Weekly Digest: White House releases National Action Plan on Combating Antibiotic Resistance

The U.S. President’s Council of Advisors on Science and Technology (PCAST) released its National Action Plan on Combating Antibiotic Resistance today. The plan, created as part of the administration’s National Strategy on Combating Antibiotic Resistance, focuses on five key goals: preventing resistant infections and slowing the spread of resistant bacteria. strengthening one-health surveillance efforts, creating rapid diagnostic tests, accelerating research and development and improving international efforts to curb resistance. PCAST was praised for its approach to most key issues but criticized for not taking a harder line on antibiotic use for growth promotion in livestock [The White House, Pew Charitable Trusts, The Washington Post]

The first volume of Disease Control Priorities, 3rd edition (DCP3), Essential Surgery, was published this week. According to the volume, basic surgical procedures are one of the most cost-effective health interventions in low- and middle-income countries, and ensuring greater access to surgical care in such places could avert 1.5 million deaths annually. CDDEP Director Ramanan Laxminarayan and Associate Director Hellen Gelband both serve as editors of DCP3. [Disease Control Priorities, 3rd edition]

CDDEP Director Ramanan Laxminarayan was interviewed for several recent news stories on CDDEP’s most recent publication, “Global trends in antimicrobial use in food animals.” The paper reported that global livestock antibiotic use is expected to increase 67% by 2030. NPR’s Goats and Soda blog highlighted differences in use between livestock types (noting the study’s findings that antibiotics are used most often in pigs, followed by chickens and then cattle), and The Atlantic placed the study in the larger context of increasing antibiotic resistance. Indian newspaper The Hindi focused on increases in India, which could see a nearly five-fold rise in poultry antibiotic use by 2030. [PNAS, NPR, The Atlantic, The Hindu]

Tuesday March 24 was World TB Day, and several organizations took the chance to warn of the spread of multidrug-resistant tuberculosis (MDR-TB). The WHO European regional office said in a statement that “MDR-TB is still ravaging the European Region, making it the most affected area of the entire world.” A CDC report found that the overall tuberculosis rate in the United States dropped by the smallest margin in a decade in 2014—just 2.2 percent. On the CDDEP blog, CDDEP Senior Research Analyst Aditi Nigam and Fellow Arindam Nandi wrote about a Gates Foundation and World Health Partners project that seeks to slow the spread of MDR-TB in India by improving early diagnosis and detection of tuberculosis through a Public Private Interface Agency. [WHO, CDC, CDDEP]

An Associated Press (AP) investigation found that the WHO delayed declaring Ebola a global emergency by up to two months. AP reporters examined emails and internal documents from WHO officials and concluded that the delay was largely due to concerns about potential adverse effects of a declaration, which critics say harmed the response. This week also brought some good news in fighting the epidemic, however: a Lancet study detailed positive safety and immunogenicity results for a vaccine based on the 2014 strain of the virus, and a study published in Science found that the virus has not evolved as quickly as some scientists had feared. [AP, The Lancet, Science]

A dramatic increase in HIV cases has led Indiana’s governor to declare a public health disaster in one rural county. Governor Mike Pence authorized a short-term needle exchange program in the area after the outbreak, which health officials believe is the state’s worst HIV outbreak on record. The outbreak appears to be tied to intravenous prescription drug abuse. [Reuters]

Chlorine use in wastewater treatment plants may be contributing to antibiotic resistance, according to research presented at a recent meeting of the American Chemical Society. The researchers describe two possible pathways that could encourage resistance: 1) chlorine treatment may not fully eliminate pharmaceuticals from the water supply, allowing discharge of trace amounts of antibiotics, which contribute to the development of resistant organisms, and 2) chlorine interacts chemically with some antibiotics to produce altered antimicrobial agents, to which resistance may develop. [Infection Control Today]

Poor sanitation and lack of clean drinking water in Haiti will allow cholera to continue spreading, according to health officials at the Pan American Health Organization (PAHO). More than 7,000 cholera cases were recorded in Haiti in the first two months of 2015, more than during the same time period in either 2012 or 2014. [Reuters]

The malaria parasite may lure mosquitoes with a pleasant scent. Research published by scientists at Washington University in St. Louis found that malaria-infected blood contained scented volatile compounds that are known to attract mosquitoes, which could become infected with the parasite and pass it on to other hosts. The single-celled parasite’s lemon- and pine-related scent production may be the result of nearly a billion years of evolution. [mBio, National Geographic]

Does speeding new antibiotics to the market actually help fix the broken pipeline? A commentary in the British Medical Journal by associate editor Peter Doshi investigates this question with regard to the FDA’s “qualified infectious disease product” program. Doshi argues that several structural issues with the program—including new drugs not having to “address an unmet medical need,” limited population non-inferiority trials and approval that doesn’t consider risk of death or decreased mortality—may lead to special status being awarded to drugs that don’t actually help address the larger problem of resistance.  [BMJ]