A weekly roundup of news on drug resistance and other topics in global health.

G20 Leaders coordinate momentum to fight AMR. During this week’s G20 Summit in Germany, leaders from major developed and developing economies convened to discuss global challenges. In the G20 Leaders’ Declaration that was released, member states committed to implement antimicrobial resistance (AMR) national action plans by the end of 2018, promoting responsible use of antimicrobials in all sectors, enhancing public understanding and improving infection prevention and control efforts. G20 leaders have also announced a new global coordinating mechanism, The Global AMR Collaboration Hub, to encourage global investment and oversee research and development of new antimicrobials, vaccines, alternative therapies, and diagnostic tools. [G20 CommuniqueCIDRAP]

European Court of Justice on vaccine safety. A ruling on a French case involving the hepatitis B vaccine and multiple sclerosis made its way to Europe’s top court, and the court’s ruling last month has sent shock waves through the vaccine community. CDDEP communications associate in Delhi, Shalini Anand explains in a blog for The Vaccine Confidence Project that the ramifications of the ruling—which suggests that in the absence of scientific evidence, “circumstantial evidence” be allowed to guide decisions—are still up for debate. Shalini concludes, “with hundreds of vaccine safety cases reported each year globally, with different countries struggling with similar public health investigations, the judgment by the EU Court of Justice may cause further ambiguity into what is already a complicated issue.” [Vaccine Confidence.org]

Yemen may not get cholera vaccine as planned. The World Health Organization’s (WHO) plans to launch a vaccine campaign in Yemen to counter the world’s largest current cholera outbreak has suffered a setback because of the continuing conflict and instability in the country. Last month, WHO had promised to deploy one million doses of the vaccine in Yemen, where more than 300,000 cholera cases have been reported, according to the International Committee of the Red Cross (ICRC). The vaccine originally destined for Yemen will be redirected to other cholera hot spots. [STATCIDRAP]

2.1 billion people lack safe drinking water, more lack safe sanitation. The WHO reports that 2.1 billion people worldwide—30 percent of the world’s population—lack access to safe, readily available water at home, and twice that number lack access to appropriate sanitation. The Joint Monitoring Programme (JMP) update on global progress in drinking water, sanitation and hygiene documents a large gap between access in urban and rural regions, a lack of basic sanitation services in countries experiencing conflict or unrest, and a lack data on the quality of water and sanitation services in many countries. The U.N. Sustainable Development Goals (SDGs) call for achieving universal and equitable access to safe water and sanitation, ending open defecation, and achieving universal access to basic services by 2030. [WHO report, press release]

mcr-1 colistin resistance found in Vietnam. A study in the International Journal of Infectious Diseasesreports the first cases in Vietnam of colistin resistance due to the mcr-1 gene. The gene was found in two of 18 multidrug-resistant E. coli samples from 2014 at a Vietnamese hospital during routine antimicrobial resistance surveillance. The mcr-1 gene that confers resistance to colistin, a last resort antibiotic, was first identified in China in a report published in 2015, and in more than 30 countries since then. [IJIDCIDRAP]

Chikungunya spreads in Bangladesh. Officials in Dhaka, the capital of Bangladesh, report 2,700 chikungunya cases since May, continuing Bangladesh’s first major outbreak of the disease. Chikungunya is spread by Aedes aegypti mosquitoes, which also transmit Zika virus and dengue. Prof. Meerjady Sabrina Flora, head of the Institute of Epidemiology, Disease Control and Research (IEDCR) warns that the situation will likely persist or worsen toward the end of September, “as Aedes mosquitoes could breed even after the ongoing monsoon.” [IANSCIDRAP]

Alternatives to Antibiotics in Animal Agriculturereport from The Pew Charitable Trusts examines the potential for alternative products, such as vaccines, probiotics, bacteriophages, immune modulators, and others, to reduce the use of antibiotics in animal agriculture for growth promotion, disease prevention, and treatment. Alternatives are already in use by some farmers, but most approaches have had little on-farm evaluation. Regulatory hurdles, the continued availability of antibiotics for these purposes, and a perceived small market have dampened incentives for more robust research and development. Pew recommends a public-private partnership approach to moving the research and development agenda forward. [Pew Charitable Trusts]

CDC releases antibiotic stewardship guide for small and rural hospitals. The Centers for Disease Control and Prevention (CDC) has released a resource for antibiotic stewardship programs in small and Critical Access Hospitals (CAHs), based on its existing framework for expanding antibiotic stewardship activities, Core Elements of Hospital Antibiotic Stewardship Programs. This is the fourth addition to the CDC Core Elements series providing recommendations for antibiotic stewardship programs in hospitals, nursing homes, and outpatient facilities. [CDC]

 

Image via DFID (CC BY-SA 2.0)