International Multi-Sectorial Partnerships as New Models for Antibiotics Innovation

The antibiotic market is facing a crisis caused by the phenomenon of antimicrobial resistance (AMR) and economic models to reorganize this market are being studied. AMR makes the Research and Development (R&D) of new antibiotics unprofitable and unattractive (1), although they are urgently needed for global health. Over the last few years, the joint efforts of academia and public institutions, such as in the DRIVE-AB project (2), have identified several potential alternative economic models that incentivize innovation in the antibiotic market by stimulating R&D. However, more evidence on the effectiveness of these models is needed.

One such model called “International Multi-Sectorial Partnership” (IMSP) includes the creation of a coordination mechanism among the different public and private actors involved in the R&D and production of new antibiotics (3). As large pharmaceutical companies have dropped their investments in antibiotics R&D, small and medium-sized enterprises (SMEs) are left on the market. Thus, IMSPs aim at supporting companies in one or more of the antibiotic R&D phases, by connecting them to key resources, creating collaborations, and supporting them in specific areas (e.g., regulatory requirements). Examples of IMSPs are CARB-X, GARD-P, ENABLE, and BARDA (Figure 1).

Figure 1. International Multi-Sectorial Partnerships (IMSPs) and the corresponding phases of the pharmaceutical research and development (R&D) process.

So far, IMSPs have been analysed by studies identifying their key dimensions and scope (3), structural features and governance form (4, 5). Relevant dimensions include how levels of vertical integration, strength of coordination, number of innovations supported, ownership of property rights, operating tools offered (services and activities), and financial tools vary across different IMSPs. The governance form of IMSPs has been defined as innovative since it relies both on the collaboration among many independent organizations, and on a strong coordination structure to accomplish a complex and high-risk task (4).

Nevertheless, current literature has not yet analysed the effects IMSPs may have on the overall field of antibiotics. Indeed, it can be argued that IMSPs are re-organizing the field through a paradigm shift from the traditional in-house R&D within an individual company into an inter-organizational network model, where the different functions, such as strategic decision making, cost & funding structures, knowledge transfer, innovation processes and HR management, are shared among different partners and coordinated by IMSPs (Figure 2). 

Figure 2. Paradigm shift from the traditional in-house R&D process to the IMSP model.

Therefore, this project will explore the following research questions:

  1. Which are the main differences in the configurations of activities between the traditional in-house R&D in a company and an IMSP in the antibiotic market (e.g., in terms of governance, control mechanisms, cost structures, knowledge transfer)?
  2. How does moving R&D from in-house to an IMSP partnership affect a company in the antibiotic market in terms of international strategy, strategic changes in innovation management, and its business network?
  3. How do IMSPs with a focus on innovation on the antibiotic market relate to other IMSPs aimed at supporting other phases of antibiotic life (e.g., PLATINEA, focused on accessibility and stewardship)?

Ultimately, the objective of this project is to contribute to AMR research by understanding the behaviour and ongoing development of the companies active in the antibiotics field. Analysing how they interact in the new IMSP model will allow to better understand its functioning and to improve its effectiveness in developing and bringing to market new antibiotics.

Researchers at UU

Olof Lindahl

Associate senior lecturer/Assistant Professor at Department of Business Studies


Project Coordinator at Uppsala Antibiotic Center

Associate senior lecturer at Uppsala Antibiotic Center

Related published research

  1. Ciabuschi, F., & Lindahl, O. 2018. “The Decline of Innovation in the Antibiotics Industry and the Global Threat of Antibiotic Resistance: When Entrepreneurial Efforts are Not Enough”. In Entrepreneurship and the Industry Life Cycle (pp. 205-229). Springer, Cham.
  2. Årdal, C., Findlay, D., Savic, M., Carmeli, Y., Gyssens, I., Laxminarayan, R., Outterson, K., and Rex., J. H. 2018. “DRIVE-AB report - Revitalizing the antibiotic pipeline”. Available at:
  3. Baraldi, E., Lindahl, O., Savic, M., Findley, D., & Årdal, C. 2018. “Antibiotic Pipeline Coordinators”. The Journal of Law, Medicine, & Ethics
  4. Ciabuschi, F., Baraldi, E. & Lindahl, O. 2020. “Joining Forces to Prevent the Antibiotic Resistance Doomsday Scenario. The Rise of Antibiotics International Multisectorial Partnerships as a New Governance Model.” Academy of Management Perspectives
  5. Kronlid, C. 2020. “Engineered temporary networks. Effects of control and temporality on interorganizational interaction”. Uppsala Dissertations from the Faculty of Science and Technology 142. 242 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-513-1025-1.
Last modified: 2022-02-02