A Stronger Path Forward for Infection Control and Antimicrobial Resistance: Learning From COVID-19
A stronger path forward for infection control and antimicrobial resistance
Kevin Outterson, executive director of CARB-X and BU Law’s Austin B. Fletcher Professor of Law photographed by Nikita Kruglov.
A Stronger Path Forward for Infection Control and Antimicrobial Resistance: Learning From COVID-19
Five years ago, the world was thrust into an unprecedented health crisis with the COVID-19 pandemic. At the time, hospitals, governments, and health organizations scrambled to respond, focusing massive attention and resources on curbing the viral threat. Fast-forward to today, and while we’ve made progress in dealing with COVID-19, we find ourselves facing another looming, but less immediately visible, crisis: antimicrobial resistance (AMR). The parallels between the two health threats are striking, but the global response to AMR has not been as urgent or coordinated as it was for COVID-19. This disparity presents an opportunity to reflect, reset, and refocus our efforts on a more sustainable and holistic approach to infection control—one that addresses both viral and bacterial threats and tackles AMR head on.
The burden of bacterial infections is not new. During the 1918 flu pandemic, bacterial pneumonia was responsible for more deaths than the influenza virus itself. The bubonic plague, which wiped out a third of Europe’s population in the 14th century, is caused by bacteria. Centuries before, it ravaged the Roman Empire. Yet, despite this long history, pandemic planning has predominantly focused on viral outbreaks, leaving bacterial threats relatively neglected.
The COVID-19 pandemic taught us that we should not rely on luck or short-term responses. The boom-and-bust funding cycles seen during the early years of COVID-19 have hindered long-term infection control. Hospitals still struggle with the lingering impacts of the pandemic, including staff shortages and overwhelmed healthcare systems. Moving forward, we must ensure that infection prevention—both viral and bacterial—is a consistent, long-term priority.
While the world’s response to COVID-19 has improved our preparedness for viral pandemics, we cannot afford to overlook bacterial threats.
As we look ahead, our response to infections must be more comprehensive. Strengthening healthcare infrastructure to better handle both viral and bacterial outbreaks is critical. We need to protect vulnerable populations—such as the elderly and those with underlying conditions—who are at higher risk for both types of infections. Equally important are enhanced surveillance systems to track both drug-resistant patterns and viral outbreaks, ensuring more coordinated responses.
A key component of this strategy is a renewed commitment to research and development (R&D). Just as we saw success with Operation Warp Speed for COVID-19 vaccines, we need similar urgency for R&D in diagnostics, treatments, and preventatives for bacterial infections. New antibiotics, vaccines, and diagnostic tools are urgently needed to address AMR and ensure we are not caught off guard by future crises.
While the world’s response to COVID-19 has improved our preparedness for viral pandemics, we cannot afford to overlook bacterial threats. By investing in R&D and strengthening our healthcare infrastructure, we can build a more resilient global health system that is better equipped to tackle both viral and bacterial infections, today and in the future.
Kevin Outterson is executive director of CARB-X (Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator) and Austin B. Fletcher Professor of Law at BU School of Law. Since its launch in 2016, CARB-X has awarded nearly $500 million in non-dilutive funding to antibacterial product developers, advancing more than 100 projects in 13 countries. CARB-X is led by Boston University and funded by a consortium of governments and foundations. Most recently, the Italian government committed $21 million to CARB-X in October 2024 to help drive the advancement of new antibiotics, vaccines, and rapid diagnostics for infections that don’t respond to existing treatments.
