WHO report boosts role of vaccines in tackling antimicrobial resistance

A new report from the World Health Organization (WHO) suggests that new and existing vaccines could have a major impact on the emergence and spread of antimicrobial resistance (AMR).

WHO announced today report Introduction and deployment of 44 vaccines against 24 pathogens will avert more than 500,000 deaths annually from drug-resistant infections, save billions of dollars in AMR-related health care costs and lost productivity, and reduce the cost of treatment needed. It is estimated that the number of antibiotics required can be reduced. 2.5 billion doses per year.

Some of the vaccines covered in the report include pneumococcal conjugate vaccines. pneumococcus Infectious diseases have been around for years but are underutilized. Other candidates include tuberculosis (TB). Escherichia coli, and Klebsiella pneumoniaestill in clinical development.

It is estimated that AMR causes more than 1 million deaths each year and nearly 5 million deaths annually. However, if these vaccines are widely rolled out and integrated into national and global AMR mitigation strategies, they could significantly reduce the incidence of infectious diseases that promote antibiotic use and create selection pressure for drug-resistant bacteria. The report concludes.

“The best infection is that it never occurs,” Ivan Hutin, MD, director of WHO's AMR division for surveillance, protection and control, said at a press conference. “When you vaccinate people, they don't get infections and they don't need antibiotics.”

Quantifying the impact of vaccines on AMR

Dr. Mateusz Hasso-Agopsovic, WHO technical officer and lead author of the report, said the purpose of the report was to assess the impact of vaccines on AMR, assess the health burden associated with AMR, and assess the economic burden (including hospital costs). quantification across two criteria. loss of productivity), use of antimicrobial agents. To do so, WHO analyzed data and consulted experts on 44 vaccines targeting 24 pathogens (19 bacteria, four viruses and one parasite).

They started by analyzing vaccines that already exist. pneumococcus, Haemophilus influenzae type b (HIB), and Salmonella typhi (typhoid). If more widely deployed, these vaccines could save up to 106,000 AMR-related deaths, 9.1 million disability-adjusted life years (DALYs), and hospital and productivity costs, while reducing antibiotic use. The researchers found that $861 million and $5.9 billion could be avoided. Used by 142 million defined daily doses (DDD).

“Countries need to expand the use of these existing vaccines,” Hassoagopsovic said. “We already have vaccines and we need to use them appropriately, especially in countries with low vaccination rates.”

The report then explored the potential impact of vaccines in later stages of clinical development, including tuberculosis, extraintestinal pathogenic vaccine candidates. Escherichia coli (ExPEC), gonorrhea, and Salmonella Paratyphoid Fever A. Report shows that if these vaccines are approved and rapidly deployed, up to 135,000 deaths a year could be avoided, 5 million DALYs, $1.2 billion in hospital costs, and $2.2 billion in lost productivity. I estimate that it can be done.

The best infection is not to develop it. When people are vaccinated, they don't develop infections and don't need antibiotics.

Dr. Hasso-Agopsowicz said that because tuberculosis treatment regimens are very long-term (six months or more) and require several drugs per day, the tuberculosis vaccine alone can dramatically reduce annual antibiotic use. I pointed out that it can be done.

“If you develop and use it [TB] “With vaccines, we could avoid administering between 1.2 billion and 1.9 billion antibiotics, which is the bulk of the total antibiotic supply,” he said.

The final group included vaccines in early stages of clinical development (e.g. maternal vaccines). Klebsiella pneumoniae, It is the leading cause of neonatal sepsis worldwide. Other vaccine candidates in this group target Acinetobacter baumannii, Staphylococcus aureus, and group A streptococcus. Together, they could potentially avert up to 408,000 deaths, 23 million DALYs, $30 billion in hospital costs, and $17.7 billion in lost productivity annually. It would also reduce antibiotic use by DDD 548 million.

However, the report notes that although this group of vaccine candidates has the potential to have a significant impact on AMR, difficulties in identifying and accessing vaccine populations make the development of some candidates less likely. I am doing it.

call to action

Dr Martin Friede, from WHO's Department of Immunization, Vaccines and Biology, said health experts had known for a long time that vaccines could play a role in controlling AMR, but the report's estimates were He said that this provided a starting point for those involved. Key points for prioritizing research and development efforts.

“To date, we have not been able to say which vaccines could play a role.” [against AMR]”And then think about what the impact will actually be. This report shows us how much they can contribute,” he said.

This report states that global, regional and national AMR and immunization strategies and implementation frameworks should include vaccines as an intervention to reduce AMR and advocate for their widespread implementation. It is recommended that there be. For example, in a report the global pneumococcus Vaccine coverage to achieve the WHO and Immunization Agenda 2023 target of 90% of children.

To expedite vaccine development, the report recommends including AMR endpoints in clinical trials, engaging with regulatory authorities, and creating a research roadmap for difficult bacterial vaccines.

Mr Hassoagopsovic said the report was a “call to action”.

“Governments, the private sector and investors must invest in developing new and improved vaccines,” he said. “Strong research and development is really needed and this will be a game-changer in combating the growing threat of antimicrobial resistance.”