AntibioticCommons decouples antibiotic revenue from volume sold — the core market failure — through two interlocking mechanisms. First, a G20-funded subscription pool: participating governments pay an annual flat fee (~$1B total/year across 20 nations) for guaranteed access to a shared formulary of priority antibiotics, regardless of units consumed.

Revenue is distributed to manufacturers based on clinical value, not sales volume. 1% levy on hospital procurement budgets globally. A joint scientific committee (WHO + national agencies) maintains the priority pathogen list and evaluates milestone claims. Open-license clauses in prize agreements ensure generic production rights for LMICs within 3 years of approval.

Together these mechanisms restore R&D incentives, steward responsible use, and ensure equitable access.