The WHO Bacterial Priority Pathogens List 2024: a prioritisation study to guide research, development, and public health strategies against antimicrobial resistance

The 2017 WHO Bacterial Priority Pathogens List (BPPL) shaped global AMR policy, R&D, and investment, and since then 13 new antibiotics have been approved. The updated 2024 WHO BPPL refines this framework, ranking 24 antibiotic-resistant bacteria using multicriteria decision analysis (mortality, incidence, resistance trends, transmissibility, treatability, etc.), weighted by input from 79 international experts.

Findings:

• Top-ranked (critical tier): carbapenem-resistant Klebsiella pneumoniae (84%), carbapenem-resistant Acinetobacter spp., 3rd-generation cephalosporin-resistant Escherichia coli, and rifampicin-resistant Mycobacterium tuberculosis.

• High community burden: fluoroquinolone-resistant Salmonella Typhi (72%), Shigella spp. (70%), and Neisseria gonorrhoeae (64%).

• Other important pathogens include Pseudomonas aeruginosa and Staphylococcus aureus.

• Rankings were highly consistent across expert groups (Spearman’s ρ = 0.9).

Interpretation:
The 2024 BPPL confirms Gram-negative bacteria and rifampicin-resistant TB as critical threats, while also emphasising community-associated pathogens. It is designed to steer R&D, global policy, and investment toward new antibacterials, but also highlights the need for equitable drug access, stronger vaccine coverage, and robust infection prevention and control measures.