Establish an Antibiotic Market Entry Guarantee (AMEG) — a commitment from G20 governments to purchase new antibiotics at guaranteed minimum volumes and prices for 10 years, de-risking the investment case for novel antibiotic development.

Design: (1) Eligible drugs must be novel mechanisms (new class or significantly new activity against resistant organisms) approved by EMA, FDA, or comparable regulator. Me-too drugs are excluded.

(2) Guaranteed purchase volume: G20 governments commit to purchasing 500,000-1,000,000 treatment courses annually for 10 years at a minimum unit price ($200-500 per treatment depending on rarity of resistance). (3) Purchase is NOT for stockpiling but for actual use via national surveillance-guided deployment protocols.

(4) Revenue is separate from and complementary to traditional reimbursement; hospitals purchase at market prices but government 'tops up' to guarantee floor. This creates $2-5B annual market, sufficient to attract R&D investment while preserving price competition. Modeled on the successful advance market commitment for pneumococcal vaccines.