ReAct welcomes the published WHO priority pathogens list (PPL), which is the first global effort to guide and promote research and development (R&D) of new antibiotics. The major objective of the PPL is to guide the prioritization of incentives and funding, help align R&D priorities with public health needs and support global coordination in the fight against antibiotic-resistant bacteria. The selection was based on several parameters as found in literature searches and by the opinion of an expert panel. The list comprises 12 bacterial pathogens placed in three priority tiers: critical, high and medium.
ReAct commends the WHO Priority Pathogens List in its effort to guide antibiotic research and development to the greatest needs: increasingly multi-drug resistant pathogens, new classes of antibiotics without cross-resistance to existing classes and focus on paediatric populations.
Although not placed in the highest tier, the panel stressed the importance of new antibiotics for community diseases with a high morbidity burden such as drug-resistant Neisseria gonorrhoeae and Salmonella typhi. Salmonella typhi causes approximately 21 million cases of typhoid fever and is associated with 222 000 deaths annually (1). Neisseria gonorrhoea is the second most common bacterial cause of a sexually transmitted disease with an estimated 78 million new cases in 2012 (2), with the greatest burden in resource-limited countries. ReAct also reminds that not all existing antibiotic treatments and prevention measures are readily available in low and middle-income countries.
As noted in the accompanying report, there are however limitations of the current evidence for infections due to antibiotic-resistant bacteria in community and healthcare settings, in particular with respect to the frequency and burden of infections. This points to the need for quality population based resistance data and health burden, specifically in low and middle-income countries. This data can also then feed into a continuous pipeline analysis, which could be performed by the newly established R&D observatory (3).
1.WHO page on Typhoid. http://www.who.int/immunization/diseases/typhoid/en/
2.WHO Guidelines for the treatment of Neisseria gonorrhoeae, 2016. Available at: http://www.who.int/reproductivehealth/publications/rtis/gonorrhoea-treatment-guidelines/en/
3.Global Observatory on Health R&D. http://www.who.int/research-observatory/en/