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.”
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.
“Malaria-carrying mosquitoes in Africa and India are becoming resistant to insecticides, putting millions of lives at greater risk and threatening eradication efforts, health experts said on Tuesday,” Reuters reports (Kelland, 5/15). Experts fear resistance “could reverse the recent drop in malaria mortality credited to insecticide spraying in the home and coating of bed nets, which save about 220,000 children’s lives each year, according to the WHO,” Nature writes, adding, “Insecticide resistance could also result in as many as 26 million further cases a year, the organization predicts, costing an extra $30 million to $60 million annually for tests and medicines” (Maxmen, 5/15).
The New York Times and the Financial Times examine concerns expressed by AIDS activists and members of an FDA panel that last week recommended Gilead Sciences’ antiretroviral drug Truvada be approved for pre-exposure prophylaxis (PrEP) to prevent HIV among healthy people at risk of contracting the virus. According to the New York Times, “Such a pill has long been a goal of research, something that might help stem a global epidemic that is still causing two million new worldwide cases each year, including 50,000 in the United States” (Grady, 5/14). The Financial Times says some have concerns over the real world efficacy of the drug; whether its approval would encourage reckless behavior, such as not using condoms; side effects that might require additional treatment; the development of drug-resistant HIV strains; and the cost of the drug.
“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).