As the global threat of drug-resistant infections accelerates, the pharmaceutical industry is losing ground, leaving vulnerable populations in sub-Saharan Africa dangerously exposed, according to the newly released 2026 Antimicrobial Resistance (AMR) Benchmark.
The comprehensive report, published by the Access to Medicine Foundation, reveals a stark reality for the continent. Across 17 sub-Saharan African countries, none of the assessed companies have registered child-friendly versions of their existing antimicrobial products. This lack of registration severely limits treatment options, fuels resistance and leaves children vulnerable to otherwise treatable infections. This access gap is particularly devastating given that 80% of children who die from tuberculosis infections live in sub-Saharan Africa.
While AMR contributes to more than 4 million deaths globally each year, the pipeline for new treatments is rapidly shrinking. The 2026 AMR Benchmark reports a 35% decrease in the number of pipeline projects in development from large research-based pharmaceutical companies since 2021. Major corporations like Johnson & Johnson have drastically reduced their pipelines, with the company ceasing its vaccines and infectious disease R&D entirely in 2023. Today, only GSK, Otsuka and Shionogi continue to invest in innovative antimicrobial R&D among the large research-based companies.
The deficit is especially severe for pediatric medicine. The report notes that only 14% of antimicrobial pipeline projects from the assessed companies are developed for children under the age of 5.
Despite these alarming trends, the Benchmark highlights crucial bright spots driven largely by small- and medium-sized enterprises (SMEs). The report identified seven new, innovative medicine projects in late-stage development by GSK, Otsuka, Shionogi, BioVersys, F2G, Innoviva and Venatorx. These projects target some of the deadliest drug-resistant pathogens that disproportionately affect people living in low- and middle-income countries.
“We can tilt the battle against superbugs in humanity’s favor,” said Jayasree K. Iyer, CEO of the Access to Medicine Foundation. “Our findings show practical approaches that can ramp up progress on all fronts.”
Some companies are demonstrating this progress by actively working to bridge the access gap. Five companies — Aurobindo, GSK, Hikma, Sandoz and Teva — stand out by registering their pediatric formulations, on average, in around 50% to 70% of the low- and middle-income countries where they register their other off-patent antimicrobials.
Furthermore, generic medicine manufacturers are stepping up to track how their medicines are used, a vital step in preventing the misuse that causes superbugs. Six of the 10 generic companies assessed now track patient reach across almost all of their antibiotic and antifungal products analyzed.
Ultimately, the 2026 AMR Benchmark stresses that overcoming this crisis requires more than isolated corporate efforts.
“From R&D through manufacturing, to access and stewardship and measuring real-world patient reach, the Benchmark illustrates the potential for companies to develop more comprehensive approaches,” noted Claudia Martinez, director of research at the Access to Medicine Foundation. “But we need intensified, industry-wide action.”
How Superbugs Are Impacting Uganda
The global findings from the 2026 AMR Benchmark reflect a growing crisis that is already claiming thousands of lives locally. In 2021, an estimated 5,620 deaths in Uganda were directly attributable to bacterial antimicrobial resistance, while nearly 26,800 deaths were associated with it, according to the Institute for Health Metrics and Evaluation (IHME) / GRAM Report. To put this in perspective, AMR-related deaths in Uganda now surpass the annual mortality from HIV and tuberculosis combined.
The burden of this crisis falls disproportionately on the country’s youngest and most vulnerable citizens. Children under the age of 5 account for the largest number of AMR-associated fatalities in Uganda, with more than 12,300 deaths recorded in this age group in 2021 alone. A recent study in the Karamoja region highlighted this severe everyday risk, revealing that nearly half of the food and water consumed by children under 5 in the area is contaminated with drug-resistant Salmonella.
The clinical landscape in the country is worsening, with up to half of all bacterial infections in Uganda now showing resistance to commonly prescribed, accessible antibiotics such as penicillin, according to the Uganda Antimicrobial Resistance National Action Plan. Currently, pathogens like Klebsiella pneumoniae, Streptococcus pneumoniae and Escherichia coli are the leading drivers of fatal drug-resistant infections across the nation.
