The announcement of the list of “priority pathogens” was timed to hit the headlines ahead of the meeting of G20 health experts which occurred in February 2017 in Berlin, where the issue of antimicrobial resistance is once again on the agenda. The aim of the list is to encourage governments to offer incentives for R&D into new antimicrobials by both public and private research groups, says the WHO, and also to find ways to preserve the efficacy of the rapidly dwindling reserve of effective drugs.
Germany’s Health Minister Hermann Gröhe pledged to push for joint action at the G20 meeting, saying: “We have to take joint action today for a healthier tomorrow. Therefore, we will discuss and bring the attention of the G20 to the fight against antimicrobial resistance.” Many of the 12 bacterial families on the list are multidrug resistant (MDR) strains that are a serious threat in clinical units such as hospitals and nursing homes, and in patients who need to be catheterized or have ventilator support.
Many companies in the pharma industry have abandoned antibiotic research to focus on more profitable chronic diseases such as cancer and diabetes, and while some programs such as cross-company consortia have been set up to try to kick-start antimicrobial R&D, these efforts are simply not sufficient, says the WHO. “Antibiotic resistance is growing, and we are fast running out of treatment options,” says the WHO’s assistant director-general for health Systems and innovation Dr Marie-Paule Kieny, who told reporters on a conference call that the antibiotic pipeline is “practically dry.”
“If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.”
A 2015 report commissioned by the UK government estimates that antimicrobial resistance could kill more people than cancer by the middle of the century at a cost to society of an eye-watering $100 trillion. The UK has also proposed a scheme that could offer up to $1 billion in prize money for research teams that can come up with effective new drug classes, funded by a surcharge levied on life science companies who decide not to invest in antibiotic R&D.
The WHO’s list includes a group of critical pathogens such as Acinetobacter, Pseudomonas and various Enterobacteriacea—including Klebsiella, Escherichia coli, Serratia, and Proteus species—that have become resistant to a large number of antibiotics including the latest carbapenem and third-generation cephalosporin drugs.
Two other categories of high- and medium-priority pathogens have been drawn up which include other drug-resistant bacterial diseases such as gonorrhoea and food poisoning caused by Salmonella. The list does not include tuberculosis, as there is already consensus that this is a priority area for R&D, said Kieny.
The ranking of the pathogens is based on how deadly they can be, their tendency to develop resistance mutations, whether infections can lead to long hospital stays and how easily they are transmitted.
REFERENCE: Fierce BioTech; 28 FEB 2017; Phil Taylor