Summary

The WHO research agenda for antimicrobial resistance (AMR) in human health has identified 40 research priorities to be addressed by the year 2030. These priorities focus on bacterial and fungal pathogens of crucial importance in addressing AMR, including drug-resistant pathogens causing tuberculosis. These research priorities encompass the entire people-centered journey, covering prevention, diagnosis, and treatment of antimicrobial-resistant infections, in addition to addressing the overarching knowledge gaps in AMR epidemiology, burden and drivers, policies and regulations, and awareness and education. The research priorities were identified through a multistage process, starting with a comprehensive scoping review of knowledge gaps, with expert inputs gathered through a survey and open call. The priority setting involved a rigorous modified Child Health and Nutrition Research Initiative approach, ensuring global representation and applicability of the findings. The ultimate goal of this research agenda is to encourage research and investment in the generation of evidence to better understand AMR dynamics and facilitate policy translation for reducing the burden and consequences of AMR.

Introduction

Antimicrobial resistance (AMR) is a global public health hazard with serious economic consequences. To mitigate the effects of AMR, the WHO member states endorsed a global action plan on AMR in the year 2015, mandating WHO to develop a global public health research agenda for filling major gaps in the knowledge on AMR and monitoring its implementation.

To facilitate evidence generation regarding the pathogens posing the greatest public health threat associated with AMR, WHO published the priority list of bacterial pathogens in 2017 and of fungal pathogens in 2022 and updated the priority list of bacterial pathogens in 2024. In addition, WHO regularly analyses the pipeline for agents that target bacteria and fungi to facilitate priority setting and inform research and development (R&D) efforts.

Despite the increasing focus on AMR research, substantial knowledge gaps continue to hamper an effective response against AMR, as illustrated by the stagnant progress in the implementation of national action plans on AMR, particularly in low-income and middle-income countries (LMICs), which carry the highest burden of bacterial AMR. Large data gaps in the prevalence and burden of disease hinder reliable estimates of AMR, particularly in settings with inadequate laboratory capacity and data collection systems.

The pressing need for evidence to inform public health policy, one of WHO’s strategic and operational priorities to address drug-resistant bacterial infections between the years 2025 and 2035, was recognized by the 77th World Health Assembly in a resolution on accelerating national and global responses to AMR. Approved on May 30, 2024, the resolution urges the WHO member states to support and foster basic, applied, and implementation research on infection prevention and control, vaccines, diagnostic tools, therapeutics, and antimicrobial stewardship through collaboration with academia, civil society, and the private sector.

Although research agendas have been successfully developed in other public health areas, initiatives aimed at bridging gaps in the research on drug-resistant bacterial infections in human health have fallen short of identifying key research priorities owing to the complex, multifaceted nature of AMR. Some initiatives focused solely on specific aspects of AMR or exclusively on the One Health interface, and priorities specifically relevant to low-resource settings were generally overlooked.

A prioritized, multidisciplinary research agenda on AMR is warranted to direct investments of governments and other research funders and to channel the attention of policy makers, researchers, and the private sector towards crucial knowledge gaps that demand evidence generation, which, in turn, could inform the development and effective implementation of AMR policies and interventions. We hereby present the first comprehensive effort focusing on infections caused by drug-resistant bacteria and fungi, developed with a robust and validated methodology for research prioritization.

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