13 March 2017

Africa: WHO Omission of TB in Priority List Denounced

Photo: John-Michael Maas/Darby Films
New tuberculosis medication aimed at children reduces the number of pills a patient has to take.

The WHO first-ever catalogue of 12 priority pathogens which pose the greatest threat of antibiotic resistance does not include Mycobacterium tuberculosis (Mtb), the bacteria responsible for TB, a fact that those fighting the disease would like to see rectified.

Excluding Mtb from the priority pathogens list (PPL) "sends the false and counterproductive message that drug-resistant TB is not a public health threat," says a statement issued by Stop TB Partnership, an international collective group of over 1,500 nongovernmental and governmental organisations that aims to eliminate tuberculosis as a public health problem.

"Tuberculosis is the biggest killer among infectious diseases in the world today. The number of people dying from TB is higher than the number of people dying because of HIV," Lucica Ditiu, executive director of the Stop TB Partnership, tells SciDev.Net.

Ditiu says research funding for TB has been declining for the past few years and this is especially difficult for high incidence countries like India and China.

"Most people don't know that it's such a big burden because TB has been neglected for so long," she says, adding that this is why their group wants WHO to review the priority pathogens list (PPL) - a catalogue of 12 families of bacteria that pose the greatest threat to human health.

The PPL (released February 27), to be used by WHO as a guide to promote development of new antibiotics, lists as 'critical' a group of multidrug-resistant bacteria including those from the Acinetobacter, Pseudomonas and Enterobacteriaceae families. The 'high' and 'medium' priority groups in the PPL include bacteria responsible for common diseases such as gonorrhoea and food poisoning.

The list, developed in collaboration with the University of Tübingen, Germany, is based on the following criteria: how deadly are the infections they cause; whether their treatment requires long hospital stays; resistance to existing antibiotics; how easily they spread; whether they are preventable; remaining treatment options; and whether new antibiotics are already in the R&D pipeline.

WHO assistant director-general, Marie-Paule Kieny, said Mtb was not included in the PPL "as there is already consensus that TB is the most important priority for R&D for new antibiotics".

Olivia Lawe-Davies, WHO communication officer, points to the Global Tuberculosis Report 2016 and the End TB Strategy that already stress the need for R&D on TB as a global priority for many years.

"WHO is very pleased with the interest that publication of the PPL has generated, but communication of the reason to exclude TB has clearly been inadequate," Lawe-Davies tells SciDev.Net.

WHO director-general Margaret Chan, during "a constructive call" with Stop TB Partnership and other stakeholders on 9 March, reaffirmed TB drug-resistance as "a very high priority".

WHO estimates that 10.4 million new TB cases were reported worldwide in 2015 with China, India, Indonesia, Nigeria, Pakistan and South Africa accounting for 60 per cent. TB killed around 1.4 million people and was among the top 10 causes of death worldwide in 2015.

WHO said the rate of decline in TB incidence, which was at 1.5 per cent in 2014-2015, needs to accelerate to a 4-5 per cent annual decline by 2020 to reach the first milestones of the End TB Strategy.

This piece was produced by SciDev.Net's Asia & Pacific desk.

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