In the latest in a series of moves responding to the global health threats posed by spread of antibiotic-resistant bacteria, the World Health Organization today released a list of “priority pathogens” calling for urgent and strongly supported research and development of new medicines to target the most dangerous among them.
Guiding selection of bacteria making the list, WHO officials said were the effectiveness of remaining viable drugs with which to control them, as well as associated death rates, prevalence and the burden they place on the health system. The list includes bacteria causing bloodstream, respiratory, skin and intestinal infections for which new treatments are needed and establishes three categories : “critical, high, and medium.” Among the highest priority, or “critical” category, are bacteria common in hospitals and nursing homes.
Mycobacterium tuberculosis, the pathogen that causes tuberculosis disease was not included on the list although its resistance to first and second lines of treatment has continued to increase and spread in health settings in recent years, because, the WHO announcement of the list said, “it is targeted by other, dedicated programmes.” WHO Assistant Director-General Dr. Marie-Paule Kieny elaborated on this decision in a telephone press conference, saying the tuberculosis causing bacteria “was not included in this exercise as there is already consensus that tuberculosis is the most important priority for research and development of new antibiotics.” Dedicated programs and consensus, however, have not overcome a lag noted by Treatment Action Group in its 2016 TB research and development funding report which showed that after a climb early this century, funding for biomedical solutions to gaps in tuberculosis treatment, diagnostics and a widely effective vaccine not only never effectively exceeded a 2009 peak, but in the last year dipped to its lowest level in eight years, with a drop of $53 million. In the meantime, TB treatment research and development saw a nearly half century gap before the development and marketing of the last new drug types targeting drug-resistant tuberculosis, and the two most recent, both approved within the last five years.
Making the list were bacteria recommended as the highest priorities for new drug development by the Infectious Diseases Society of America (which produces this blog), an association of infectious disease specialists that has worked to draw attention to the need for antibiotic research and development and improved management of the medicines for more than a decade including with its 2004 report Bad Bugs, No Drugs. The organization welcomed release of the list, urged U.S. and international policy makers to support its goals with resources and called for a comprehensive approach including through disease prevention, drug stewardship, and resistance surveillance through a “one health” approach encompassing antibiotic use in livestock and crops as well as human medical treatment.
The humanitarian response Médecins Sans Frontières released a statement calling the list “a valuable and urgently-needed tool,” while calling on governments worldwide to confront the needs that occasion their use, and also to ensure new drugs developed through government funding are universally accessible.