First-of-its-kind, peer-reviewed evaluation demonstrates CARB-X delivers on its mission to accelerate life-saving innovation
(BOSTON: July 8, 2026) – Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) today welcomed the publication of the first-ever independent, peer-reviewed evaluation of a push incentive to address antimicrobial resistance (AMR). Published in Health Affairs Scholar, the new study found that research and development projects supported by CARB-X have nearly five times greater odds to advance into clinical development than projects of similar quality which were not funded by the global initiative.
“CARB-X support was positively and statistically significantly associated with advancement in phase,” the authors of the article stated. They also observed positive associations with patent activity and the continued operation of both the project and firm, though the latter were not statistically significant. The conclusion is that “the success of CARB-X helps address the AMR crisis by creating more promising drug candidates in the early part of the pipeline, an element that is needed.”
Revitalizing the pipeline of life-saving antibacterial products is an urgent global priority. Recent estimates project that AMR could cause 39 million deaths over the next 25 years, and that a sustained pipeline of new, potent antibiotics targeting Gram-negative bacteria, one of CARB‑X’s strategic priorities, could save 11.1 million of those lives. The development of new preventatives and diagnostics, which are also within the scope of CARB-X’s activities, would lead to even greater impacts.
“We now have independent evidence that shows the CARB-X public private partnership materially bends the curve in antibacterial innovation – significantly increasing the odds that life-saving products reach patients,” said Kevin Outterson, Executive Director of CARB-X. “Sustaining this momentum will require continued global commitment. To fully realize the potential of antibacterial incentives, governments and partners must stay engaged and invest at the scale needed to address the growing threat of drug-resistant infections.”
CARB‑X’s impact over the past decade has been possible through the support of its global funding partners: six of the G7 governments, the European Commission, and three of world’s largest health foundations. Based on the findings of the independent evaluation, the researchers suggest that future initiatives might “aim to shore up resources to support CARB-X.” A separate study on antibacterial innovation, published by the European Commission in 2023, found “there is relative consensus on the need to provide additional push funding, in a range between USD 250 and USD 400 million on an annual basis, and at a global level.” It also highlighted how crucial it is to “ensure international alignment and avoid duplication of efforts.”
Health Affairs Scholar is a fully open access journal that publishes peer-reviewed research about emerging and global health policy. It features high-quality research from a multidisciplinary community of scholars and policy leaders. The authors of the new study explain that “understanding the impact of CARB-X and other initiatives encouraging novel antibiotic development is important,” and that their “analytic approach ensures the greater success of funded projects can be attributed to CARB-X support, and not to an inherently superior set of applications.”
“For CARB‑X, monitoring, evaluation, and continuous improvement are central to how we operate,” said Genevieve Holmes, Chief Operating Officer at CARB-X. “Over the past decade, we have built robust processes to track performance, learn systematically from our portfolio, and improve the effectiveness of our global partnership. This independent, peer-reviewed evaluation represents an important validation moment for those efforts, confirming that our model is delivering measurable impact while reinforcing our commitment to transparency and accountability.”
When CARB-X was founded in 2016, the early-stage antibiotic pipeline was stalled. Since then, CARB-X has supported 123 R&D projects in 15 countries, and CARB-X product developers have made significant progress: 28 projects have advanced into or completed clinical trials; 17 remain active in clinical development, including late-stage clinical trials; and three products have reached the market. In addition, more than 10 product developers with active R&D projects have already secured advanced development partnerships which can help support their projects’ clinical development after leaving the CARB-X portfolio. All CARB-X-funded product developers are contractually obligated to develop a Stewardship and Access Plan for their product, outlining strategies to ensure responsible stewardship and appropriate access in low- and middle-income countries.
CARB-X is funded by federal funds from the U.S. Department of Health and Human Services (HHS); Administration for Strategic Preparedness and Response; Biomedical Advanced Research and Development Authority (BARDA) under agreement number 75A50122C00028 and by awards from Wellcome (WT224842), the UK Department of Health and Social Care’s Global Antimicrobial Resistance Innovation Fund (GAMRIF), the Gates Foundation, Germany’s Federal Ministry of Research, Technology and Space (BMFTR), the Novo Nordisk Foundation, the Public Health Agency of Canada, (PHAC), Italy’s Ministry of Economy and Finance (MEF), Japan’s Ministry of Health, the European Commission’s DG Health Emergency Preparedness and Response Authority (DG HERA), and KfW Development Bank. The U.S. National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH) in HHS, provides support in the form of in-kind services through access to a suite of preclinical services for product development. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of any CARB-X funders.
CARB-X Contact: Marissa Novel, carbxpr@bu.edu
About CARB-X
CARB-X (Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator) is a global non-profit partnership dedicated to supporting early-stage antibacterial research and development to address the rising threat of drug-resistant bacteria. CARB-X supports innovative therapeutics, preventatives and rapid diagnostics. CARB-X is led by Boston University and funded by a consortium of governments and foundations. CARB-X funds only projects that target the most serious, resistant bacteria identified on global priority lists, syndromes with the greatest global morbidity and mortality, and performance characteristics necessary for patients. https://carb-x.org/ | X (formerly Twitter) @CARB_X
About BARDA and NIAID
The U.S. Department of Health and Human Services works to enhance and protect the health and well-being of all Americans, providing for effective health and human services and fostering advances in medicine, public health, and social services. The Administration for Strategic Preparedness and Response leads the nation’s medical and public health preparedness for, response to and recovery from disaster and other public health emergencies. Within ASPR, the Biomedical Advanced Research and Development Authority (BARDA) invests in innovation, advanced research and development, acquisition, and manufacturing of medical countermeasures needed to combat health security threats. BARDA is one of the leading public sector funders of advanced development of antimicrobial therapeutics and diagnostics worldwide, having invested more than $2.7 billion in antimicrobial products since 2010. This investment has supported the development of over 190 antimicrobial products and led to the U.S. Food and Drug Administration (FDA) approval of six new antibiotics and FDA 510(k) clearance of 10 diagnostics.
As part of HHS, NIH is the primary U.S. federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses.
About Wellcome
Wellcome supports science to solve the urgent health challenges facing everyone. We support discovery research into life, health and wellbeing, and we’re taking on three worldwide health challenges: mental health, infectious disease and climate and health.
About the German Federal Ministry of Research, Technology, and Space and Research (BMFTR)
Research and innovation are the foundations for our future. The promotion of science and research by BMFTR represents an important contribution to securing Germany’s prosperity. Research is a German Federal Government policy priority, which is reflected in the development of the funding it is making available to these fields.
About the Global AMR Innovation Fund (GAMRIF)
The Global AMR Innovation Fund (GAMRIF) is a One Health aid fund that supports research and development around the world to reduce the threat of antimicrobial resistance (AMR) in humans, animals and the environment for the benefit of people in low- and middle-income countries (LMICs). GAMRIF core objectives are to develop innovative One Health solutions to tackle AMR; increase availability of context-specific, accessible, and affordable innovations for LMICs; establish international research partnerships with industry, academia, and governments; and collaborate with and leverage additional funding from other global donors.
About the Novo Nordisk Foundation
Established in Denmark in 1924, the Novo Nordisk Foundation is an enterprise foundation with philanthropic objectives. The vision of the Foundation is to improve people’s health and the sustainability of society and the planet. The Foundation’s mission is to progress research and innovation in the prevention and treatment of cardiometabolic and infectious diseases as well as to advance knowledge and solutions to support a green transformation of society. www.novonordiskfonden.dk/en
About the Ministry of Economy and Finance of Italy
The Italian Ministry of Economy and Finance (MEF) performs the functions and tasks incumbent on the State in matters of economic and financial policy, budgeting, public investment planning and public debt management. The Ministry’s activities include coordinating and monitoring public spending and its trends, tax policies and the tax system and state assets. Moreover, the Ministry represents the Italian Government in the main European and international economic and financial fora, performs functions related to global governance and international financial cooperation, maintains relations with international economic, monetary, and financial institutions (such as the IMF, OECD, and Multilateral Development Banks), and negotiates and concludes international agreements and treaties with economic and financial content.
About the Japan’s Ministry of Health, Labour and Welfare (MHLW)
MHLW is a ministry of the Government of Japan whose missions are to improve and promote social welfare, social security, and public health in order to secure and improve the livelihoods of the people and contribute to economic development. Recognizing the urgent global public health threat posed by AMR, MHLW has been supporting various domestic and international efforts to advance research and development of antimicrobials. MHLW has committed to providing contributions to CARB-X from 2024 to 2026.
About the Health Emergency Preparedness and Response Authority (DG HERA)
DG HERA is part of the European Commission, is responsible for ensuring the availability and accessibility of medical countermeasures needed to respond to cross-border health threats. It plays a central role in strengthening the EU’s preparedness and resilience against antimicrobial resistance and other health emergencies.
About KfW Development Bank
KfW is one of the world’s leading promotional banks and a key implementing partner of the German Federal Government. It finances and manages programmes that foster sustainable economic and social development and strengthen global health security, including through support for public–private partnerships and innovation in medical countermeasures.
About Boston University
Founded in 1839, Boston University is an internationally recognized institution of higher education and research. With nearly 37,000 students, it is one of the largest private residential universities in the United States. BU consists of 17 schools and colleges, along with the Faculty of Computing & Data Sciences and a number of multi-disciplinary centers and institutes integral to the University’s research and teaching mission. In 2012, BU joined the Association of American Universities (AAU), a consortium of leading research universities in the United States and Canada. For further information, please contact Meridith St. Jean at stjean28@bu.edu. www.bu.edu