October 01, 2024
Health taxes are needed to reduce the global noncommunicable disease burden.
An analysis by One Health Trust researchers Dr. Amit Summan, Divija Samria, and Dr. Ramanan Laxminarayan supported key arguments in a report launched by a special task force on fiscal policies for health at the United Nations General Assembly. Increasing health taxes sufficiently to raise prices by 50 percent on tobacco, alcohol, and sugary beverages could generate approximately US$3.7 trillion in additional revenue over 5 years. Allocating these funds to health initiatives could increase global government health budgets by 12 percent and those in low- and middle-income countries by 40 percent. The Task Force on Fiscal Policy for Health, co-chaired by former New York mayor Mike Bloomberg, Prime Minister of Barbados Mia Amor Mottley, and economist Larry Summers, emphasizes the necessity of these taxes to combat noncommunicable diseases, which claim over 40 million lives annually. [Bloomberg Philanthropies]
The need for sustainable access to effective antibiotics
Ahead of the United Nations General Assembly high-level meeting on antimicrobial resistance on September 26, OHT’s Dr. Ramanan Laxminarayan affirmed that while awareness of AMR has increased and antibiotic misuse persists, a lack of access to existing antibiotics is still a significant cause of death, particularly in low- and middle-income countries. Dr. Laxminarayan affirmed that the United Nations resolution, which was eventually passed on September 26, establishes targets for mortality reduction and proposes an independent panel to review evidence and share knowledge and strategies to combat AMR globally. [Think Global Health]
New WHO guidance to mitigate gender disparities in the prevention and treatment of drug-resistant infections
OHT researcher Dr. Deepshikha Batheja contributed to the World Health Organization’s (WHO) new guidance to address gender disparities in the prevention, diagnosis, and treatment of antimicrobial-resistant infections. Women and girls are at a greater risk of complications from drug-resistant infections due to gender-related barriers to healthcare and exposure to drug-resistant pathogens, including through unpaid labor. Women are also 27 percent more likely than men to receive antibiotics in their lifetime. The WHO guidance outlines 20 recommendations for United Nations Member States that aim to promote equitable antibiotic access and mitigate gender-specific vulnerabilities linked to AMR. [WHO]
Considerations for teamwork in antimicrobial stewardship implementation
An ethnographic study of antimicrobial stewardship (AMS) in Spain identified teamwork as a critical aspect of AMS interventions in clinical settings. The six elements of teamwork in AMS programs are professional recognition, maintaining work relationships, emotions and diplomatic work, apprenticeship and teamwork skills, information infrastructures and communication, and job security and sustaining AMS interventions. Reflecting on these six characteristics is crucial for the feasible and sustainable implementation of AMS interventions in healthcare settings. [JAC-Antimicrobial Resistance]
Antibiotic resistance genes identified in food-producing animal fecal samples in Brazil
Whole-genome sequencing of three multidrug-resistant Providencia rettgeri isolates revealed the presence of a variety of antimicrobial resistance genes (ARGs) collected from swine and bovine stool samples in rural Brazil, including one that promotes the production of NDM-1 (an enzyme that confers resistance to a broad range of beta-lactam antibiotics.) These findings suggest that feces from food-producing animals in Brazil can contribute to the spread and persistence of ARGs in surrounding environments. [One Health]
Novel antibiotic treatment for gonorrhea requires more research and surveillance
Zoliflodacin, a novel, single-dose oral antibiotic developed through a public-private partnership, treats uncomplicated urogenital gonorrhea and was recently shown to be safe and non-inferior to ceftriaxone plus azithromycin in a phase 3 randomized controlled trial. Following a workshop convened by the Global Antibiotic Research & Development Partnership in 2023, experts recommend further evidence generation and AMR surveillance in Neisseria gonorrhoeae to support the regulatory approval and roll-out of zoliflodacin in low- and middle-income countries. [BMC Global and Public Health]
Risk factors for recurrent bacterial STI for people on HIV pre-exposure prophylaxis
A secondary analysis of prospective data from men who have sex with men and transgender women on HIV pre-exposure prophylaxis in Brazil, Mexico, and Peru found that 61.2 percent of bacterial sexually transmitted infection (STI) diagnoses in the follow-up period were recurrent cases. Recurrent bacterial STI diagnoses were more common among participants aged 18-24 years, those who reported multiple sexual partners since the last visit, those who reported recreational use of inhaled alkyl nitrates, and those with previous STI diagnosis at baseline. [The Lancet HIV]
Characterizing resistance among pathogens found in children in the WHO Western Pacific Region
A systematic review and meta-analysis of bacteria responsible for common infections in children across the WHO Western Pacific Region (WPRO) highlighted the significant burden of resistance among pathogens, including Escherichia coli and Klesbiella spp., to WHO-recommended empiric antimicrobial agents such as ampicillin, gentamicin, and third-generation cephalosporins. Notably, only 6 out of 18 low- and middle-income countries in WPRO were represented in this review, underscoring the limited generalizability of these findings and the need for improved AMR surveillance. [The Lancet Regional Health – Western Pacific]
Recommendations for food safety technical working groups in low- and middle-income countries
A qualitative analysis of food safety technical working groups (FSTWGs) in Vietnam and Ethiopia (created under each country’s One Health platform) found that financial and technical support from development partners was critical in initiating working groups. At the same time, the absence of a legal framework prevented the attainment of governmental commitment and political will. Recommendations to other low- and middle-income countries include incorporating existing FSTWGs into national One Health efforts to bolster federal policy and process changes. [One Health Outlook]
Assessing tuberculosis among infants born to mothers with drug-resistant tuberculosis
About 23 percent of infants born to 101 mothers with multidrug- or rifampicin-resistant tuberculosis (TB) in KwaZulu-Natal province, South Africa, between 2013 and 2022, were diagnosed with TB. Mothers whose infants were diagnosed with TB were more likely to test positive on sputum culture at birth than those whose infants were not diagnosed with TB (40 vs. 14 percent). Three infant cases of TB were partly attributed to health system failures, such as the administration of an antibiotic to which the mother had documented resistance and failure to administer prophylactical treatment to a mother whose husband tested positive for TB. [eClinicalMedicine]
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