OFFICES IN Washington D.C. & New Delhi

Center For Disease Dynamics, Economics & Policy

Weekly Digest: World Health Assembly and G20 meeting focus on AMR; New resistance gene found in bacteria isolated from chickens 

A weekly roundup of news on drug resistance and other topics in global health.  

Shared regional infectious disease threat deserves regional cooperation in South Asia. CDDEP Director Ramanan Laxminarayan and Professor Buddha Basnyat, Director of the Oxford University Clinical Research Unit-Nepal, writing in The Economic Times, assess the current state of communication between countries in South Asia on disease threats. India, Nepal, Sri Lanka, Pakistan and Bangladesh are home to a quarter of the world’s population and share a high infectious disease burden and vulnerability to emerging infectious diseases like Zika, Ebola, MERS-CoV, and avian influenza. The authors write, “We may choose not to talk to our neighbors, but we share their diseases,” concluding, “Unless we address infectious diseases together, we are putting millions of lives at stake.” [Economic Times]

World Health Assembly and G20 meeting focus on AMR. This week, Ministers from around the world convened in Geneva for the 70th World Health Assembly to discuss progress and priorities, including antimicrobial resistance (AMR). The World Health Organization budget approved for the next two years includes increased investment in the new WHO Health Emergencies Programme (US$69.1 million) and combating AMR (US$23.2 million). Member countries also presented their national action plans for AMR. CDDEP’s Global Antibiotic Resistance Partnership has worked with 15 low- and middle-income countries (LMICs) over nearly a decade to complete situation analyses and national action plans. [CDDEP]

The WHO, World Organisation for Animal Health (OIE), and Food and Agriculture Organization of the UN (FAO) released results of their joint survey of countries’ AMR  national action plans at the 70th World Health Assembly, to which 145 governments (representing around 95 percent of the world’s population) responded. The survey topics are based on WHO’s Global Action Plan on Antimicrobial Resistance, adopted in 2015. High-income countries report greater capacity in all aspects of the AMR response than LMICs, and human health systems are progressing better than those for animal health. [The Lancet]

The Berlin Declaration of the G20 Health Ministers was issued at their May 19 meeting, signaling an agreement to work together on pressing global health issues. Among other commitments, G20 members agreed to strengthen national monitoring and surveillance of AMR and antibiotic consumption and cooperate with low- and middle-income countries to build their AMR surveillance capacity. [G20 Berlin Declaration]

Cholera outbreak in Yemen; recorded cases nearly double. At least 23,000 new suspected cases of cholera and 242 deaths have been recorded in the ongoing outbreak in Yemen in the past month, according to the World Health Organization (WHO). The WHO said the new cases represent a “significant upsurge,” reported from 210 districts across the country. Since the outbreak began in October 2016, about 50,000 suspected cases have been reported, including 362 deaths. Efforts to fight the outbreak have been heightened with four cholera treatment centers and 16 oral dehydration centers established across the country. [The Wire, CIDRAP]

Pandemic un-preparedness. A report from the World Bank finds that most countries are not adequately prepared to address pandemic diseases and the world is doing too little to finance strengthened preparedness. The report, From Panic and Neglect to Investing in Health Security: Financing Pandemic Preparedness at a National Level, recommends twelve actions to ensure adequate financial support and infrastructure to respond to infectious disease outbreaks. [World Bank report, CIDRAP]

Bacterial colonization and succession in a newly-opened hospital: Researchers from the University of Chicago monitored the evolution of the bacterial flora in a newly-built hospital before it was occupied and during its first year of operation, reporting results in Science Translational Medicine. They tested a variety of surfaces for two months before the hospital became operational, then continued testing equipment and surfaces, as well as patient skin and employee belongings for one year. Patients initially acquired bacteria already present in their rooms, but over time, patients’ own microbes began to influence their surroundings. [Science Translational Medicine, CIDRAP]

New resistance gene found in bacteria isolated from chickens. A new resistance gene called fosA7 has been identified in Salmonella found in broiler chickens, according to a study in Antimicrobial Agents and Chemotherapy. A team of Canadian scientists identified the gene in chickens in British Columbia, and found that it confers resistance to the broad-spectrum antibiotic fosfomycin. Resistance to this antibiotic could be a bigger problem as fosfomycin is commonly used to treat both human and veterinary infections, including urinary tract infections, and for treating multidrug-resistant infections. The gene was found in several Salmonella strains, including one of the leading causes of Salmonella infection in humans. Of great concern is the possible spread of the gene to other strains of Salmonella and to other bacterial species. [CIDRAP, Science Daily]

Directly observed therapy reduces MDR TB mortality. A new study finds that directly observed therapy (DOT) reduces mortality rates by 77 percent in MDR TB patients in the United States compared to self-administered treatment. Using surveillance data for more than 3,000 MDR TB patients from 1993 to 2013 in the United States, researchers at the Centers for Disease Control and Prevention found that as DOT increased from 74 percent (1993-2002) to 95 percent (2002-2013) of MDR TB patients, all-cause mortality decreased from 31 percent to 11 percent. Other services, such as transportation assistance and food stamps, which are provided along with DOT, may also play a role in the better outcomes. The findings were reported at the 2017 American Thoracic Society International Conference. [MedPage Today, CIDRAP]

Corrected antibiotic use data. In Lancet Infectious Diseases, Thomas Van Boeckel and CDDEP Director Ramanan Laxminarayan issue a correction to a 2014 study of global trends in antibiotic consumption. The study relied on retail and hospital sales data from IMS Health. Corrected values are linked to the Lancet Infectious Diseases correspondence. [Lancet ID, Lancet ID 2014 study]