October 09, 2016
A weekly roundup of news on drug resistance and other topics in global health.
Resource poor countries experience higher levels of antimicrobial resistance. The first study to examine the association between national income status and antimicrobial resistance (AMR) prevalence, conducted by CDDEP researchers and colleagues, found that AMR prevalence increases as national income decreases, and is highest among the poorest countries. These findings underscore the urgent need for new policies to address AMR in resource-poor settings. In their analysis, researchers used ResistanceMap, a web-based collection of data visualization tools developed by CDDEP, featuring antibiotic consumption data from 75 countries and antibiotic resistance data from 49 countries. [IJID, ResistanceMap]
Hurricane Matthew flooding expected to fuel Zika and cholera. The storm hit Haiti on Sunday and later Cuba, then the east coast of the United States. CDC’s Benjamin Haynes explained that an initial drop in mosquito populations is expected due to the storm, but the resulting flooding is likely to cause a population spike. Hurricanes and floods do not directly cause an increase in the spread of mosquito-borne illnesses, but people are more likely spend more time outside, cleaning up from the storm, exposing them to more mosquitoes. Haiti has also been experiencing a cholera epidemic since 2010, when the disease was accidentally introduced by UN aid workers. According to Jean Luc Poncelet, PAHO/WHO Representative in Haiti, “Cholera is a highly transmissible disease through water contamination. [South-western Haiti] is seriously devastated, so the risk of transmission after a hurricane like that is increased.” [CIDRAP, The Verge]
FDA guidance designed to ensure judicious use of antibiotics in animals falls short, according to an issue brief from The Pew Charitable Trusts. The US Food and Drug Administration’s Guidance for Industry #213, which takes effect January 2017, asks animal drug companies to make two changes for antibiotics shared by humans and animals: remove indications for growth promotion from the labels of antibiotics and require veterinarians to oversee the addition of the drugs to feed and water. The Pew analysis of 389 labels found that 240 met FDA’s judicious use standards, but the remainder fell short, in at least one of three ways: 100 did not adequately specify the maximum duration of use, some did not adequately specify a narrowly defined dosage, and 80 raised concerns about the indications listed. Pew calls on the FDA to take action to press companies to rectify these remaining problems. [The Pew Charitable Trusts]
UK investigation launched as online pharmacies found to dispense antibiotics inappropriately. A BBC investigation of 17 UK-based pharmacies selling antibiotics online found that, while most operated within National Institute for Health and Care Excellence (NICE) guidelines, one issued three prescriptions within 24 hours that did not conform to guidelines and others overcharged or provided the wrong drugs. The General Medical Council (GMC), which is responsible for regulating individual doctors in the UK, has since launched a probe based on the evidence found by the BBC. Lord Jim O’Neill, Chair of the Review on AMR told BBC, “Of course it is disturbing because we need to stop this dreaded risk [of antibiotic resistance]. Hopefully as a result of [the] investigation, something happens as a consequence.” [BBC, GMC]
Global Burden of Disease Study 2015 examines life-expectancy and mortality over 35 years. The study is a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. Researchers estimated all-cause mortality by age, sex, geography, and year using an analytical approach developed for GBD 2013 and GBD 2010. The study finds that age-specific mortality has steadily improved over the past 35 years with deaths from communicable diseases declining, while deaths from most non-communicable causes are increasing in most countries. The decrease in death due to communicable diseases is largely a result of decreased mortality rates among patients with HIV/AIDS (42.1 percent decrease) and malaria (43.1 percent decrease). [The Lancet, CIDRAP]