THE LANCET | The cost of research efforts and scale of AMR require an international, integrated and equitable approach to drug research, ownership and stewardship. While the authors recognize that a short-term intensification of public-private sponsorship (like CARB-X) is necessary to protect existing investments and prevent a global loss of antibiotic R&D expertise, they propose that public ownership of antibiotic R&D is a more attractive, sustainable and equitable medium-term to long-term solution to refilling the stalling antibiotic pipeline.