Yesterday, the World Health Organization published its first ever list (below) of antibiotic-resistant “priority pathogens” – a catalogue of 12 families of bacteria that pose the greatest threat to human health.
The 12 bugs on the list are classified as critical, high and medium priority, based on their level of resistance to treatment, their mortality rates, their prevalence in the community, and the burden on the health system they cause.
MRSA is listed as a high priority, i.e. those bacteria that cause a large number of deaths and infections in otherwise healthy people. The US Centers for Disease Control said the same thing in 2013 when it ranked superbugs having the most impact on human health. The CDC Threat Report also used 3 categories – Urgent, Serious, and Concerning – and ranked MRSA’s threat level as “Serious” on the basis that (1) it alone is responsible for about half of the 23,000 deaths caused each year in the US by antibiotic-resistant bacteria, and (2) it causes more than 80,000 serious infections each year.
However, there’s a crucial difference between the WHO and CDC reports: The WHO’s intent is to “spur governments to put in place policies that incentivize basic science and advanced research and development.” Dr. Marie-Paule Kieny, WHO’s Assistant Director-General explains:
Antibiotic resistance is growing, and we are fast running out of treatment options. If we leave it to market forces alone, the new antibiotics we most urgently need are not going to be developed in time.
The science community believes that because antibiotic-resistant bacteria are a global issue, that the solution has to be global too; namely, a coordinated game plan that’s bought into by world governments, especially the major players on the global stage.
Which brings us to our problem – the United States, and whether or not they’re willing to play ball.
In 2015 the Obama administration rolled out its National Action Plan for Combating Antibiotic-Resistant Bacteria, a 5-year strategy to address what the president called “an issue of great importance to the public health of America and the world … [i.e.] antibiotics becoming less effective … one of the most serious public health issues we face today.” The plan was quarterbacked by the president’s science advisor, John Holdren, PhD, and the President’s Council of Advisors on Science and Technology (PCAST).
As of today, however, there’s still no presidential science advisor. The Action Plan and PCAST are in limbo. For this and other reasons, US scientists are livid and in an unprecedented move will march on Washington on April 22 to publicly air their concerns.
All of this matters because according to a highly-regarded UK government report, antibiotic-resistant disease will cause more deaths than cancer by 2050.
Yesterday’s report by the WHO was a call to action to prevent that from happening. It was also an admission that it will take a village – a global government village – to address the problem. And that if someone doesn’t want to do their fair share, it will hurt all of us.
The WHO list:
Priority 1: Critical
1. Acinetobacter baumannii, carbapenem-resistant
2. Pseudomonas aeruginosa, carbapenem-resistant
3. Enterobacteriaceae, carbapenem-resistant, ESBL-producing
Priority 2: High
4. Enterococcus faecium, vancomycin-resistant
5. Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant
6. Helicobacter pylori, clarithromycin-resistant
7. Campylobacter spp., fluoroquinolone-resistant
8. Salmonellae, fluoroquinolone-resistant
9. Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant
Priority 3: Medium
10. Streptococcus pneumoniae, penicillin-non-susceptible
11. Haemophilus influenzae, ampicillin-resistant
12. Shigella spp., fluoroquinolone-resistant