November 12, 2016
A weekly roundup of news on drug resistance and other topics in global health.
Genetic markers for drug-resistant malaria identified; Would antimalarial mass drug administration increase resistance? Two studies reported in Lancet Infectious Diseases searched for genetic signatures of of Plasmodium falciparum malaria resistance to piperaquine, which is used in combination with an artemisinin compound to treat malaria. In the accompanying commentary, Professor. Arjen Dondorp writes, “The converging results of these studies make plasmepsin 2–3 amplification a robust marker for piperaquine resistance in the region.”[Lancet ID Commentary, Lancet ID study, Lancet ID study, CIDRAP]
In a Lancet Infectious Diseases Personal View, Professor Nicholas J. White, FRS, asks: Does antimalarial mass drug administration increase or decrease the risk of resistance? Professor White determines, “an argument can be made for eliminating malaria earlier rather than later,” with population-wide drug administration. [Lancet ID Personal View]
Are C. difficile infections the “lowest hanging fruit” for antibiotic stewardship? A recent study of national antibiotic stewardship in Scotland, which began in 2009, found that stewardship interventions halved the use of “4C antibiotics” (fluoroquinolones, clindamycin, co-amoxiclav, and cephalosporins) in hospitals and the community, and that C difficile infection prevalence fell by 68 percent in hospitals and 45 percent in the community compared to projected levels without the interventions. The study area serves 11 percent of the Scottish population. A comment in Lancet Infectious Diseases suggests that C. difficile “represents one of the clearest opportunities for antimicrobial stewardship programmes to demonstrate their benefit,” on many levels – hospitals, systems, and populations. [Lancet ID study, CIDRAP, Lancet ID comment]
Lancet report estimates $1-2 per person monthly would fund access to 201 essential medicines all over the world. The Lancet Commission on Essential Medicines Policies released a report analyzing essential medicines policies over the past 30 years, since the Nairobi Conference on Rational Use of Drugs in 1985. Essential medicine policy includes: paying for a basket of essential medicines, affordability of medicines, ensuring quality of medicines, promoting quality medicines, and developing new and missing medicines. The report also provides actionable recommendations for global policies and for the global health agenda. [Lancet EMP Commission]
U.S. cities vote in taxes on sugary beverages. Voters in three California cities—San Francisco, Oakland, and Albany—passed a 1-cent-per-ounce tax on sugar-sweetened beverages (SSBs) and in Boulder, CO, the increase is 2-cents-per-ounce. These cities join Philadelphia and Berkeley in the United States and some foreign jurisdictions, including Mexico. According to NYU Professor Marion Nestle, “Why would [the beverage industry] put millions and millions and millions of dollars into fighting [SSB taxes] in every community that is coming up with one of these if [they] didn’t think it would make a difference and a big one? It will have an enormous impact.” [EconLife]
What more can India do to address drug-resistant tuberculosis? Activists interrupted an international conference in England to draw attention to what they consider broken promises in implementing India’s Revised National Tuberculosis Control Program (RNTCP). The protest and the activtists’ claims were the subject of a column in The Hindu, a leading Indian newspaper. India has more patients living with drug-resistant tuberculosis than any other country on the globe and an estimated 79,000 people contract drug-resistant TB in India each year. According to Dr. Mario Raviglione, Director of WHO’s Global Tuberculosis Programme, “If India does not move, the world does not move. We cannot do much without India as they have nearly 30 per cent of the TB cases there.” [The Hindu]
Next week is World Antibiotic Awareness Week 2016. WAAW is a time to increase awareness of antibiotic resistance and encourage good stewardship practices among agencies and the public. Global Antibiotic Resistance Partnership (GARP)-Kenya will be holding a week-long event called “Antibiotics-Handle with Care,” featuring presentations and sessions with civil society organizations in health and agriculture. GARP-Nepal’s activities include a bicycle rally, poster and essay competitions, and information sessions. CDDEP will be sharing policy strategies for national action against antibiotic overuse and resistance throughout the week via social media and will also highlight (GARP) and Conscience of Antimicrobial Resistance Accountability (CARA) developments on the CDDEP blog.
