A baffling omission from the ‘priority pathogen’ list

From Dr Lucica Ditiu and others.

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Sir, The World Health Organization has badly misstepped in leaving out Mycobacterium tuberculosis (M.tb) from its list of 12 priority superbugs for which new antibiotics are needed urgently (“WHO raises alarm over drug-resistant superbugs”, FT.com, February 27).

Tuberculosis (TB), which is caused by infection with M.tb, is the world’s biggest infectious disease killer, and efforts to control it are complicated by the shadow of antibiotic resistance. This year alone, more than half a million people will develop drug-resistant TB, the cure rate for which is about 50 per cent. Those patients being treated for extensively drug-resistant TB have a less than one in three chance of survival. Although TB is a bacterial disease, currently available antibiotic medicines simply cannot keep up against rapidly evolving resistance.

TB patients desperately need new and better medicines, and drug-resistant TB needs to be acknowledged as the biggest health threat in the antibiotic resistance crisis. According to the UK government-commissioned AMR Review, almost 30 per cent of deaths estimated to be caused by antimicrobial infections are due to drug-resistant TB. The same review estimated that properly addressing multidrug-resistant TB could save the world $16.7tn by 2050.

Yet the TB research community remains badly underfunded. The Stop TB Partnership’s “Global Plan to Stop TB, 2011-2015” identified a need of $810m in drug research and development in 2015. In reality, according to the Treatment Action Group, only about a quarter of those needs were met. In addition, 2015 saw the biggest decline in R&D funding for TB in more than a decade.

In light of this, the World Health Organization’s decision to omit M.tb from this “priority pathogen” list is baffling. We have the evidence that no action in the fight against global antibiotic resistance can be truly effective if it does not include tackling tuberculosis. Therefore, we urge WHO to revise the list and include Mycobacterium tuberculosis.

Dr Lucica Ditiu

Executive Director, Stop TB Partnership,

Geneva, Switzerland

Dr Mel Spigelman

President and CEO, TB Alliance, and Co-Chair, Working Group on New Drugs, Stop TB Partnership, New York, NY, US

José Luis Castro

Executive Director, International Union Against Tuberculosis and Lung Disease, Paris, France

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