WHO’s urgent call: World needs new antimicrobial resistance vaccines

Urges equitable and global access to existing vaccines as well
WHO’s urgent call: World needs new antimicrobial resistance vaccines

The World Health Organization has stressed the need to accelerate trials for antimicrobial resistance-related vaccines in late-stage development and maximise the use of existing ones.

The global health body released the first-ever report June 12, 2022, on the pipeline of the vaccines currently developing to prevent infections by AMR bacterial pathogens.

Resistant-bacterial infections are associated with nearly 4.95 million deaths per year, with 1.27 million deaths directly attributed to AMR, WHO said.

However, AMR is about more than bacterial infections. The resistance occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines.

When an individual becomes infected with these microbes, the infection is said to be resistant to antimicrobial medicines. These infections are often difficult to treat.

Vaccines are powerful tools to prevent infections in the first place and therefore have the potential to curb the spread of AMR infections. The AMR vaccine pipeline report aims to guide investments and research into feasible vaccines to mitigate AMR, WHO said.

Preventing infections using vaccination reduces the use of antibiotics, which is one of the main drivers of AMR, said Dr Hanan Balkhy, WHO assistant director-general, antimicrobial resistance.

“Yet, of the top six bacterial pathogens responsible for deaths due to AMR, only one — Pneumococcal disease (Streptococcus pneumoniae) — has a vaccine,” she said, adding that affordable and equitable access to life-saving vaccines is urgently needed.

The analysis identifies 61 vaccine candidates in various stages of clinical development, including several in late stages of development, to address diseases listed on the bacterial-priority pathogens list, which WHO has prioritised for research and development.

While the report describes these late-stage vaccine candidates as having high-development feasibility, the report cautions that most will not be available anytime soon.

The report calls for equitable and global access to the already existing vaccines, especially among populations that need them most in limited-resource settings.

There are already vaccines available against four priority bacterial pathogens: Pneumococcal disease (Streptococcus pneumoniae), Hib (Haemophilus influenzae type b) Tuberculosis (mycobacterium tuberculosis) and Typhoid fever (Salmonella Typhi).

Current Bacillus Calmette-Guérin (BCG) vaccines against tuberculosis (TB) do not adequately protect against TB and the development of more effective vaccines against TB should be accelerated, the report said. 

The remaining three vaccines are effective, and we need to increase the number of people receiving them to contribute to a reduction in the use of antibiotics and prevent further deaths.

“The lessons from COVID-19 vaccine development and mRNA vaccines offer unique opportunities to explore for developing vaccines against bacteria,’’ said Dr Haileyesus Getahun, WHO director of AMR global coordination department.

Messenger RNA (mRNA) vaccines teach our cells how to make a protein that will trigger an immune response inside our bodies.

Of significance in the global fight against AMR, the bacteria noted in the priority pathogens list pose a significant threat to public health precisely because of their resistance to antibiotics — but they currently have a very weak vaccine pipeline in terms of the number of candidates and feasibility.

Vaccines against these pathogens are unlikely to be available in the short term, and alternative interventions should be pursued urgently to prevent resistant infections due to priority bacterial pathogens.

Vaccine development is expensive and scientifically challenging, often with high failure rates, said Dr Kate O’Brien, director of immunisation, vaccines and biologicals department at WHO.

“For successful candidates, complex regulatory and manufacturing requirements require further time,” O’Brien said. “We have to leverage the lessons of COVID vaccine development and speed up our search for vaccines to address AMR and speed up our search for vaccines to address AMR.”

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