“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.”
“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.
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).
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).
The Institute of Medicine (IOM) on Friday released a summary of a joint workshop by the Institute of Medicine, the Indian National Science Academy, and the Indian Council of Medical Research, titled, “Facing the Reality of Drug-Resistant Tuberculosis: Challenges and Potential Solutions in India.” According to the report’s webpage, “The aim of the workshop was to highlight key challenges to controlling the spread of drug-resistant strains of [tuberculosis (TB)] in India and to discuss strategies for advancing and integrating local and international efforts to prevent and treat drug-resistant TB” (4/27).
A strain of malaria that is resistant to artemether, the main ingredient in Coartem, a widely used drug to treat the disease, may be spreading in Africa, according to a study published Thursday in Malaria Journal, Bloomberg Businessweek reports. “Studies in Cambodia and Thailand have shown that drugs based on artemisinin, the class of remedies to which artemether belongs, are becoming less effective there,” the news service writes, adding that study author Sanjeev Krishna of the University of London said, “Drug resistance could eventually become a devastating problem in Africa, and not just in southeast Asia where most of the world is watching for resistance.” According to the authors, “[t]he effectiveness of other artemisinin-based drugs, such as artesunate, wasn’t significantly affected by the mutations,” the news service states (Bennett, 4/26).
“The World Health Organization heralded major gains Tuesday in the fight against malaria, one of the developing world’s biggest killers, but warned universal access to treatment remains elusive,” Agence France-Presse reports, noting, “The assessment came on the eve of World Malaria Day,” observed Wednesday and “designed to shine the light on the mosquito-borne parasite that killed 655,000 people in 2010, including 560,000 children under five” (4/24). “A massive acceleration in the global distribution of mosquito nets, the expansion of programs to spray the insides of buildings with insecticides, and an increase in access to prompt antimalarial treatment has brought down malaria mortality rates by more than a quarter worldwide, and by one-third in Africa since 2000,” but “simply maintaining current rates of progress will not be enough to meet global targets for malaria control,” the agency writes in a news release (4/24).
“In recent weeks, the emergence on the Thai-Myanmar border of malaria strains resistant to artemisinin, a plant-derived drug, have led to pessimistic headlines and reminders of the setback caused by resistance to the drug chloroquine, which began in the 1950s,” columnist and author Matt Ridley writes in the Wall Street Journal’s “Mind & Matter,” noting, “April 25 is World Malaria Day, designed to draw attention to the planet’s biggest infectious killer.” He continues, “For this reason, prevention generally works better than cure in eradicating infectious diseases: Vaccination beat smallpox, clean water beats cholera, less crowded living beats tuberculosis and protection from mosquitoes beats malaria.”
Yaws, a skin and bone disease caused by a treponematoses bacterium that can cause long-term deformities, “has recently been put on WHO’s list of 17 so-called neglected tropical diseases (NTDs)” and, along with Guinea worm, is “slated for eradication,” the Lancet reports. A “massive push to free the world from yaws failed in the 1950s and 1960s,” and the WHO in 1995 estimated “there were 2.5 million cases of endemic treponematoses (mostly yaws),” according to the Lancet. A study published in the Lancet in January showed a single dose of the antibiotic azithromycin was effective at curing the disease among children, a finding that “jump-started the NTD community into action,” the article states.
A strain of malaria that is resistant to artemisinin combination therapy (ACT) is spreading along the Thai-Myanmar border and has the potential to spread to Africa if efforts to effectively treat and prevent the disease are not undertaken, according to a study published in the Lancet on Friday, Reuters reports (Lyn, 4/5). Since 2008, patients treated with ACT have been slower to clear the parasite than previously, “[a]nd this precursor to resistance seems to be spreading, despite efforts to carefully use artemisinin (by giving it in combination with other drugs) to avoid the emergence of resistance,” Scientific American writes.