Urgent access to vaccines that can fight and prevent infections, and curb the risk of antimicrobial resistance (AMR) is needed to save lives, according to a report by the World Health Organisation (WHO).
WHO has released the first-ever report1 looking at the pipeline of vaccines currently in development to fight infections caused by (AMR)
It outlines that whilst there are 61 vaccine candidates in clinical development targeting diseases listed on WHO’s bacterial priority pathogen list2, most of these will not be available anytime soon.
The report highlights the need to accelerate clinical trials for AMR-related vaccines in late-stage development and also to maximise the use of current existing vaccines.
For the vaccines that already exist, the report calls for equitable and global access to them, especially for countries and populations that have limited resources.
Currently, there are vaccines available for four of WHO’s priority bacterial pathogens – pneumococcal disease (Streptococcus pneumoniae), Hib (Haemophilus influenzae type b) Tuberculosis (mycobacterium tuberculosis) and Typhoid fever (Salmonella Typhi).
However, WHO is calling on more effective vaccines against tuberculosis (TB) to be developed as current ones do not adequately protect against the disease.
For vaccines that are currently effective, WHO states that health systems need to increase the number of people receiving them in order to reduce the use of antibiotics and to prevent further death.
Bacteria noted in WHO’S priority pathogens list pose a significant health risk due to their resistance to antibiotics. More so, they currently have a very weak vaccine pipeline due to a low number of candidates and feasibility. Since vaccines against priority pathogens are unlikely to be available in the short-term, alternative interventions should be pursued in an effort to prevent resistant infections.
The report also highlights the challenges of vaccine innovation and development, with a focus on pathogens associated with hospital-acquired infections (HAI). These include the difficulty in defining target populations among admitted hospital patients, the cost and complexity of vaccine efficacy trials and the lack of regulatory and/or policy precedent for vaccines against HAIs.
The silent pandemic
AMR has been labelled the silent pandemic due to its growth as a major public health concern. Currently, resistant bacterial infections cause nearly 4.95 million death every year, with 1.27 million directly attributed to AMR.
AMR 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 and is often difficult to treat.
Official comments
“Preventing infections using vaccination reduces the use of antibiotics, which is one of the main drivers of AMR. Yet of the top six bacterial pathogens responsible for deaths due to AMR, only one, Pnuemoccocal disease (Streptococcus pneumoniae) has a vaccine” said Dr Hanan Balkhy, WHO Assistant Director-General, Antimicrobial Resistance. “Affordable and equitable access to life-saving vaccines such as those against pneumococcus, are urgently needed to save lives, and mitigate the rise of AMR” she added.
“Disruptive approaches are needed to enrich the pipeline and accelerate vaccine development. The lessons from Covid 19 vaccine development and mRNA vaccines offer unique opportunities to explore for developing vaccines against bacteria’’ added Dr Haileyesus Getahun, WHO Director of AMR Global Coordination Department.
“Vaccine development is expensive, and scientifically challenging, often with high failure rates, and for successful candidates complex regulatory and manufacturing requirements require further time. We have to leverage the lessons of COVID vaccine development and speed up our search for vaccines to address AMR,” commented Dr Kate O’Brien, Director Immunization, Vaccines and Biologicals Department at WHO.
References
1: https://www.who.int/publications/i/item/9789240052451
2: https://www.who.int/news/item/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed