The EU's Antimicrobial Toolbox Needs Funding

It has been nearly a year since the Commission published its Medical Countermeasures Strategy, which laid out a toolbox approach to solving the antimicrobial innovation problem. Politicians heralded three pieces of legislation as possible vehicles for delivering the tools required to rebuild Europe's antibiotic infrastructure: the Geaneral Pharmaceutical Legislation, the Critical Medicines Act and the Biotechnology Act. Despite many tabled amendments, only one of these prongs has so far borne the fruit required to support novel antimicrobial development, whether by incentivising it, directly financing it, improving market access pathways, or building manufacturing capacity.

The case for action is no longer in dispute. Antimicrobial resistance is a problem no Member State can solve on its own, and the Council has already recommended centrally pooled EU-level action on a cross-country incentive for antimicrobials. The political decision has, in effect, already been taken. As the 2028–2034 Multiannual Financial Framework (MFF) takes shape, the Union therefore has a decisive and time-limited window to ensure the toolbox is sufficiently financed. If it is not, Europe risks squandering the years of political capital it has taken to reach this point.

As well as the Commission's AMR research agenda and HERA, created to anticipate cross-border health threats and secure the medical countermeasures, sustained funding for highly effective organisations across the pipeline is paramount, particularly through CARB-X, which backs early-stage discovery and development and GARDP, which carries promising candidates through late-stage development and into access for the patients who need them. Three instruments within the MFF: the European Competitiveness Fund, the Union Civil Protection Mechanism+ and Global Europe, offer the means to deliver this.

Why the MFF is the decisive window

The MFF is the EU's seven-year budget, it decides which programmes exist and what they are allowed to fund, and a phrase inserted today sets the legal basis that HERA, the Commission, the Parliament and Member States draw on for the next decade. An antimicrobial priority that is not named is not formally excluded, but in the competition for funding that follows, unnamed priorities lose.

European Competitiveness Fund

The European Competitiveness Fund (ECF) is the flagship instrument of the next MFF, consolidating fourteen programmes into a single €234.3 billion fund for industrial competitiveness and innovation. Within it, health holds no dedicated allocation: it shares a window with biotech, agriculture and the bioeconomy worth under 9% of the fund, while defence, security and space take more than half.

A sustained antimicrobial pipeline protects healthcare systems, workforce productivity and supply chains, delivering a substantial return to the European economy and reinforcing the very competitiveness the Fund exists to secure.

The Fund is strategically built to lend. This does not serve novel antimicrobials, whose value lies in their function as infrastructure and is captured insufficiently at present by European health systems. A developer cannot generate the short-term returns to service a loan against a medicine designed to be used as little as possible. This is the textbook case the Fund's own rules already provide for, reserving grants for public-interest priorities. Our ask is that antimicrobials be named as a recognised case of market failure, which moves them off the loan track and onto the grant track where they belong.

Union Civil Protection Mechanism+

The Union Civil Protection Mechanism+ (UCPM+) merges the EU's civil protection mechanism with the health-emergency strand previously funded under EU4Health into a single €10.6 billion instrument, and it is the framework from which HERA draws its mandate and resources. It funds collective readiness for major cross-border threats: surveillance, stockpiling medical countermeasures, reserving manufacturing capacity, and coordinating response across Member States. Antimicrobial resistance is precisely the kind of slow-moving threat it exists to address, and already ranks among HERA's three priority threats.

HERA is already engaged in antimicrobial innovation in a range of ways. The task at MFF level is to ensure the instrument underpinning that work names antimicrobial resistance and the development of new countermeasures, not only their stockpiling, so that a priority HERA already holds is secured in the text.

Global Europe

Global Europe is the EU's €200.3 billion instrument for action beyond its borders, consolidating its external-action and development funding into a single framework. It funds international partnerships, development financing, and cooperation with bodies such as the World Bank and other international financial institutions. It is relevant here because the other instruments are largely confined to expenditure on EU territory, whereas antimicrobial resistance is a global challenge, with the bulk of resistance existing in low- and middle-income countries.

Supporting access to these markets also broadens the commercial opportunities open to European developers, strengthening the business case for the antibiotics they produce, so a single instrument can advance access and competitiveness at once. The Council's position includes a reference to antimicrobial resistance here, and we support this position: it may enable EU development funding to back access programmes of the kind led by GARDP and WHO through the SECURE initiative, bringing new antibiotics to patients in lower-income countries while opening the markets that make their development worthwhile.

In summary

Europe's toolkit is still fledgling. If it is to protect and develop its antibiotic infrastructure in the years to come, the channels for funding it must be kept open, and that starts by naming antimicrobial resistance in all three instruments: the European Competitiveness Fund, the Union Civil Protection Mechanism+, and Global Europe.