The United Nations Office at Geneva
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WHO - Press conference: update on drug-resistant bacteria
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24:26
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1.4 GB
WHO plans to release its updated Bacterial Pathogen Priority List (BPPL), featuring 15 families of antibiotic-resistant bacteria of public health importance. This revised list reflects how antimicrobial resistance (AMR) is evolving and highlights the importance of continuous research and development (R&D), surveillance, and investments to address emerging public health threats.
Like the first BPPL released in 2017, the bacteria are organized into critical, high, and medium priority tiers, offering a structured approach for targeted interventions and resource allocation.
Speakers:
- Dr Alexandra Cameron, Senior Advisor, and acting Unit Head of Impact Initiatives and Research Coordination, WHO AMR Division.
- Dr Hatim Sati, BPPL project lead. Technical Officer, WHO AMR Division.
Moderated by: Tarik Jasarevic, WHO spokesperson
Teleprompter
uh, good morning, everyone. Uh, from, uh,
UN headquarters in Geneva.
And welcome to this press point from the World Health Organisation
on updated bacterial priority pathogen list. We have sent yesterday
to you a credit to reporters.
Press release.
This press point is not under embargo. The press release alongside the
report and other supporting
documents will be published shortly on the
website and available to everyone.
What we wanted really today is to bring our experts to tell you about
this list. You may have remembered that
that
in 2017 we issued
what we call
a
bacterial priority pathogen list. And since then, lots of work has been done.
And now we are issuing updated lists. So for that,
we have here Dr
Alexandra Cameron, who is our senior expert with in the
Department of Antimicrobial Resistance, and
Dr Haim
Sati,
who is a project lead for this Priority pathogen list within the same
antimicrobial resistance department of the World Health Organisation.
So with that, I'll give the floor first to Dr
Cameron to put a little bit the publication of this update,
at least into broader context of antimicrobial
resistance.
Dr.
Cameron,
thank you very much. and good morning. Good afternoon.
We're pleased to be here today to announce the
launch of the 2024 WHO Bacterial Priority Pathogens List,
which identifies antibiotic resistant bacteria that
pose the greatest challenge to human health
due to antimicrobial resistance, or AM. R
AM R occurs when bacteria, viruses,
fungi and parasites change over time and no longer respond
to our our current medicines,
making infections harder to treat and increasing the risk of disease spread,
Severe illness and death.
AM R is a public health crisis.
It's estimated that bacterial infections resistant to antibiotics were
associated with close to 5 million deaths in 2019,
and low and middle income countries bear the bulk of this burden.
For this reason,
ensuring that we continue to have antibiotics available to
treat drug resistant infections is a critical need.
However, the world is facing an antibiotic pipeline and access crisis.
Current research and development is insufficient to
deliver the innovative antibiotics we need to
treat drug resistant infections,
and many countries are facing a lack of equitable access
to new antibiotics as well as to existing antibiotics.
The Bacterial Priority Pathogen list categorises antibiotic resistant
bacteria into critical high and medium priority groups
by identifying resistant bacteria that pro pose
the greatest challenge to public health.
The list aims to guide research and development of new antibiotics
as well as public health interventions
to areas of greatest need.
The first bacterial priority pathogen list was published by WHO
in 2017.
Since that time,
it's played a crucial role in guiding investments
in research and development towards priority pathogens.
However, we still do not have the pipeline that we need.
The list has also served as a basis for
activities related to surveillance and control of AM R.
The 2017 WHO Bacterial Priority Pathogens list has been updated to reflect the
evolving nature of AM R and to incorporate new evidence on AM R,
disease burden and trends.
The new list emphasises the need to intensify research and development
as well as public health efforts
against resistant bacteria that represent the greatest public health threat,
especially in low and middle income countries.
The Bacterial Priority Pathogen list is one of a
number of steps that WHO is taking to address
the antibiotic pipeline and access crisis.
WHO also assesses the antibacterial research
and development pipeline on an annual basis
and will soon be publishing the next edition,
which looks at the current state of the pipeline
against the updated priority list.
I'll now hand over to my colleague doctor Hatim
Sati,
who will provide an overview of the key highlights
of the new WHO Bacterial Priority Pathogens list.
Thank you, Ali and Good morning, everyone
and thank you for your time and attention. Today
I am Dr Haim
Sati,
the technical lead for the project,
and I am pleased to share the top line results from the 2024
updates of the Bacterial Priority Pathogens list.
Over the past two years, we have conducted an extensive
comprehensive assessment of the most
threatening antibiotic resistant bacteria.
The scientific assessment considered factors such as mortality, disability
caused by these bacteria,
their preventable transmissibility resistance
and the availability of treatment options,
including treatment candidates in the pipeline.
Accordingly, we have categorised the pathogens into three
priority categories. These categories are labelled critical, high and medium.
First, I would like to highlight some of the critical priority pathogens
in the critical category.
Gramme negative bacteria resistant to the last
resolved antibiotics remain a critical concern.
They cause severe infections like pneumonia,
complicated intra abdominal infections,
complicated urinary tract infections and bloodstream infections,
especially in hospitalised patients.
These bacteria are notorious for their ability to acquire resistant to Ava
killing,
but also to share these tricks among one another
to evade the available antibiotics.
These multidrug resistant gramme negative bacteria
are of major concern due to their high mortality and high economic burden globally.
Also newly categorised into the critical category in the 2024 update
is multidrug resistant TB.
Multi drug resistant TB disease is exceedingly difficult to treat.
It poses a significant threat to the global TB prevention and control efforts
as it's associated with high morbidity and mortality,
especially among vulnerable populations.
Next,
I would like to emphasise some examples of bacteria from the high priority category
in this category and probably this is one of the major updates.
Community pathogens prevalent in low and
middle income countries such as salmonella,
TaII,
shigella
gained prominent placement in the updated highlight,
and this highlights the prominence of these pathogens globally.
These pathogens are becoming increasingly resistant to antibiotics,
leading to a higher disease burden, especially among vulnerable groups.
Take, for example, salmonella typhi, the causative agent of typhoid fever.
It leads to a potentially life threatening illness,
and in severe cases it can lead to intestinal perforation and systematic,
systematic infections and death.
Shigella
is known for causing a highly contagious dial
diseases.
It can lead to severe dehydration and in some cases can be fatal,
particularly to young Children and individuals with immunocompromised systems.
Also in the high priority category is multidrug
resistant niia
gonorrhoea.
Gonorrhoea is a prevalent STI, as you may know,
and the untreated infections disproportionately impact young adults and
particularly women in low and middle income countries,
leading to complications like infertility, pelvic inflammatory disease
and others.
The rise of antibiotic resistant
has made treatment of gonorrhoea more challenging,
and therefore it is categorised in the high category.
One last example from this category is methicillin resistant Staph
aureus, or mercer
for short
Mersa
infections present challenge in various healthcare settings,
especially in long term assisted living facilities across the world.
Outbreaks are happening and reported since 2017 regularly.
The economic burden, as well as the fatal burden of this infection, is large and
particularly impacting hospitalised patients
in healthcare facilities across the world.
Lastly, the medium priority category
includes new
additions to the list
bacteria such as Group A and group B, streptococcal
and streptococcus pneumonia.
These bacteria can be resistant to various antibiotics
and can cause a range of infections, mostly impacting vulnerable populations,
particularly in elderly and newborns.
Take, for example, streptococcus Group A.
It can cause mild or asymptomatic infections in adults. However,
in newborns it can lead to neonatal sepsis.
It can lead to meningitis, which is the inflammation of the brain covering,
and in severe cases it can result in bacteremia and death.
To protect babies, you need access to quality, preventive antibiotics
and access to quality health care systems.
These are just some of the highlights,
but the list also covers other important antibiotic resistant bacteria,
and we invite you to review the list and the report for more details.
One important point we would like to emphasise
is the importance of tailoring and contextualising,
the list considering factors such as geography,
ecology, variation,
healthcare, infrastructure and population demographics.
Regional health authorities,
national health authorities and local healthcare professionals are
encouraged to read this list carefully and tailor it
depending on their population's unmet need and their local context
in conclusions.
In conclusion, our findings underscore the evolving nature of antimicrobial
resistance, infection,
infect
and infectious diseases,
emphasising the urgent need for collaborative efforts
to address drug resistant bacterial pathogens.
At
the heart of this is prioritising sustained investment in research
and development of new tools to address these infections.
Surveillance,
prevention and control are crucial in mitigating antimicrobial
resistance and in safeguarding global public health.
Thank you very much for your attention and we are happy to take questions.
Thank you very much, Doctor Cameron and Dr Sati
For this comprehensive
overview of the updated list,
I'll just see if we have questions from reporters online.
Christiana Uri
from German News Agency DPA
Christian
Uh Thank you, Tari.
Yes, um 2017, 2024. That's, uh, seven years.
What has been done on the one that was and still is on the top of the priority list, Uh,
aine
to
B
Bomani E.
Um, the question is, uh do you see any, um,
do do you see enough, um,
reaction to your
to your call for more investment and more research.
If seven years later, the same bacteria is still on the top of the priority list.
Thank you.
Thank you. Very much.
That's an excellent question.
In fact, since the
release of the list in 2017 as Dr
Cameron
eluded,
there has been a new antibiotics targeted towards these critical pathogens.
About nine antibiotics entered the market.
However, the issue is
two folds. The first fold is the innovative level in these new antibiotics.
Most of these new antibiotics tend to be
spinoffs of existing classes of antibiotics, and therefore
they are not, or resistance is quickly
developed towards these pathogens.
The second fold and maybe
Ali can elaborate on that is an issue of access to these newly developed drugs.
Newly developed drugs tend to be costly
and tend to be limited
upon their introduction
to high
income settings
for multiple reasons. And we are happy to get into some of these factors.
So what's needed is sustained investment that focuses on innovation,
truly innovative
antimicrobials and also prevention and control measures.
This is a huge gap, especially in low and middle income countries.
Prevention and control is still largely sub
optimal and under funded,
and we also need to invest in access to quality health care,
access to quality medicines and new and old antibiotics as well
sure? Yes, I'm happy to also add on. As Dr
Hatti said,
the problem is of resistance is an ongoing issue.
And even though we have had some successes in past
years of bringing to market new products against priority pathogens,
we will need to continue to replenish
the supply of new products to keep pace with the resistance that's developing,
sometimes even before the products are even launched.
Um, so that was was one thing I wanted to emphasise.
And then, uh, with respect to access, indeed,
Um, many of the products that,
uh are becoming available are what we call last resort products.
We would like to save them,
uh, and use them for the most, uh, you know, the most tenacious,
most drug resistant infections.
And this means that the market for these products is extremely small.
Uh, and as a result,
uh, there isn't, uh, enough of an incentive for suppliers to first of all,
develop those products
and then supply them in a wide range of countries,
particularly in low and middle income countries.
so what we see with many of these new
products is that they are not registered or available
in many countries.
Uh, and when they are, um, you know, there is often an issue of affordability as well.
so addressing some of these challenges of access alongside the R
and D challenges is really what we need to do to
both develop new products,
but also make sure that they're available to the patients who need them.
Thank you. Uh,
Christian, do you have a follow up?
Yes. Thank you. Tare
a follow up, these nine new, um,
antibiotics that entered the market Was that targeted on the,
uh,
again or the one that is still that B
is still on the top of the list
to ban?
Or was that, uh, on all the, uh is that about an antibacterial that is
used for several of those,
uh,
bacteria on the list? Thank you.
Can you hear me now?
Yes. The
new antibiotics that entered the market. Indeed. These ones that we flagged
are targeting specifically critical priority gramme negative bacteria.
This, of course, includes
ater
bal
mani, but also bacteria belonging to the family of interior,
bacterial
and or the order of interior bacterial
as well as Pseudomonas
aosa.
There are very few
of these nine
that are actually proven to be effective against multi drug resistant
as bacter
Bomani
and overall multi drug resistant gramme negative
bacteria remain challenging due to the limited
options available for their treatment.
And so the
targeting
of these specific pathogens needs to be intensified.
We need to also have an approach that addresses specific
resistance mechanisms.
There is no shortage of, let's say,
antibiotics that address certain common mechanisms
of resistance and that's of value.
Of course, these are high burden
infections,
but there are still some
challenging
mechanisms of resistance that we need
innovative antibiotics that target these specific
mechanisms of resistance. In this case, as
to Bakar,
Bomani is on the top of the list to
be targeted through this innovative approach.
Thank you so much, Doctor Hay
uh Kathrine fianca
Boon
Fat
Yes. Good morning to all of you and good morning. Uh, Tariq,
Uh, thank you for organising the briefing. Um
uh, Doctor
sati, could you please share your notes?
Uh, with Tariq So he will be able to mail it to us. It would be very useful.
Thank you so much.
And I have a question related to TB.
Uh, could you please elaborate a little bit more. Um, on TB.
Um, how difficult it would be, uh, to treat TB What could be done to, um,
identify TB as we know that there are more and more cases.
Um, and that people, um don't think about it.
I mean, it's not, I suppose,
in the normal process of investigation when someone is sick.
So what? What could be done
about it? Thank you so much for your answer.
Thank you very much indeed.
TB remains one of the most critical global health threats,
and TB is addressed within the
as you know,
through a specialised programme, the TB programme. So I'm going to
provide perhaps a limited response on behalf of our colleagues.
But we are happy to also
take inquiries to the programme of TB
in terms of
resistant, multi drug resistant
TB. Overall, as you said, is challenging. It's a challenging disease
because of its dynamics,
its disease process, its course
because of the population that it impacts
oftentimes vulnerable populations with underlying infections or
immunocompromised status.
Access to TB care diagnostics, quality treatment,
prevention, control measures remain still very limited globally, especially in
the highest burden settings.
Additionally TB of course, is a disease of poverty, it impacts the least in society,
and that makes it further complicated.
When you add to this picture the limited number of treatments
that are approved through guidelines and through
clinical trials for treatment of TB,
you can see immediately that
antimicrobial resistance can further complicate
this limited options available.
The available options to treat TB as well have a number of issues.
A. They are combination therapies, so you need multiple drugs to treat TB.
They tend to be very prolonged, raising issues around compliance and side effects.
They also tend to be impacted, as I said,
because of the prolonged treatment and
other factors by antimicrobial resistance.
So indeed, TB is a very important priority for the who
and in this list, TB has been categorised into the
critical category for these reasons,
thank you very much. Uh,
doctors
and Dr
Cameron, I don't see any further questions from journalists in the room.
So just to remind you that you have received
the press release with all this information that has been presented today,
it will be sent to global media list
shortly.
Also,
the report itself will be posted with more
details And if you have any further questions on
the topic of antimicrobial resistance, don't hesitate to contact
Media Team. And I'm sure Dr Hat
and Dr Cameron
will be happy to
get in touch with you. With this, we will conclude this
press briefing from the World Health
Organisation thanks to colleagues in UNICE for
logistical support and wish you a nice day.
Thank you.