

In 2016, a woman in Nevada died from an infection caused by Klebsiella pneumoniae that was resistant to all 26 antibiotics available in the U.S. This pan-resistant “superbug” likely evolved overseas and proved untreatable despite every effort, a stark preview of a post-antibiotic era.

Common infections are becoming harder to treat. For example, gonorrhea has developed high-level resistance to essentially all oral antibiotics, and only one last-resort injectable drug remains effective in most cases. The WHO has warned of untreatable gonorrhea strains emerging in multiple countries, which could make a once-manageable disease a serious public health threat. Similarly, extensively drug-resistant tuberculosis (XDR-TB) has spread in parts of Asia and Eastern Europe; treating it requires two years of toxic drugs and still only achieves ~50% cure rates. In 2021 alone, about 191,000 deaths were caused by drug-resistant TB, highlighting how AMR jeopardizes progress against diseases we thought under control.

The COVID-19 pandemic underscored and exacerbated the AMR problem. Hospitals overwhelmed by COVID saw surges in secondary bacterial infections; antibiotic use spiked (often prophylactically for lung complications), and infection control lapses enabled resistant hospital bugs to spread. The U.S. CDC reported a 15% increase in hospital-related resistant infections in 2020-2021 after years of decline. Furthermore, Candida auris, a resistant fungus, saw a five-fold increase in cases during the pandemic. This backslide shows that without constant vigilance, gains against AMR can be swiftly lost.

The Rising Threat of Antibiotic Resistance

Antimicrobial resistance occurs as microbes (bacteria, fungi, viruses, parasites) evolve to survive the drugs designed to kill them. Antibiotic resistance in bacteria is the most acute concern, since bacterial infections like pneumonia, sepsis, and diarrheal diseases have historically been curable with simple antibiotics. That cure is now in jeopardy. Overuse and misuse of antibiotics accelerate this evolution. Every unnecessary prescription or improper use (not completing courses, using wrong doses) gives bacteria more chances to develop resistance. In agriculture, heavy use of antibiotics in animal feed has created reservoirs of resistant bacteria that can jump to humans through the food chain or environment.

The result is a mounting global health crisis:

The WHO estimates at least 1.27 million people died in 2019 due to drug-resistant bacterial infections, with nearly 5 million deaths associated with AMR that year. This makes AMR a leading cause of death globally. For context, annual HIV/AIDS deaths and malaria deaths are each under 1 million; AMR already exceeds both. In fact, a landmark study published in The Lancet found that in many parts of the world, AMR is now a bigger killer than HIV/AIDS.

Without action, the toll will worsen: Forecasts suggest that by 2050, up to 10 million lives per year could be lost to resistant infections, in a worst-case scenario, effectively a parallel pandemic. Even a more moderate projection shows AMR deaths rising about 70% by 2050, reaching ~1.9 million direct deaths annually (and ~8 million including contributing factors). The economic damage would be immense. The World Bank projects AMR could slash global GDP by $1.0-3.4 trillion per year by 2030 and push 24 million more people into extreme poverty by 2050 if unchecked.

Modern medicine at risk: Antibiotics underpin much of modern healthcare. Procedures like organ transplants, chemotherapy for cancer, and complex surgeries are only safe because we can treat infections that arise. The WHO warns that AMR is rolling back these advances. Routine surgeries or childbirth could again become high-risk if even minor infections can’t be treated. Already, drug-resistant infections add lengthy hospital stays and high costs. For example, in the U.S., just six common multi-drug-resistant pathogens are estimated to impose over $4.6 billion in excess healthcare costs annually due to longer, more intensive treatments when first-line antibiotics fail.

Moreover, the threat is truly global. Unlike an outbreak of one specific virus, antibiotic resistance is a slower-moving, diffuse pandemic, but one that recognizes no borders. A resistant strain that emerges in one country can spread internationally via travel and trade (as seen with the New Delhi NDM-1 resistance gene, which was first identified in India and then found worldwide within years). Low-income countries often bear the brunt, as they have higher infectious disease burdens and weaker health systems, but developed nations are not spared, witness the resurgence of gonorrhea and MRSA in places like the US and UK. No country can tackle AMR alone; it requires a coordinated global effort.

Key Findings from talk is biotech!

During a recent episode of talk is biotech!, host Guru Singh, CEO of Scispot (a life sciences software company specializing in advanced data infrastructure and AI tools for biotechnology labs), sat down with Ivan Liachko, Founder and CEO of Phase Genomics. Their conversation highlighted several important innovations in the fight against AMR:

1. Phase Genomics has developed breakthrough technologies for mapping bacterial genomes and identifying bacteriophage interactions that could lead to novel therapies for drug-resistant infections.
2. Liachko’s team has built what he describes as “the world’s largest collection” of bacteriophage genomes and their associated lysin proteins, creating a resource that researchers can use to find targeted solutions against specific bacterial pathogens.
3. The discussion emphasized how genome sequencing technologies are being applied not just to human health challenges like cancer, but also to address the growing crisis of antibiotic resistance.
4. Both experts agreed that a multi-pronged approach combining new technologies, policy changes, and international cooperation is essential to address the AMR threat before it becomes unmanageable.

The Way Forward: A Multi-Stakeholder Action Plan

Antibiotic resistance is often called a slow tsunami. Unlike a sudden viral pandemic, its rise is gradual yet relentless, but that also means we can see it coming and have a window to act. The podcast conversation between Guru Singh and Ivan Liachko ended on an optimistic note that biotech innovation, if coupled with smart policy and global action, can avert the worst-case scenario of a post-antibiotic era. To leverage that potential, stakeholders across sectors must coordinate their efforts.

Biotech and Pharma Industry

• Double down on innovative R&D: Biotech startups should continue exploring unconventional approaches like bacteriophages, lysins, microbiome therapies, anti-virulence drugs, and AI-designed molecules. Companies like Phase Genomics exemplify how focusing on niche solutions can create valuable new antimicrobial tools.
• Embrace partnerships and push incentives: Firms should take advantage of initiatives like CARB-X, which provide non-dilutive funding and expert support for early-stage antibiotic programs.
• Plan for stewardship and access: Developers of new antibiotics or therapies should proactively work on deployment models that ensure access globally while maintaining proper stewardship.

Healthcare Providers and Hospitals

• Strengthen antimicrobial stewardship programs: Every hospital should have a robust stewardship team reviewing antibiotic use, providing feedback to prescribers, and implementing guidelines.
• Invest in infection prevention and control: Hospitals must relentlessly enforce infection control to prevent the spread of resistant organisms.
• Leverage diagnostics and data: Healthcare providers should push for access to rapid diagnostics and share antibiotic resistance data with regional networks.

Public Health Agencies and Governments

• Implement and fund National Action Plans: Countries need comprehensive AMR action plans covering surveillance, stewardship, sanitation, vaccination, and R&D.
• Incentivize antibiotic development: Governments should pass and implement “pull” incentives like market entry rewards or subscription payments.
• Tighten regulations on antibiotic use in agriculture: Every country should eliminate growth promotion uses of human-critical antibiotics in farming, as per WHO guidance.
• Public awareness and education: Government health departments should sustain campaigns to educate the public about AMR.

International Organizations and Coalitions

• Facilitate data sharing and global surveillance: The WHO, together with partners, should continue to expand integrated surveillance platforms.
• Support low-income countries: Wealthy nations and global banks need to invest in AMR mitigation in the Global South.
• Coordinate research agendas: International bodies can convene experts to set research priorities and coordinate funding calls.
• Global governance and accountability: The idea of a binding international agreement on AMR could be advanced.

General Public and Civil Society

• Awareness and advocacy: Civil society organizations can keep pressure on governments and industries.
• Personal responsibility: Individuals can contribute by using antibiotics responsibly.
• Community engagement: Traditional healers, pharmacists, and community leaders can help extend the reach of stewardship messages.

Conclusion

The war against superbugs will be won or lost not by any single entity, but by the concerted actions of all of us: scientists, doctors, policymakers, business leaders, and citizens. The podcast that sparked this discussion, with Scispot’s Guru Singh highlighting the power of an AI-driven lab tech stack to accelerate discoveries, and Ivan Liachko demonstrating how genomics can unlock new cures hidden in nature, underscores that we have no shortage of human ingenuity.

The core insights are clear: antibiotic resistance is a solvable crisis, but only if we treat it with the urgency and unified effort it deserves. We stand at a crossroads. Down one path, we allow inertia and short-term thinking to continue, and we drift into a post-antibiotic dystopia where simple infections kill routinely. Down the alternative path, we recognize AMR as “the next pandemic” now and marshal a response on par with that threat, investing in innovation, changing how we use medicines, and collaborating across borders and disciplines. Future generations will judge us by which path we choose.

The time to act is now, and with the right strategy, we can ensure that the miracles of modern medicine remain effective for decades to come.