Children in parts of sub-Saharan Africa are missing out on life-saving antibiotics even as drug-resistant infections continue to rise worldwide, according to a new global report released on Tuesday.
The 2026 Antimicrobial Resistance (AMR) Benchmark, published by the Access to Medicine Foundation, found that child-friendly versions of key antibiotics have not been registered in 17 countries in sub-Saharan Africa, leaving vulnerable children at risk of receiving inadequate treatment.
Antimicrobial resistance occurs when bacteria, viruses and other microbes evolve to resist medicines designed to kill them. The problem is already severe, with more than one million people dying each year directly from drug-resistant infections, while the condition contributes to over four million deaths globally.
Researchers warn that the lack of proper medicines for children could worsen the crisis.
“Patients too often receive treatments that are not suitable or strong enough, allowing resistance to develop,” the report said.
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Children are particularly vulnerable to infectious diseases, yet new antibiotics are rarely designed or approved quickly for paediatric use. Even when medicines exist, access in low- and middle-income countries remains limited.
Among pharmaceutical companies producing antibiotics, Aurobindo, GSK, Hikma, Sandoz and Teva were identified as leaders in making child-friendly formulations available more widely than their peers.
On average, these companies register paediatric antibiotic formulations in 50 percent to 70 percent of the low- and middle-income countries where they market their other antimicrobial medicines.
However, large gaps remain in Africa, where none of the companies assessed in the benchmark had registered certain child-friendly antibiotics in 17 countries.
The findings come as global efforts to develop new antibiotics continue to weaken. The report found a 35 percent decline in antimicrobial research pipelines among large pharmaceutical companies since the previous benchmark in 2021.
Despite the shrinking pipeline, the report identified seven promising late-stage antibiotic projects targeting dangerous drug-resistant pathogens.
These are being developed by companies including GSK, Otsuka and Shionogi, as well as biotechnology firms BioVersys, F2G, Innoviva and Venatorx.
Some recent approvals are seen as encouraging signs. For example, GSK’s gepotidacin, recently approved for uncomplicated urinary tract infections, represents the first new oral antibiotic class for such infections in nearly three decades.
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Another drug, zoliflodacin, developed by Innoviva, offers a new treatment option for gonorrhoea, which infects about 82 million people every year and has become resistant to many existing antibiotics.
Still, experts say such breakthroughs remain too few to match the growing threat of drug resistance.
“We can tilt the battle against superbugs in humanity’s favour. Our findings show practical approaches that can increase progress, but action must expand across the industry,” said Jayasree K. Iyer, chief executive of the Access to Medicine Foundation.
The report also highlighted the increasing role of smaller biotechnology firms in antibiotic development. The eight small- and medium-sized companies assessed now account for almost a quarter of antimicrobial projects in development, helping fill gaps left by larger drugmakers.
However, limited funding and smaller global distribution networks make it difficult for these companies to bring new treatments to patients worldwide.
Experts say solving the antimicrobial resistance crisis will require stronger action from governments, pharmaceutical companies and global health organisations.
“From research and manufacturing to access and responsible use, companies have opportunities to strengthen their response to antimicrobial resistance,” said Claudia Martínez, director of research at the Access to Medicine Foundation.
Without faster innovation and wider access to effective antibiotics, particularly for children in poorer regions, health experts warn that the global superbug crisis could continue to escalate.
