On May 17, the World Health Organization (WHO) released its updated Bacterial Priority Pathogens List (BPPL) 2024 and for the first time in its history it included a drug resistant strain of Mycobacterium tuberculosis. Along with three other new families of antibiotic-resistant bacterial pathogens, the WHO included rifampicin-resistant Mycobacterium tuberculosis (RR-TB) providing a strong indication of the high level of risk that RR-TB poses to the global community. In the report, RR-TB is described as ‘a critical antimicrobial resistance (AMR) pathogen’ stating “In this update, RR-TB was included as a critical priority. RR-TB poses significant additional challenges to those of drug-susceptible TB in terms of diagnosis, treatment, clinical management and overall public health response. Capacity to detect resistance to rifampicin and to most anti-TB medicines remains severely limited worldwide.” 

First released in 2017, this vital list is intended to guide the development of new treatments to combat AMR. AMR occurs when pathogens become resistant to medicines, leading to more severe illness and increased mortality rates. A related news release states “The critical priority pathogens, such as gram-negative bacteria resistant to last-resort antibiotics, and Mycobacterium tuberculosis resistant to the antibiotic rifampicin, present major global threats due to their high burden, and ability to resist treatment and spread resistance to other bacteria.” 

The updates in the 2024 BPPL reflect the evolving nature of AMR, highlighting the need for specific interventions, using new evidence and expert insights to direct research and development efforts and encourage international collaboration for innovation in antibiotics. The BPPL's flexibility to adapt to country and regional contexts, addressing variations in pathogen distribution and AMR burden, is detailed in the report, which also explains the rationale, methodologies, and key findings behind the list.