From Surveillance to Strategy: Prioritizing Pathogens in the AMR Battle

Abstract: Globally, antimicrobial resistance (AMR) continues to increase, highlighting the need to move beyond surveillance and toward evidence-based action. The 2024 WHO Bacterial Priority Pathogens List (BPPL) updates global AMR priorities using expanded criteria, including disability-adjusted life years (DALYs) and the PAPRIKA (Potentially All Pairwise Rankings of All Possible Alternatives) multi-criteria decision analysis method. This report summarizes the major changes in the 2024 list and compares them with the 2017 WHO priority pathogens list. The analysis shows that rifampicin-resistant Mycobacterium tuberculosis remains a major concern, while Acinetobacter baumannii and carbapenem-resistant Enterobacteriaceae remain in the highest-priority tier. The increased priority of Neisseria gonorrhoeae, Shigella, and Salmonella reflects the declining effectiveness of key frontline antibiotics. The burden of AMR is further intensified, particularly in low- and middle-income countries, by factors such as climate-related pressures, conflict-associated collapse of health systems, and unequal access to newly developed treatments. The report identifies three priorities for translating surveillance into action: strengthening GLASS (Global Antimicrobial Resistance and Use Surveillance System), integrating AMR into One Health initiatives and climate-related frameworks, and expanding laboratory capacity in resource- limited settings. These findings clarify how the 2024 BPPL reshapes global AMR priorities and provide a basis for more targeted, evidence-based action in 2026 and beyond.