WHO has published its very first list of antibiotic-resistant "priority pathogens" - a catalog of 12 families of bacteria that pose the greatest threat to human health. The WHO list is divided into three categories according to the urgency of the need for new antibiotics: critical, high priority and medium.
The list was developed to guide and promote research and development (R & D) of new antibiotics as part of WHO's efforts to address the growing global resistance to antimicrobial drugs. The list highlights in particular the threat of gram-negative bacteria that are resistant to multiple antibiotics. These bacteria have built-in abilities to find new ways to resist treatment and can transmit the genetic material that allows other bacteria to become equally resistant to drugs.
"This list is a new tool to ensure that R & D meets urgent public health needs," said Marie-Paule Kieny, WHO's Deputy Director-General for Health Systems and Innovation. "Antibiotic resistance continues to grow, and treatment options are no longer in the short term. If we leave the market to market forces alone, the new antibiotics we need most will not be developed in time.
The list is intended to spur governments to put in place policies that incentivize basic science and advanced R&D by both publicly funded agencies and the private sector investing in new antibiotic discovery. It will provide guidance to new R&D initiatives such as the WHO/Drugs for Neglected Diseases initiative (DNDi) Global Antibiotic R&D Partnership that is engaging in not-for-profit development of new antibiotics.
This list was developed in collaboration with the Division of Infectious Diseases, University of Tübingen, Germany, using a multicriteria decision analysis technique, reviewed by a group of international experts. The criteria for selecting pathogens on the list were: mortality of the infections they cause; If treatment requires long hospital stays; How often they are resistant to existing antibiotics when people in communities catch them; The ease with which they propagate between animals, animals to humans, and from person to person; If they can be prevented (eg by good hygiene and vaccination); How many treatment options remain; And if new antibiotics to treat them are already in the R & D pipeline.
The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia. These bacteria have become resistant to a large number of antibiotics, including third-generation carbapenems and cephalosporins - the best antibiotics available to treat multidrug-resistant bacteria.
The G20 experts will meet this week in Berlin. Hermann Gröhe, Federal Minister for Health, Germany, said: "We need effective antibiotics for our health systems, we must act together today for a healthier future. WHO priority pathogens is an important new tool for securing and guiding research and development related to new antibiotics.
"New antibiotics targeting this priority list of pathogens will help to reduce deaths due to resistant infections around the world," says Prof Evelina Tacconelli, Head of the Division of Infectious Diseases at the University of Tübingen and a major contributor to the development of the list. "Waiting any longer will cause further public health problems and dramatically impact on patient care."
