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Weekly Digest: DCP3 key messages published in The Lancet; WHO finds ten percent of drugs in developing countries substandard or fake; Health challenges require intersectoral interventions

Intersectoral interventions for health are the need of the hour. The Disease Control Priorities, 3rd Edition (DCP3) key messages published in The Lancet recommends twenty-one essential packages that contain both intersectoral and health-system interventions. These include building surgical services, meeting unmet demand for contraception, adopting a multipronged approach to air pollution, and prolonging investments in child health and development far beyond the first 1,000 days of a child’s life. CDDEP was a DCP3 institutional partner and various CDDEP researchers including Ramanan Laxminarayan and Arindam Nandi contributed to DCP3 volumes. [The Lancet]

Value in more schooling for girls, prioritizing early-life health and nutrition. CDDEP Fellow Arindam Nandi and colleagues write in chapter 27 of Disease Control Priorities, 3rd Edition (DCP3) about the potential impact on the health and economic benefits of interventions that improve early childhood nutrition like micronutrient supplementation and breastfeeding, especially in developing countries. Similarly, chapter 28 offers a cost-effectiveness analysis of postponing adolescent parity in developing countries and underscores the impact of early-life health and nutrition on schooling, earnings, and productivity over the lifecycle. [Chapter 27Chapter 28 Disease Control Priorities, 3rd Edition]

Gut microbes may affect the outcome of cancer treatment. A study in Science finds that gut microbes determine the outcome of cancer immunotherapy treatment with PD-1 inhibitors. Patients who took routine antibiotics before or soon after taking PD-1 inhibitor were more likely to relapse and die compared to those without antibiotics. In fact, “avoiding antibiotics while taking PD-1 blockers could boost patient responses from the current twenty-five percent to forty percent.” More trials are planned to study if manipulating patients’ gut microbiome could improve the response to the therapy. [Science StudyScience]

WHO: ten percent of drugs in developing countries are substandard or fake. A World Health Organization (WHO) report estimates that one in ten medicines sold in low- and middle-income countries could be substandard or falsified; antimalarials and antibiotics are among the most widely sold substandard or falsified drugs. Since 2013, the WHO received 1500 such reports out of which forty-two percent were from Sub-Saharan Africa. [WHO Global Surveillance and Monitoring System for substandard and falsified medical products] 

WHO: Global malaria control not on track. Following global successes in malaria control, progress may have slowed, according to the World Malaria Report 2017. Malaria increased by an estimated five million cases in 2016 over the previous year, although no rise in malaria deaths was observed. Insufficient funding at both the domestic and international levels may be creating gaps in lifesaving interventions. [World Malaria Report 2017]

Antibiotic use in mothers during labor may affect babies’ gut microbes. Antibiotics given to mothers to prevent infections during labor may alter the gut microbiomes of their babies, but the effects resolve in 3 months, according to a study in Scientific Reports. The research indicates that antibiotics could delay the growth of microbes in the infant gut. [Scientific Reports]

Antibiotics given for sepsis by emergency medical services do not help. Administering antibiotics to suspected sepsis patients in emergency situations, such as in ambulances en route to the hospital, does not improve survival, according to a study in The Lancet Respiratory Medicine. The study of 2,672 patients found that eight percent of patients in both the intervention group and the control group had died at day twenty-eight, regardless of illness severity. [The Lancet Respiratory MedicineCIDRAP]

Four factors identified for pneumonia diagnosis. According to a study published in the European Respiratory Journal, testing for fever, high pulse rate, crackly breath sounds, and low oxygen levels could help distinguish pneumonia from less serious infections. The researchers say this approach could reduce antibiotic prescribing and use. [European Respiratory Journal]

Clostridium difficile infections in children impose economic burden. A study in Infection Control and Hospital Epidemiology finds that the cost of a Clostridium difficile infection (CDI) in hospitalized children in the US ranged from $2,000 to more than $8,000, depending on the length of stay. The researchers say the pediatric economic burden is similar to estimated costs for adult CDI care, and they support interventions to prevent the infections in children. [Infection Control and Hospital Epidemiology]

Fecal transplant pill may be as effective as colonoscopy for Clostridium difficile infections. Delivering fecal transplants by capsule may be as effective as colonoscopy for treating patients with recurrent Clostridium difficile infections (RCDI), according to a study in the Journal of the American Medical Association. Researchers found that fecal microbiota transplantation via oral capsule led to similar improvements and resulted in fewer adverse events. [Journal of the American Medical Association]

Global polio investments running dry. As the Global Polio Eradication Initiative (GPEI) winds down, a report warns of losing 70 percent of global funding for surveillance and a potential for collapse of immunization systems in developing countries. 60 percent of the world’s unimmunized infants live in sixteen GPEI priority countries. The report recommends that national governments increase immunization resources and support from bilateral donors to strengthen routine immunization. [A Balancing Act: Risks and Opportunities as Polio and its Funding Disappears]

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