The unchecked growth of drug-resistant infections – which are increasingly hard to treat – is a silent pandemic with long-term consequences for global public health and the global economy. According to recently released data published in the Lancet, at least 1.27 million people died of drug resistant infections in 2019. Antimicrobial resistance (AMR) also threatens the viability of surgical and curative medical interventions, such as chemotherapy. It is no longer a threat with future consequences, but a complex existential emergency of infections by multiple microbes. Many countries lack access to existing antibiotics, while in other countries rising rates of resistance require new treatments that have not yet been developed. Drug-resistant infections are a long-term challenge for which governments, including through G7 leadership, as well as the private sector, and civil society, must construct a durable infrastructure to prepare and respond. One pressing concern is for this infrastructure to ensure sustained research and development of novel antibiotics that address priority infections, and responsible access to novel and existing antibiotics to save lives and assure the long-term viability of such critical countermeasures.