India’s prescription to tackle superbugs

IN 1928, Sir Alexander Fleming returned from a holiday to accidentally discover something that heralded a medical breakthrough: penicillin. It soon became the miracle cure for bacterial infections, which was a major cause of fatalities until then. Nearly a century later, on December 28, 2025, Prime Minister Narendra Modi had some advice during his Mann Ki Baat radio address. Quoting a recent Indian Council of Medical Research (ICMR) report, he warned of an imminent threat: antibiotics are proving ineffective against many diseases, including pneumonia and urinary tract infections (UTI). “Diseases and infections are proving to be too strong for these antibiotics. Medicines require guidance, and antibiotics require doctors. This practice will help to improve your health,” he said. He likely referred to the ICMR study, ‘Strengthening Antibiotic Access in India’. It flagged the indiscriminate use of antibiotics, often without a doctor’s intervention, as a key reason disease-causing microorganisms (bacteria, viruses, fungi, etc.) are becoming medicine-resistant ‘superbugs’. By offering a simple, straightforward solution to tackle antimicrobial resistance (AMR), Modi helped raise public awareness of a raging problem driven by the rampant misuse of antibiotics across medical, veterinary, and agricultural sectors worldwide. Ironically, antibiotic research has come full circle. Despite its discovery in 1928, it was not until the 1940s that penicillin started to be developed at scale. The decades from 1940 to 1970, known as the Golden Age of Antibiotics, saw the development of nearly two-thirds of all current antibiotic drug classes. Average human life expectancy rose dramatically — from 40–45 to about 72–73 years globally. Cut to 2026, the World Health Organization (WHO) now considers AMR to be one of the Top 10 health threats, undermining the effectiveness of essential treatments and placing millions at risk of untreatable infections. WHO’s AMR Report 2025 states that in 2023, antibiotic-resistant bacteria caused nearly one in six laboratory-confirmed infections. In 2021, bacterial AMR was linked to around 1.14 million deaths globally. By 2050, this figure could be as high as 10 million deaths every year, the WHO estimates. India is highly vulnerable, given its dense population, high disease burden, and diverse healthcare practices. This vulnerability is also the reason why India is the best place to fight AMR. Despite India’s reputation as the “ground zero” of the global AMR crisis, the ICMR study emphasises that the country may lie at the heart of the solution. “Given its scientific expertise, clinical resources, and pharmaceutical sector, India has everything it needs to not only reverse the crisis within its own borders, but also to lead the way in the global AMR response. India is home to one-fifth of the world’s population, and existing evidence shows increasing levels of AMR. The size of the population and the levels of AMR mean that, studies conducted in India... can be carried out on large and highly relevant populations, delivering robust results,” the report states. Scientific expertise and the industry aside, India fulfils another criterion: economies of scale. High antibiotic demand in populations as large as India’s makes business sense for investments. Multipronged interventions are needed to tackle superbugs. The Prime Minister’s advice is one. India and the world also need new antibiotics to combat drug-resistant, disease-causing germs, diagnostic tools to identify AMR pathogens, technologies to neutralise them, devices to stop the spread of drug-resistant infections, and a lot more. While the Mann Ki Baat’s 129th episode did not discuss all those measures, the Centre, research centres, companies, startups, and even impact funds are working hard to find solutions to tackle the problem. Many such extremely promising attempts could offer solutions not just for India, but for the world. On January 2, Mumbai-based drug major Wockhardt Ltd received the Central Drugs Standard Control Organisation’s (CDSCO) approval for nafithromycin, the country’s first indigenously developed antibiotic for community-acquired bacterial pneumonia, including illnesses caused by multidrug-resistant pathogens. The regulatory nod came after more than 15 years of extensive non-clinical and clinical studies, including human trials in the U.S., Europe, South Africa, and India. For about 25 years, Wockhardt focussed its research efforts on developing antibiotics for multidrug-resistant infections, which resulted in a portfolio of six products, including nafithromycin, at various stages of clinical development and commercialisation, each of which holds the U.S. Food and Drug Administration’s (FDA) Qualified Infectious Disease Product (QIDP) status. Wockhardt claims it is the only company globally to receive the QIDP status for six products effective against untreatable ‘superbugs’. Chennai-based Orchid Pharma is another pioneer. Now part of the Dhanuka Group, the company out-licensed its research drug, enmetazobactam, to Allecra Therapeutics in Germany during the clinical trial stage in 2013, while retaining the rights to develop and sell the product in India. “Enmetazobactam, in combination with cefepime, is a significant breakthrough against multidrug-resistant infections. It is the first molecule invented in India to get U.S. FDA approval,” says Manish Dhanuka, MD, Orchid Pharma. It has also received approvals from the U.K.’s Medicines and Healthcare products Regulatory Agency and CDSCO, to treat serious infections such as complicated UTI (cUTI) and hospital-acquired pneumonia, often caused by resistant pathogens. “With increasing resistance to the current drugs — for instance, Piperacillin-tazobactam for cUTI — doctors were forced to start using carbapenems, a reserve drug meant to be used when most other drugs don’t work. Orchid’s Cefepime-enmetazobactam will allow doctors to spare carbapenems, prolonging their effective life by restricting their use,” says Dhanuka. In 2024, Orchid partnered with domestic rug maker Cipla to market the antibiotic combination across India. Panchkula-based Venus Remedies is another AMR-focussed company. It has launched a fixed-dose antibiotic formulation under the brand name Elores to tackle multidrug-resistant infections. The company also out‑licensed it to Cipla for the Indian market in 2019, thereby ensuring a wider reach. “Elores became one of India’s most successful critical care antibiotics, demonstrating our ability to take the molecule from concept through regulatory approval,” says Saransh Chaudhary, president, global critical care, Venus Remedies. Venus also received QIDP status for one of its investigational products meant to tackle AMR. It also runs GASAR (Genetic Assessment and Surveillance of Antibiotic Resistance), India’s largest private AMR surveillance study. “The study is part of our broader commitment to combating AMR and contributing to the UN’s ‘One Health’ objective,” Chaudhary, who is also the CEO of Venus Medicine Research Centre, says. Wockhardt and Orchid are early entrants in the segment where the market is small (as it is used only when other antibiotics don’t work). But that doesn’t deter newer players, as the ability to save lives makes it a high-value market. For instance, Bugworks Research India, a Bengaluru startup, hopes to take India’s fight to the next level through its broad-spectrum antibiotic, currently under development. Anand Anandkumar, CEO and MD of Bugworks, says the world is now waiting for solutions from India because other companies and countries seem less interested. “Our lead molecule has now been tried out as IV (intravenous/injection) and oral (tablet). There is no novel broad-spectrum IV with oral option available anywhere. We have spent the last year and a half perfecting the formulation. We now have an IV formulation undergoing clinical trials. The tablet form is also getting ready for phase I clinical trials in 2026,” he says. The oral programme will be announced after the completion of the IV clinical trials. Anandkumar is confident that these products will be used to treat serious infections. It will be life-saving for populations with limited access to clinics and hospitals, he adds. “We could have a product by 2029-end if markets like India allow us early approvals and early access. We may take more time to complete the trials in the U.S.,” he says. That said, the U.S. government has a favourable outlook because it is a single product that addresses public health and bio-defence issues, Anandkumar explains. Then comes the Foundation for Neglected Disease Research (FNDR). This not-for-profit biotech R&D entity focusses on discovering and developing novel therapeutics, diagnostics, and devices for diseases with a high socio-economic impact. It considers the fight against drug-resistant microorganisms integral to its mandate. All its research is AMR-linked. “Our most advanced asset is one for tuberculosis, developed in partnership with TB Alliance. It is a novel molecule and a novel mechanism. We have completed phase II clinical trial in South Africa. The molecule has shown efficacy in TB [treatment],” says Shridhar Narayanan, chairman, CEO, & co-founder of FNDR. He aspires to bring the molecule back to India and work with the government for further development. “Our drug will work on sensitive and drug-resistant cases.” He flags another issue: antibiotic pollution of water. Antibacterial agents released from drug manufacturing units, poultry, animal husbandry, and pharma industries, and hospitals often end up in water bodies. Drugs consumed also get eliminated through faeces or urine, and get into the water supply. FNDR, whose work spans drugs, devices, and diagnostics, has developed a tool that can eliminate 25-30 commonly used antibiotics from contaminated water. “The device can absorb more than 90% antibiotics. We are trying to improve it,” Narayanan claims. The solution is less than 12 months away from being deployed. “We have done a field trial in a hospital. We have seen that with our initial prototype device, we could remove almost 70-80% of the antibiotics that were being flushed through the ETP (effluent treatment plant) in the hospital.” When it comes to AMR-related innovation support, Bengaluru-based Centre for Cellular and Molecular Platforms (C-CAMP), an initiative of the Department of Biotechnology, is India’s leading entrepreneurship hub that facilitates funding, advanced incubators, and mentorship and business accelerator programmes to create a vibrant ecosystem for nurturing life-saving innovations. On February 26, it organised an India AMR Innovation Workshop in New Delhi. The event featured the launch and technology showcase of 14 breakthrough innovations supported by C-CAMP, including air sterilisation systems, rapid genomics-based diagnostics and surveillance, treatment of biopharmaceutical wastewater effluents, and antibiotic-free aquaculture, among others. “We must work together to foster solutions for AMR by leveraging cutting-edge research and innovation through the convergence of mandates and collaborative action that IAIH (India AMR Innovation Hub) stands for,” said Taslimarif Saiyed, CEO and director of C-CAMP, at the workshop backed by the Office of the Principal Scientific Adviser to the central government and IAIH, the official innovation arm of the National Action Plan (NAP 2.0) on Antimicrobial Resistance, launched by the Ministry of Health and Family Welfare in November 2025. In a separate interaction, Saiyed tells Fortune India that C-CAMP has supported about 75 exciting AMR-related innovations in 10 years. “Over many years, we have been able to become the leading national organisation to support AMR innovations. We are working with national and international partners to do this,” he says. Recently, C-CAMP received support from the U.K.-based Global AMR Innovation Fund to develop innovative AMR solutions for the environment. “It is only a subcomponent of the larger AMR field, which also includes a human component, an agri and animal health component, and an environmental component,” Saiyed explains. It has also partnered with the Denmark-based International Centre for Antimicrobial Resistance Solutions to advance One Health AMR innovation. “U.S.-based CARB-X is a long-time partner as well for innovations in human health, with emphasis on the WHO-designated priority pathogens known as the ESKAPE pathogen domain. Nationally, we are funded by SBI Foundation,” he adds. ESKAPE pathogens are a group of six highly virulent and multidrug-resistant bacteria that are the leading cause of hospital-acquired infections worldwide. C-CAMP is now India’s nodal point in addressing the AMR menace. It has been supporting AMR-related diagnostics in human health and therapeutic work, such as drug discovery and screening, and now agri-, animal-, and environmental health solutions. While several global organisations focus on AMR, Saiyed says C-CAMP is among the few looking to build science-based solutions. Incidentally, one of the early companies that received C-CAMP support is Bugworks. The other promising ones include GangaGen (specialising in discovering, designing, and developing novel therapies to treat serious bacterial infections) and Diagopreutic Pvt. Ltd (manufacturer of ESKAPE IVD Kit — a game-changing phenotypic antimicrobial susceptibility testing solution), Biomoneta Pvt. Ltd (developing devices to prevent the spread of drug-resistant infections in healthcare environments), and Mylab Discovery Solutions (developing tools for rapid detection of pathogens from wastewater samples and detection of environment-related antibiotic resistance genes). All these efforts re-emphasise the point Prime Minister Modi was trying to make: AMR is a national problem. And the government and other stakeholders have begun to acknowledge the scale of the problem.

India’s prescription to tackle superbugs

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