Context: Recently, the World Health Organization (WHO) updated its Bacterial Pathogens Priority List (BPPL), highlighting critical antibiotic-resistant bacteria and their impact on global health.

• This list, revised after seven years, underscores the growing threat of antimicrobial resistance and the need for targeted research and public health interventions to address it.

Need for the List

• By mapping the global burden of drug-resistant bacteria and assessing their impact on public health, this list is key to guiding investment and for grappling with the antibiotics pipeline and access crisis.

• Since the first Bacterial Priority Pathogens List was released in 2017, the threat of antimicrobial resistance has intensified, eroding the efficacy of numerous antibiotics and putting many of the gains of modern medicine at risk.

Key highlights

• The list includes gram-negative bacteria resistant to last-resort antibiotics and Mycobacterium tuberculosis resistant to Rifampicin.

• High-priority pathogens such as salmonella, shigella, Pseudomonas aeruginosa, and Staphylococcus aureus pose significant challenges, especially in low- and middle-income countries.

• Antimicrobial Resistance (AMR) occurs due to misuse and overuse of antimicrobials, leading to increased disease spread and deaths.

• Other high-priority pathogens like antibiotic-resistant Neisseria gonorrhoeae and Enterococcus faecium require targeted research and public health interventions.

• Yukiko Nakatani, WHO’s Assistant Director-General for Antimicrobial Resistance, emphasises the importance of the list in guiding investment and addressing the antibiotics pipeline and access crisis amidst intensifying antimicrobial resistance threats.

Bacterial Pathogens Priority List (BPPL)

• Bacterial Pathogens Priority List (BPPL): Compiled by the World Health Organization (WHO), it identifies bacteria posing the greatest threat to human health.

• Purpose: To guide research, development, and prioritisation of antibiotics and other interventions.

• Criteria: Based on the urgency of need for new treatments due to antibiotic resistance, virulence, ease of transmission, and availability of effective countermeasures.

• Listed Pathogens: It includes gram-negative bacteria resistant to last-resort antibiotics and Mycobacterium tuberculosis resistant to Rifampicin.

• Impact: Helps focus resources and efforts on combating the most pressing bacterial threats globally.

Antimicrobial Resistance (AMR)

• Antimicrobial Resistance (AMR): It occurs when microorganisms such as bacteria, viruses, fungi, and parasites develop resistance to antimicrobial drugs.

• Mechanism: Microorganisms evolve mechanisms to withstand the effects of antimicrobial agents, rendering them ineffective.

• Causes: Overuse and misuse of antimicrobial drugs in humans, animals, and agriculture contribute to the development of AMR.

• Consequences: AMR leads to prolonged illness, increased mortality rates, and higher healthcare costs due to the need for alternative, often more expensive, treatments.

• Global Threat: Recognized as a major global health threat, requiring coordinated efforts across sectors to mitigate its impact and preserve the effectiveness of antimicrobial drugs.

Challenges Posed by AMR

• Antibiotic resistance is emerging as the threat to successful treatment of infectious diseases, organ transplantation, cancer chemotherapy and major surgeries.

• The issue of AMR causes out of pocket expenditure on health care, especially on medicines. The use of high order drugs or second-line expensive antibiotics pushing treatment costs high.

Road Ahead

• Addressing the challenges posed by AMR requires a coordinated global effort involving healthcare professionals, researchers, policymakers, and the public. 

• Further initiatives to promote responsible antimicrobial use, surveillance of resistance patterns, development of new drugs, and international collaboration are crucial to mitigating the impact of AMR on public health.