ZURICH. While global health agencies warn of a coming era in which routine infections kill again, a cluster of laboratories in Basel has quietly assembled one of the world's most productive antimicrobial research pipelines. Between the university, the tropical institute and the pharmaceutical corridor along the Rhine, more than a dozen experimental compounds against resistant bacteria are now in active development.
The latest addition, reported this month by a University of Basel team, is a molecule that disables the efflux pumps bacteria use to expel antibiotics before the drugs can act. Efflux pumps are protein valves embedded in the bacterial cell wall, and blocking them in effect restores the potency of existing antibiotics that bacteria had learned to resist.
The approach is deliberately unglamorous. Rather than hunting for an entirely new antibiotic, which can take 15 years, the Basel strategy pairs a pump-blocker with an old drug, reviving combinations the market abandoned. Early tests against multi-resistant strains of Klebsiella and Acinetobacter, two of the hospital pathogens that frighten clinicians most, showed the combination clearing infections in animal models at safe doses.
The significance extends well beyond Switzerland. The World Health Organization estimates that antimicrobial resistance directly caused more than one million deaths annually even before the pandemic, and the pipeline of genuinely new drugs has been nearly empty since the 1990s. A viable resistance-breaker would change treatment protocols in hospitals on every continent.
The concentration of expertise in Basel is no accident. The city's pharmaceutical majors, including Roche and Novartis, retain antibacterial units that most of their competitors closed, and the Swiss Tropical and Public Health Institute contributes decades of field experience from resistant infections in Africa and Asia. Federal funding through the National Research Programme on antimicrobial resistance, running since 2016, knitted the pieces together.
The cluster has also revived approaches the industry once shelved. A Basel group is engineering bacteriophages, viruses that hunt specific bacteria, as precision treatments for infections that no antibiotic touches, drawing on phage collections assembled in eastern Europe a century ago. Another unit mines soil samples from Swiss alpine meadows for microbes whose chemical warfare has never been catalogued.
The researchers are frank about the limits. The pump-blocker works against Gram-negative bacteria only, leaving the resistant staphylococci untouched, and bacteria will eventually evolve around it, as they do around everything. Toxicity at higher doses also remains a concern that the animal data have not fully resolved. The honest framing is that the compound extends the useful life of existing drugs rather than replacing them.
“We are not claiming to have beaten resistance,” said the project's principal investigator. “We are claiming to have bought time, which in this field is a genuine victory.”
The route from the Basel laboratory to the clinic now runs through a licensing agreement with a mid-sized pharmaceutical partner, which will fund the first human safety trial. That trial, involving around 90 healthy volunteers, is planned to begin within eighteen months at a university hospital.
If safety is confirmed, combination trials in infected patients would follow, with realistic hopes of a marketable product around 2030. The team is meanwhile screening a library of related molecules for compounds active against a broader range of bacterial families.
Basel's position illustrates a wider shift in how antibiotic research is financed. Because new antibiotics must be used sparingly to remain effective, they make poor commercial products, and governments have begun experimenting with subscription-style purchase guarantees. Switzerland is among the countries piloting such schemes.
The quiet accumulation of results along the Rhine suggests that the model can work. Resistance, as the researchers like to say, never takes a holiday, but in Basel it is at least being made to work for its living.