The Washington Post examines how the “discovery of an almost untreatable form of tuberculosis [TB] in India has set off alarm bells around the world and helped spur a dramatic expansion of government efforts to battle the killer lung disease.” The newspaper writes, “For the past decade, a nationwide tuberculosis program involving millions of health workers and volunteers has made slow but significant progress in battling the disease in India and has been hailed as a public health success story,” but “any sense of complacency was dispelled in December when a doctor in Mumbai, Zarir Udwadia, discovered a strain of the disease that did not respond to any of the 12 frontline drugs.”
“The World Health Organization said Thursday that governments in the Mekong region must act ‘urgently’ to stop the spread of drug-resistant malaria which has emerged in parts of Vietnam and Myanmar,” Agence France-Presse reports. “There is growing evidence that the malaria parasite is becoming resistant to a frontline treatment, the anti-malarial drug artemisinin, in southern and central Vietnam and in southeastern Myanmar, the WHO said in a statement,” AFP writes, noting, “WHO regional director, Shin Young-soo, said countries must ‘urgently address this issue before we put at risk not only the fragile gains we have made in malaria control but also our goal of a malaria-free Western Pacific Region.’” The news service adds, “Countries in the Mekong region must “intensify and expand” operations to contain and eliminate artemisinin-resistant malaria, Shin said at a WHO regional meeting in Hanoi” (9/28).
“If you had $75 billion to spend over the next four years and your goal was to advance human welfare, especially in the developing world, how could you get the most value for your money?” Bjorn Lomborg, an author and director of the Copenhagen Consensus Center, asks in this opinion piece in Slate Magazine’s “Copenhagen Consensus 2012” section. “That is the question that I posed to a panel of five top economists, including four Nobel laureates, in the Copenhagen Consensus 2012 project,” he writes, noting, “The panel members were chosen for their expertise in prioritization and their ability to use economic principles to compare policy choices.”
Scientific American examines how strains of cephalosporin-resistant gonnorhea have “been emerging in Japan, and moving east and west from there, for at least a decade.” The magazine writes, “Rapid international travel allowed the resistance mutation to hopscotch the globe,” noting antibiotic-resistant strains that have been identified in Sweden, England, Norway, the Philippines, Spain, and France. “‘We can’t go back to older antibiotics,’ says Peter Leone, who is board chair of the National Coalition of STD Directors and medical director of North Carolina’s STD prevention program. ‘Once resistance emerges in gonorrhea, it is there for good. Cephalosporins are all we have left,’” he added, according to Scientific American. The magazine writes that efforts “to educate physicians and patients, to track resistant strains and to develop new treatments … must be carefully targeted and well coordinated with one another,” and concludes, “If not, truly untreatable gonorrhea, and its expensive, destructive consequences, could be the worldwide result” (McKenna, 5/4).
“A third of the world’s population is carrying tuberculosis [TB], and the disease could become incurable if governments fail to act, the World Health Organization (WHO) has warned,” noting that a “[l]ack of funding for public health programs, the sale of inaccurate blood tests and the misuse of drugs, particularly in the private health sector, are hampering the fight against the disease and leading to drug resistance,” the Independent reports. “The rate of TB deaths had declined dramatically — by 40 percent between 1990 and 2000 — after a worldwide health campaign, which was particularly successful in China,” but “the emergence of drug-resistant strains threatens to halt progress and jeopardizes the WHO’s goal of eradicating the disease as a public health problem by 2050,” the newspaper writes, noting, “Two billion people are carriers of the TB bacillus” globally.
“Counterfeit, falsified, and substandard drugs are a dangerous threat to people around the world, including Americans,” therefore “we have a vital interest in ensuring the safety of an ever more complex global drug supply chain,” Jennifer White, a foreign service officer in the Office of International Health and Biodefense in the Bureau of Oceans and International Environmental and Scientific Affairs, writes in a post in the State Department’s “DipNote” blog. She notes that the “Department of State engages in the fight against counterfeit medicines using a multi-faceted approach,” including training foreign drug regulators; funding consumer outreach to raise awareness of the problem; being active in international bodies that address counterfeiting, such as the WHO; and “work[ing] in partnership with other U.S. government agencies, the health care community, patients, civil society, and the pharmaceutical industry to ensure that patients receive safe medicines and that those who put patients’ lives at risk can be prosecuted” (5/22).
In this Wall Street Journal opinion piece, Jay Winsten, associate dean at the Harvard School of Public Health, and Trish Stroman, a principal at the Boston Consulting Group, examine “the emergence in Southeast Asia of malarial parasites resistant to artemisinin — the current gold-standard drug for treating the disease,” writing it “poses grave new challenges.” Winsten and Stroman recount a brief history of artemisinin resistance in the region and note, “While many affected countries in the region are taking swift countermeasures, the situation remains serious in Burma,” also known as Myanmar.
GlobalPost’s “Global Pulse” blog reports on a potential public-private partnership that aims to bring tuberculosis (TB) vaccine trials to the gold mines of Southern Africa, where, “[f]or every 100,000 workers …, 3,000 have tuberculosis, and many have often-fatal, drug-resistant strains of TB.” The blog writes that mining company “Anglo American announced Tuesday at the GBCHealth Conference [in New York] that it has agreed in principle to make its mines available for TB vaccine trials organized by Aeras, a non-profit that has 12 TB vaccine candidates now in various stages of research,” noting, “No formal agreement has been reached, but Anglo American’s spokesman vowed to make it happen.”
“Low-quality and fake anti-malarial drugs flooding into markets in Asia and Africa are driving drug resistance and threatening gains made in the fight against the disease in the past decade, according to a study” conducted by researchers at the National Institutes of Health (NIH) and published Monday in the journal Lancet Infectious Diseases, Reuters reports (Kelland, 5/21). In an analysis of “27 sets of tests of antimalarial drugs purchased in Southeast Asia and Africa between 1999 and 2010,” “[a]bout a third of the drug samples from both continents failed,” the New York Times writes, noting, “Some were clearly criminal counterfeits, some were expired drugs that had been repackaged and some were poorly made with too little active ingredient” (McNeil, 5/21).
Bloomberg Markets Examines Spread Of Multidrug-Resistant Bacteria In India, Discusses Global Implications
Bloomberg Markets magazine in its June issue examines microbes that incorporate the New Delhi metallo-beta-lactamase-1, or NDM-1, gene, making them resistant to nearly all available antibiotics. The article focuses on India, where the gene is thought to have developed due to the widespread and uncontrolled use of antibiotics, but notes that cases of NDM-1 antibiotic-resistant bacteria have been documented in Canada, France, Italy, Kosovo, and South Africa, without patients having traveled to India. Bloomberg describes how the gene was discovered and named; how NDM-1 is affecting India’s medical tourism industry; what the Indian government and health officials in the country and elsewhere are doing to fight multidrug-resistant bacteria; and how NDM-1 is spreading through the water and possibly food supply in India. “The number of countries reporting NDM-1 will continue to grow as more bacteria pick up the gene and people transport it around the globe,” Bloomberg writes (Gale/Narayan, 5/7).