This is the fourth in a six-part series by our CEO, Mads Krogsgaard Thomsen, about how the Novo Nordisk Foundation is changing. Read Part One here, Part Two here, Part Three here, and look out for Part Five soon.
In the time it took you to brush your teeth this morning, four people died from drug-resistant infections – a problem known as antimicrobial resistance, or AMR. This is not a future threat – it’s a present-day global health emergency and a growing economic and security crisis. But it can be solved.
I first came across AMR more than 40 years ago as a young veterinary student. When farmers injected healthy pigs with antibiotics to make them grow faster, they were also unintentionally speeding up the natural process through which bacteria evolve to resist the drugs designed to kill them, making those drugs useless.
It was a problem then. Today, it’s a crisis. Bacterial AMR is now the third leading cause of death globally, with one in six common infections no longer responding to standard antibiotics.
Our world’s primary defence against infections is failing, with severe consequences.
As infections become harder to prevent and cure, routine surgeries and medical treatments become far riskier. It’s a problem everywhere, but the risks are growing fastest in low- and middle-income countries, where limited access to effective antibiotics combined with struggling health systems often makes it hard to control the spread of infections.
The economic cost is rising too, as is the threat to national and international security. AMR can slash productivity, cripple healthcare systems, and jeopardise food supply chains.
And yet, I’m hopeful. What I’ve learned since my days as a student is that AMR is solvable – and our Foundation, alongside many other organisations, has a role to play.
Piecing the puzzle together
So, why is drug resistance rising? Largely because antibiotics are often overused or misused, infections aren’t prevented well enough, and the market for new antibiotics is fundamentally broken. Developing them is high-risk and expensive, while sales are kept low to preserve effectiveness – the economic model simply doesn’t work.
We can think of the solution as a jigsaw puzzle. Many different pieces need to come together before we see change. The Foundation is working hard, often with partners, on three key areas of the puzzle.
First, we support the basic and translational research needed to fuel the pipeline of tomorrow’s drugs – not just new antibiotics, but antifungals and antivirals too.
Our grants help researchers pursue solution-focused ideas, while a new global consortium, launched together with Gates Foundation and Wellcome, aims to speed up early-stage discovery of antibiotics for some of the resistant bacteria that are hardest to treat.
Second, we help drive the innovation pipeline – advancing better tools for prevention, diagnosis, and targeted treatment. We’re proud to back the global non-profit CARB-X, a powerful engine fuelling the early pipeline of antibiotics, vaccines and diagnostics. Later stage support comes via the Foundation’s investment company, Novo Holdings, through the REPAIR Impact Fund and the AMR Action Fund.
We’re also funding development of new vaccines for respiratory diseases, while a joint grant with Singapore’s Temasek Foundation is helping advance diagnostics for severe bacterial infections in Asia.
Third, we work on the policy changes that are critical for any of this to succeed. We need new commercial models for antimicrobials that reward innovation without encouraging overuse, and stronger systems to ensure effective antibiotics are available where they are needed. That’s why we use our voice – in Denmark through our co-founded AMR Alliance, and at EU and global levels – to advocate for the right investment and policies.
Much more is needed
The Foundation is one of many organisations working hard across the value chain, and some progress has been made – but not nearly enough.
In 2024, all 193 UN Member States agreed on an ambitious plan to tackle AMR, recognising that only a coordinated, global effort can make a difference. But follow-through remains uneven and implementation is difficult.
In the EU, lawmakers have now agreed on a voucher scheme for priority antimicrobials and a voluntary subscription model for antibiotics to delink company revenues from sales volumes – important steps towards reviving the pipeline. But as they stand, these incentives fall short of what’s needed to make antibiotic development commercially viable.
So again, why am I hopeful?
Because AMR is finally gaining the attention it deserves at national, regional, and global levels. And because the path forward is clear: targeted public and private investment, the right policy frameworks, and coordination across regions.
With these ingredients, we can rebuild the antibiotics market, fuel the pipeline, and ensure that antimicrobials remain effective and available where they are truly needed.
We at the Foundation are committed to doing our part.
