Antibiotic innovation has slowed since the 1980s and incentivising research and development (R&D) has triggered substantial investment by the international community. This presentation draws on a mixed methods analysis of scientific papers, policy reports, oral histories, and industry reporting to reconstruct evolving innovation concerns and interventions between 1980 and 2024. It shows the importance of the emerging metaphor of the empty antibiotic pipeline and its underlying diagnosis of market failure in transforming a public health threat into a market and innovation challenge. Despite disagreement over concrete financial models, this  reframing of antimicrobial resistance (AMR) suited industrial, donor, and high-income country interests during a time of significant change in Global Health politics. However, despite significant investment of public funds, the resulting public-private innovation ecosystem has so far failed to sustainably reinvigorate R&D and address ongoing access problems and supply chain volatility. The presentation argues that realigning market and public health values not only depends on diversifying the geographies and investment ecologies driving R&D, but also on broadening popular concepts of innovation to encompass processes of recycling and repurposing.

Claas Kirchhelle is a historian of ‘bugs and drugs’. He works as an Associate Professor for the French National Institute of Health and Medical Research (INSERM) and is based at the interdisciplinary CERMES3 Unit in Paris. His research focuses on everything related to the history of microbes, laboratory infrastructures, and the development, marketing, and regulation of antibiotics and vaccines (https://www.bugsdrugs.org/).