March 25, 2016
A weekly roundup of news on drug resistance and other topics in global health.
Public health is hard: Overcoming obstacles in Nepal. On the CDDEP blog, Associate Director Hellen Gelband writes about health practitioners in Nepal working to solve public health problems creatively in the wake of the unofficial blockade of Indian goods and subsequent fuel shortage in the country. Gelband writes about the journey that Shyam Sundar Budhathoki, Assistant Professor at the BP Koirala Institute of the Health Sciences (BPKIHS) School of Public Health, undertook to develop curriculum for sexual and reproductive health and rights at BPKIHS. Though the blockade is now more or less over, the challenges involved highlight Nepal’s vulnerabilities. [CDDEP]
CDDEP Director Ramanan Laxminarayan will deliver the 2016 John Ring LaMontagne Memorial Lecture at the U.S. National Institutes of Health on April 5. Laxminarayan’s presentation, entitled “The State of the World’s Antibiotics,” will take place in the Lipsett Amphitheater in Building 10 on the NIH campus in Bethesda, MD from 3-4pm on April 5. [National Institute of Allergy and Infectious Diseases]
Basic infection prevention—handwashing, sanitation and clean water—and strong surveillance systems are critical in the fight to prevent the spread of antibiotic resistance, concludes the latest report from the Review on AMR. The Review, commissioned by UK Prime Minister David Cameron, will issue one final report to conclude the series on global antibiotic resistance and possible methods to combat the problem. [Review on AMR, National Geographic]
Multi-drug resistant tuberculosis (MDR TB) patients in Myanmar are under treatment with two new drugs. A lucky 20 patients—out of 9,000 each year in the country with MDR TB—are getting the new drugs, bedaquiline and delamanid, from medical charity Médecins Sans Frontiéres (MSF), with special funding from UNITAID. These drugs, the first new anti-TB drugs in 50 years, are approved and for sale around the world, but the price is high: $1700 per course for the delmanid component alone, as a concessionary price for poor countries. Otsuka, the developer of delamanid points out that this is a 95 percent reduction from the list price in Europe. MSF estimates that 2 percent of those with MDR TB globally have access to these drugs. [The Guardian]
New reimbursement models to delink antibiotic development from sales income may help rationalize the economics of antibiotic development, write John Rex and Kevin Outterson in a comment in The Lancet Infectious Diseases. Outterson and Rex address this perversely incentivized situation—that maintaining the effectiveness of new antibiotics depends on limited use of the drug—which minimizes sales and de-incentivizes pharmaceutical companies to develop new antibiotics. Their ideas include incentives such as cash prizes for new drug development or insurance-like models that don’t directly reward sales. But different antibiotics carry different societal value, depending on which infections they treat and where those infections are common, so the authors argue that a graded array of approaches that offer financial rewards based on expected worldwide societal value would most effectively stimulate development of needed antibiotics. [The Lancet Infectious Diseases]
The first birth defects tied to Zika virus infection in Panama were reported this week, according to the World Health Organization. Panama is only the second country, after Brazil, with confirmed cases of microcephaly linked to Zika infection. Colombia is currently investigating several possible Zika-linked microcephaly cases. The US Congress adjourned for a spring recess Wednesday without conducting a vote on President Obama’s requested $1.9 billion emergency funding request for research to limit the spread of Zika. Officials from CDC and the National Institute of Allergy and Infectious Diseases stated that because they lack funding for Zika, funds are currently being shifted away from other critical public health programs. South Korea reported its first case of Zika virus infection this week, adding to a handful of confirmed cases in Asia. [The New York Times, STAT News, BBC]
India has begun a national rotavirus vaccination campaign, which will be one of its largest ever public health initiatives. The campaign, which aims to vaccinate children under the age of one year, will start in four states: Odisha, Andhra Pradesh, Haryana and Himachal Pradesh. Current estimates indicate that rotavirus, which causes diarrheal disease, causes 120,000 deaths in children under five annually in India. [Wall Street Journal, Times of India]
Antibiotic exposure in infancy is not associated with weight gain through age seven in U.S. children, according to research published in JAMA. The records of more than 38,000 children born between November 2001 and December 2011 were analyzed, finding that about 14 percent received antibiotics in the first six months of life. Through age seven, these children did not gain more weight than children with no antibiotics in the first six months. Previous research in animal models suggested that early exposure to antibiotics was associated with weight gain, but it does not appear to be true for humans. Write the authors, “There are many reasons to limit antibiotic exposure in young, healthy children, but weight gain is likely not one of them.” [JAMA]
The United States has seen a late season surge in flu activity, through early March. The weekly flu report from CDC found widespread circulation in 40 US states and Puerto Rico for the week of March 6-12, up from 37 states and Puerto Rico the prior week. Eight flu-related deaths in children were also reported—a significant uptick from previous weeks, bringing total pediatric flu-related deaths for this season to 28. This is still considerably lower than the previous three seasons, with more than 100 pediatric deaths each year. [CIDRAP, CDC]
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