US needs to work with China in pandemic fight; Let’s return to reason and science:US economist

 

Expert: Both countries should cooperate in fight against pandemic

 

Prof Dr Jeffrey Sachs

 

 

KUALA LUMPUR: The United States needs to work with China to find a global solution in the fight against the Covid-19 pandemic, says prominent academician Prof Dr Jeffrey Sachs

“This is tragic, since China has done an excellent job of suppressing the pandemic, and the world could and should have learned a lot more from China’s response.

“The United States should learn some good manners to work cooperatively with China, rather than trying to impose its will on that nation,” the head of the Lancet Covid-19 Commission said.

In an email interview, the Columbia University lecturer was asked to comment on the increasing friction between the US and China over the origins of the coronavirus and the pressure on the World Health Organisation to conduct another round of investigations to determine the source of the problem.

“Both governments have information that they should add to the investigation of the origin of the virus.

“Indeed, much of the research underway at the Wuhan Institute of Virology was a joint US-China project, with funding by the US.

“Therefore, there is no cause for finger-pointing by one country towards the other. We need scientific cooperation between the US and China in the search for the origin of SARS-CoV-2, the virus that causes Covid-19,” he added.

On how the synergy can be established and areas to focus on, Dr Sachs said “scientists from the two countries have actually been working together on SARS-like viruses”.

“The two governments should be cooperating transparently together. Both should be adding more information to the investigation. The US should acknowledge its role in the laboratory work, and therefore, its co-responsibility in investigating the possible origins of the virus.”

Dr Sachs said rich countries had also not generously shared their knowledge, especially on vaccines, adding that the major regions including the United States, Euro­pean Union, China, India, Russia and Asean had not attempted any kind of coordinated response.

“The global financing system has favoured the rich countries, providing too little support to developing countries,” he said.

“The culture in many societies – such as the United States – has put personal behaviour ahead of the social good.

“In the name of ‘liberty’, Americans have failed to follow basic rules and protocols, and the disease has therefore been allowed to run rampant in the US.”

WONG CHUN WAI

> See the full interview on Let’s return to reason and science - Award-winning Jeffrey D. Sachs is an economics professor, best-selling author, innovative educator and a global leader in sustainable development. He serves as the director of the Center for Sustainable Develop­ment at Columbia University in New York, and is a University Professor, Columbia’s highest academic rank.

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 Let’s return to reason and science

  Looking ahead: Malaysia’s Institute for Medical Research is currently working on a few Covid-19 vaccines. — SAMUEL ONG/The Star

 Internationally renowned academician Professor Dr Jeffrey Sachs, who heads the Lancet Covid-19 Commission, shares his views in an exclusive interview on the fight against the pandemic, the US-China rivalry and his call to Malaysia to produce its own vaccine.

The United States should learn some good manners to work cooperatively with China, rather than trying to impose its will on that nation," said renowned U.S. economist Jeffrey Sachs.

  

Prof Dr Sachs: Malaysia started late in vaccination because it’s not a vaccine producer, but now, the country is catching up. Malaysia should aim to produce vaccines in the future.

> The Lancet Covid-19 Commission was created to help speed up global, equitable and lasting solutions to the pandemic. How much has been achieved and what are the hurdles?

The global response to the pandemic has been wholly inadequate. This results from five main factors:

(1) The epidemic has been handled as a matter of national policy-making, without adequate regional and global coordination;

(2) The major regions, including the US, EU, China, India, Russia and Asean, have not attempted any kind of coordinated response;

(3) The rich countries have not fairly shared their technologies, especially on vaccines;

(4) The global financing system has favoured the rich countries, providing too little support to the developing countries;

(5) The culture in many societies – such as the United States – have put personal behaviour ahead of the social good. In the name of “liberty”, Americans have failed to follow basic rules and protocols, and the disease has therefore been allowed to run rampant in the United States.

Perhaps the main geopolitical problem has been the failure of the US to work with China for global solutions. This is tragic, since China has done an excellent job of suppressing the pandemic, and the world could and should have learned a lot more from China’s response.

> On a personal level, what is your role?

I am participating in policy discussions almost daily with governments and international organisations, as well as with the Commissioners and the experts on our various task forces. My job is to help coordinate the work of the Commission, and to oversee the drafting of various statements and the final report, which will be published in mid-2022.

While the world still battles the raging pandemic, new variants have surfaced, making it harder to contain the problem.

> What are your views on the continuing obstacles?

The delta variant has been a huge setback, but given the faulty policies by so many governments around the world, the emergence of new variants like delta has been made much more likely by the delays in comprehensively suppressing the virus. We should have known better but failed to act wisely.

> Vaccination remains the most effective way to fight the pandemic. What is your view on how Malaysia is handling its vaccination exercise?

We know that the vaccines are not enough to stop transmission – as Israel has shown (with high vaccine coverage but a strong epidemic). Vaccines cut serious disease, but do not stop transmission by themselves. Thus, countries need to combine vaccination with strong suppression policies (based on social distancing, prohibition of super-spreader events, face mask wearing, widespread and readily available testing, emphasis on outdoor rather than indoor activities, contact tracing, and other measures). Malaysia started late in vaccination because it’s not a vaccine producer, but now, the country is catching up. Malaysia should aim to produce vaccines in the future.

> Obtaining vaccines continues to be an issue for many developing countries. It’s worse in Africa. How real is the hoarding of vaccines by powerful developed countries?

Very real. The failure of the vaccine-producing countries to come up with a plan to scale up production and distribution of vaccines to developing countries is a great disappointment. It is a moral failure as well as a practical failure, leading to more deaths and more chances of dangerous variants.

> Many scientists have said the third vaccination – the booster – isn’t necessary as it will further deprive many countries from having access to the supply. What are your thoughts?

The evidence is not comprehensive, but it is a shame for rich countries to give the third dose without even a plan for the first dose in much of the world. That is unwise, unfair, and immoral in my view. The US, China, Russia, EU, UK, and India should present a coherent, coordinated plan for global vaccination coverage, and the US and EU should waive IP (intellectual property) to facilitate the scale-up of vaccine production in more countries. China, for example, should be helped to speed the production of mRNA vaccines.

> Ordinary people are overloaded with all kinds of information. Vaccines – whether they are Pfizer, AstraZeneca or Sinovac, are basically the same, but because the US, Europe and China have adopted different requirements, it has led to anxiety for securing entry into these countries. What are your views on this?

Once again, there is too little coordination and cooperation among the major countries, and too little sharing of information.

> Can you comment on how politics, especially geopolitical rivalry, can be separated from science?

The United States should learn some good manners, to work cooperatively with China rather than try to impose its will on the country.

> What is your comment on the increasing friction between China and the US over the origins of the coronavirus and the pressure on the WHO to have another round of investigations to determine its source?

Both governments have information that they should add to the investigation on the origin of the virus. Indeed, much of the research underway at the Wuhan Institute of Virology was a joint US-China project, with funding by the US. Therefore, there is no cause for finger-pointing by one country at the other. We need scientific cooperation between the US and China in the search for the origin of SARS-CoV-2, the virus that causes Covid-19.

> What should the US and China be doing in the fight against the pandemic, instead of having this side issue? How can both sides work together and in what areas can they combine resources? Both sides have accused each other of the virus originating from lab leaks.

As I just mentioned, scientists from the two countries have actually been working together on SARS-like viruses. The two governments should be cooperating transparently together. Both should be adding more information to the investigation. The US should acknowledge its role in the laboratory work, and therefore, its co-responsibility in investigating the possible origins of the virus.

> The WHO’s team, comprising experts from China and other countries, arrived in Wuhan for a month’s investigations into the origins of the virus. There is now another request for a follow up probe while China has also demanded a separate investigation into Fort Detrick in the US. What is your take?

We need a clear investigation of the joint US-China research programme to see if, by some terrible accident, it somehow contributed to a research-related spill over event. That is one hypothesis that needs investigation, along with various possibilities of natural spill over events.

> Finally, in the post Covid-19 pandemic world, how should the world and health experts brace for more infectious diseases?

We have many disease crises around the world, ranging from known infectious diseases that are not yet properly controlled (such as Malaria, worm infections, TB, HIV, etc.), as well as emerging infectious diseases such as Covid-19, non-communicable diseases (such as the global diabetes epidemic), and environmental ills (such as lung and cardiovascular diseases caused by air pollution). We should be investing far more resources into epidemiology, disease surveillance, disease prevention, and disease treatments. The Global Fund to Fight AIDS, TB, and Malaria should become the Global Health Fund, to finance the response to the global disease burden in developing countries. All of this requires foresight, long-term thinking, and more resources from the rich world

 

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Convincing the non-believers for vaccination

With the Covid-19 vaccine rollout starting soon, the onus is on the government to engage the fence sitters.

RECENT news that Indonesia has made Covid-19 vaccination for its citizens compulsory has given rise to speculation that Malaysia could follow suit.

With the National Covid-19 Immunisation Plan around the corner, the government machinery has swung into gear to convince the people that vaccination is the only way out of this pandemic that has imprisoned our lives.

The government has already hinted of fines for those who decline the vaccine and there is also a possibility that individuals who reject the vaccination could have their movements restricted. This means that they will be barred from entering business premises or restaurants.

While there are no plans at this time to draw up legislation to make it compulsory for everyone to be vaccinated, the sledgehammer approach may not be as effective as we think.

The World Health Organisation (WHO) believes that making vaccines compulsory is counter-productive, as it will increase vaccine hesitancy that is already present.

I believe that Malaysians can be divided into three categories: proponents of the vaccine, anti-vaxxers and the fence sitters, people who though unopposed to taking the vaccine, are yet to be convinced that vaccination is essential for herd immunity.

It will be nigh on impossible for the government to convince the anti-vaxxer movement. They may be small in number, but these fellow Malaysians, like others around the world, are dead set against the vaccination plan.

In fact, some of these anti-vaxxers are also Covid-19 deniers. They believe that the pandemic is a conspiracy that has been exaggerated by the media and that Covid-19 is a hoax.

So no amount of cajoling or threats are going to make them change their minds. It is the third category that the government should focus on – Malaysians who are wary or unsure of taking the vaccine.

There needs to be a massive public relations drive to reach these fence sitters. From vaccine safety issues to side effects, from registration protocols to logistical challenges, the government needs to address the concerns of this segment of the populace. Public education is going to be key, not harsh fines, penalties and sanctions.

And it should not only be government agencies that embark on this blitz. Key opinion leaders, influencers and NGOs should be roped in to assist in this, our biggest ever immunisation programme.

Of crucial importance is getting the vaccination message across to the rural areas and not just our urban centres.

The government made the right move by also allowing free vaccinations for foreign workers. There must now be a concerted effort to get undocumented foreign workers to also come forward to receive vaccines. There could be as many as a million undocumented workers in the country, and if they are not vaccinated, our objective of reaching herd immunity will not come to fruition.

It should be pointed out that we will not be taking shortcuts to achieving herd immunity.

The Pfizer vaccine that will arrive on Sunday requires two doses, 21 days apart. Even though other countries have spaced this out to as much as eight weeks, thereby vaccinating a greater number of people, Malaysian authorities have already confirmed that they will stick to the manufacturer’s recommended dosage.

But in the race to vaccinate its populations, we are already behind many countries.

For example, more than 15 million people in the United Kingdom have already received their dose. This works out to almost 24 doses per 100 residents.

In the United States it’s 16 doses per 100 and in the European Union as at mid February it is five doses per 100 residents.

Surprisingly France, which has one of the best public healthcare systems in the world, has been slow to administer vaccines to its population. This could be because of the strong anti-vaccine sentiment in the country.

A poll last year revealed that only 54% of French were willing to be immunised.

So, that should be a concern for our government too. We need to do our best to combat anti-vaccine propaganda because we have no time to lose.

As more of the world is vaccinated, travel bubbles will open up. Soon travellers will be required to show a digital health passport, possibly via an app on your phone that proves you have been vaccinated.

This may be the only way travel restrictions will be lifted.

As more companies roll out vaccinations, Covid-19 doses will eventually become as common as a flu shot. That is a reality that Malaysians must expect and embrace.

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https://youtu.be/WV2v8osGAa4

WHO chief blasts rich countries for hoarding vaccines

https://youtu.be/2SFm_lc_r0k

WHO Director-General Tedros Adhanom Ghebreyesus on Monday lashed out at inequitable distribution of COVID-19 vaccines. He said most of the vaccines "have now been administered" in rich countries. "The world is on the brink of a catastrophic moral failure - and the price of this failure will be paid with lives and livelihoods in the world's poorest countries," he warned.

For now, seven COVID-19 vaccine candidates have been administered worldwide, the key of which are the US-developed and China-developed ones. The US-made vaccines have basically flowed to developed countries, while the China ones have mainly gone to developing countries.

Among rich countries that use US vaccines, the US has vaccinated 12 million people, ranking the first. 4.31 million doses (including the Oxford-AstraZeneca vaccine) have been administered in the UK, topping European countries. Canada reportedly has ordered enough vaccine doses to protect each Canadian five times. Three members of the Five Eyes alliance have left others way behind them in vaccine distribution. They have prioritized their own demands amid short vaccine supply, though Britain claimed it raised donations to help vulnerable countries access COVID-19 vaccines.

The US, the UK and Canada all shout loudly for developing countries' human rights. But they are the ones contributing to "a catastrophic moral failure" that Ghebreyesus said. When the interests of their own countries are not involved, they express concerns about human rights of other countries. But when they need to take real actions to help other countries realize human rights, they retract their heads as turtles.

Vaccines developed by Chinese companies have become a key resource to break rich countries' privilege and safeguard developing countries' rights. Chinese vaccines are cheap, easy to be transported and used all over the world. Besides, China has an explosive vaccine production capability and it has a greater surplus to provide the outside world, since the domestic epidemic in China has been relatively alleviated.

At the initial stage of distribution when supply is short, US vaccines will inevitably go to developed countries. The Five Eyes countries know this well. According to the WHO, it took over 10 years for life-saving HIV/AIDS drugs to reach poor countries after its invention. When the poor countries could put the HINI vaccines into use, the epidemic had already been over. Based on the vaccine distribution order in the past, developing countries will undergo many delays and setbacks to get US COVID-19 vaccines.

The Chinese vaccines are an important humanitarian supplement, but the US and its major allies have taken a cold attitude and even disparaged Chinese vaccines. They didn't offer much help in Chinese vaccines' Phase III trials. Particularly, Western public opinion in general is not friendly. It is keen on hyping and exaggerating any information unfavorable to Chinese vaccines and accuses China of engaging in "vaccine diplomacy."

This has formed a sharp contrast with the fact that Western public opinion influencers are flattering Pfizer vaccines and downplaying news the vaccines caused deaths.

This represents vaccine nationalism and egoism that disregards the urgent humanitarian demands, giving rise to an atmosphere in which political prejudice dominates the pandemic fight. Unity is lacking in the fight against the virus, mainly because of the negative attitudes of the US and its major allies.

On the other hand, the top leaders in several countries such as Indonesia, Turkey, Seychelles, Serbia and the Philippines have strongly backed Chinese vaccines. Some even publicly got vaccinated with Chinese vaccines. This has had a positive impact on the confidence of developing countries with Chinese vaccines. They are safeguarding the rights of developing countries to get vaccinated simultaneously with developed countries and they are bravely pursuing fairness.

US and Chinese vaccines have their own advantages. They are supposed to cooperate with each other closely to fight the novel coronavirus. Besides prices and logistical factors, their usage in developed and developing countries should not be affected by politics. Don't let the "catastrophic moral failure" become reality and consolidated. It must be stressed that the coronavirus is the common foe of humanity, and the battlefield and tools that fight against it cannot be separated.

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Clean hands save lives, wash your hands to combat germs!

PETALING JAYA: The role of hand hygiene in preventing the spread of drug-resistant germs is the focus of the World Health Organisation’s annual “SAVE LIVES: Clean Your Hands” campaign this year.

Launched yesterday, the campaign is in line with WHO’s recently-released report on Antimicrobial Resistance: Global Report on Surveillance.

How bacteria become resistant

Bacteria grow resistant to antibiotics through natural selection. When drugs are used, some organisms may have ways of surviving. As they reproduce or pass DNA to other bacteria, those traits become more common, weakening antibiotics’ power.

The report states that there are increasingly more types of bacteria which cannot be killed by antibiotics. The report also stated that no one in the world is safe from this menace.

However, WHO also reported that should compliance with hand hygiene in health facilities increase from under 60% to 90%, there could be up to a 24% reduction in the infection of methicillin-resistant Stap­hylococcus aureus (MRSA).

MRSA, most commonly contracted in hospitals, is rapidly becoming more difficult to treat with current drugs.

“Whether it is the hands of the patient, their visitors or the healthcare team, people must remember to practise good hand hygiene in a healthcare setting, especially in hospitals,” said Patient Safety Council of Malaysia member Dr Milton Lum.

Good hand hygiene means washing the hands thoroughly with soap and water before and after touching a patient.

“Everyone has germs on his or her body so despite our good intentions in visiting our sick relatives or friends, we may actually pass on a bug unintentionally,” said Dr Lum.

Patients for Patients Safety Malaysia chairman J. Manvir said he believed that patients should also wear masks to protect themselves from airborne infections.

“Children under 12 should not be visiting patients, especially in hospitals.

“You may not be able to teach them to practise good hand hygiene but you can keep them at home to prevent them from passing on an infection to the patient as well as preventing them from getting ill,” said Manvir.

Antibiotic resistance has been around since the 1940s when the first antibiotic, penicillin, allowed doctors to kill off the many bacteria that were the source of different infections.

However, subsequent misuse of penicillin accelerated the natural evolution of the bacteria, resulting in the microbes becoming resistant.

Contributed by Tan Shiow Chin The Star/Asia News Network

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WHO's Alarm Bells: Antibiotic Resistance Now a 'Major Threat to Public Health'

The world's leading health organization is sounding serious alarm bells about the problem of antibiotic resistance.

Related: Good hand hygiene can save lives - SDHB

WHO's Alarm Bells: Antibiotic Resistance Now a 'Major Threat to Public Health'

The world's leading health organization is sounding serious alarm bells about the problem of antibiotic resistance.

In its first report on the issue ever, the World Health Organization (WHO) is sounding alarms about the issue of antibiotic resistance and the global public health threats it poses to our increasingly interconnected world.

"The problem is so serious that it threatens the achievements of modern medicine. A post-antibiotic era—in which common infections and minor injuries can kill—is a very real possibility for the 21st century," the report states.

Antibiotic resistance occurs when bacteria no longer die when treated with antibiotics. As a result, doctors have to use stronger, more potent antibiotics, and the more those are used, the more resistance bacteria develop to those as well. The WHO is warning that we're reaching a point in which the strongest antibiotics doctors have in their arsenal, the "treatment of last resort" drugs as they're called, no longer work.

And in fact, it's no longer just bacteria that are becoming resistant. The WHO has stopped referring to the problem as "antibiotic resistance" and now calls it "antimicrobial resistance," to encompass other organisms, such as viruses and parasites, that no longer respond to the drugs of choice. Namely, treating the viruses tuberculosis and HIV, and malaria (a parasite), has become harder as these diseases become resistant to medications. Even H1N1, the so-called "swine flu" that reached pandemic levels in 2009, has begun developing resistance to potent antiviral drugs.

Resistance Is a Worldwide Problem

One of the major points of the report is that diseases that used to be restricted to certain locales are now spreading internationally:

Among their key findings:
• Resistance to the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, Klebsiella pneumonia—carbapenem antibiotics—has spread to all regions of the world. K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients. In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections.

• Treatment failure to the last resort of treatment for gonorrhea—third generation cephalosporins—has been confirmed in Austria, Australia, Canada, France, Japan, Norway, Slovenia, South Africa, Sweden and the United Kingdom. More than 1 million people are infected with gonorrhoea around the world every day.

• People with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64 percent more likely to die than people with a non-resistant form of the infection. MRSA, which can cause septic bloodstream infections when exposed to broken skin, is one of the most common "community-acquired" resistant infections, meaning you're likely to pick it up anywhere other people are—your gym, place of worship, a nearby park or even at schools. In the Americas, as many as 90 percent of staph infections are reported to be MRSA.

• There hasn't been a new class of antibiotics developed since the late 1980s.

We Can't Track What We Don't Know

The WHO is calling on countries all over the world to step up their surveillance of these deadly infections, something that happens rarely, if at all. An investigative report, "Hunting the Nightmare Bacteria," that ran on the PBS program Frontline in October 2013 revealed that public health officials in the U.S. have little to no data on the extent of antimicrobial resistance in this country. Healthcare facilities aren't required to report outbreaks, the report found, and many don't because they don't want to scare people or have to deal with bad PR.

“It is frankly embarrassing that we as a country do not know where resistance is occurring, how bad the problem is for various organisms or who’s using what antibiotics when,” Brad Spellberg, MD, an infectious disease doctor at Harbor-UCLA Medical Center, said in the documentary.

The Centers for Disease Control and Prevention has estimated that antimicrobial resistant infections hit two million people a year and kill at least 23,000. But the WHO notes that in most countries around the world, including the U.S., often only the most severe infections are documented and minor community-acquired infections (which can get passed along repeatedly and wind up as a severe infection) go unreported.

Clean Up the Food Supply!

For quite possibly the first time, the WHO also called out the food industry for its contribution to antimicrobial resistance. " The use of antibiotics in animal husbandry—including in livestock, poultry and fish farming—are leading to increasing recognition that urgent action is needed to avoid inappropriate use, and to reduce antibiotic usage in animal husbandry and aquaculture, as well as in humans," the report states. In the U.S., 80 percent of antibiotics sold go into animal feed to prevent infections in healthy animals or to speed growth. And we're not alone. "In many countries, the total amount of antibiotics used in animals (both food-producing and companion animals), measured as gross weight, exceeds the quantity used in the treatment of disease in humans," the authors found.

The same classes of antibiotics used on these animals are the same as those given to humans. In particular, fluoroquinolones, antibiotics used widely in the poultry industry, are increasingly ineffective against urinary tract infections caused by drug-resistant E. coli bacteria, which have been detected on all forms of supermarket meat, and against MRSA soft-tissue and skin infections.

Numerous groups in the U.S. have sued the Food and Drug Administration to revoke its approvals in animals for antibiotics that are valuable for humans. The agency's only response has been to set voluntary guidelines for the industry.

What You Can Do

Despite the damage factory farming has done to antibiotic effectiveness, the WHO and other public health officials insist that the first line of defense in controlling the problem of antimicrobial resistance is the healthcare setting: Stopping doctors from giving patients antibiotics for conditions they aren't designed to treat, for instance, when you're given antibiotics for a cold that's caused by a virus, not bacteria.

• Don't automatically ask for antibiotics when you feel sick and visit a doctor.

• If your doctor prescribes an antibiotic, ask if there's an alternative before just accepting the advice. Some doctors feel compelled to offer the drugs to make people feel better, but asking for an alternative can open up a dialogue about other options.

• When you do need an antibiotic, take the full course, even if you're feeling better.

• Wash your hands frequently to protect yourself from community-acquired infections, and keep your hands away from your nose, eyes and mouth, where infections can enter.

Contributed by  By EMILY MAIN

 


Alarm bells over antibiotic resistance 

The World Health Organisation’s most comprehensive report to date sounds a warning that we are entering a world where antibiotics have little effect.

THE World Health Organisation (WHO) has sounded a warning that many types of disease-causing bacteria can no longer be treated with the usual antibiotics and the benefits of modern medicine are increasingly being eroded.

The comprehensive 232-page report on anti-microbial resistance with data from 114 countries shows how this threat is happening now in every region of the world and can affect anyone in any country.

Antibiotic resistance – when bacteria evolve so that antibiotics no longer work to treat infections – is described by the report as “a problem so serious that it threatens the achievements of modern medicine”.

“A post-antibiotic era, in which common infections and minor injuries can kill, far from being an apocalyptic fantasy, is instead a very real possibility for the 21st century,” said Dr Keiji Fukuda, WHO assistant director-general who coordinates its work on anti-microbial resistance.

“Without urgent, coordinated action, the world is headed for a post-antibiotic era in which common infections and minor injuries which have been treatable for decades can once again kill.

“Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine.

“Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.”

The report, “Antimicrobial Resistance: Global Report on Surveillance”, shows that resistance is occurring in many bacteria causing different infections.

It focuses on antibiotic resistance in seven bacteria responsible for common, serious diseases, such as bloodstream infections (sepsis), diarrhoea, pneumonia, urinary tract infections and gonorrhoea.

What is especially alarming is that the bacteria’s resistance has also breached “last resort” antibiotics, which are the most powerful medicines that doctors resort to when the usual ones do not work.

When patients do not respond to the usual medicines (known as first-line or first-generation medicines), doctors prescribe newer (second line medicines) which also usually also cost more.

When these also don’t work, newer and often more powerful (but sometimes with also more side effects) antibiotics are used, and they are even more expensive.

If these third-line or “last resort” medicines are not available or too costly for the patient, or if they don’t work on a patient because of antibiotic resistance, the patient remains ill or dies if the infection is a serious one.

New antibiotics have been discovered in the past to treat infections when the old ones became useless due to resistance.

But these discoveries dried up in the past 25 years.

The last completely new classes of anti-bacterial drugs were discovered in the 1980s.

Pathogens that are becoming increasingly resistant including to the more powerful antibiotics include E. coli, K. pneumonia, S. aureus, S. pneumonia, salmonelia, shigella and n. gonorrhoeae.

Key findings from the report include:

> Resistance to the treatment of last resort for life-threatening infections caused by a common intestinal bacteria, K. pneumonia — carbapenem antibiotics — has spread worldwide.

K. pneumoniae is a major cause of hospital-acquired infections such as pneumonia, bloodstream infections, infections in newborns and intensive-care unit patients.

In some countries, because of resistance, carbapenem antibiotics would not work in more than half of people treated for K. pneumoniae infections;

> Resistance to one of the most widely used antibacterial medicines for the treatment of urinary tract infections caused by E. coli – fluoroquinolones – is very widespread.

In the 1980s, when these drugs were first introduced, resistance was virtually zero.

In many countries today, this treatment is ineffective in more than half of patients;

> The sexually transmitted disease, gonorrhoea may soon be untreatable unless there are new drugs. Treatment failure to the last resort of treatment for gonorrhoea – third generation cephalosporins – has been confirmed in several countries; and

> Antibiotic resistance causes people to be sick for longer and increases the risk of death.

For example, people with MRSA (methicillin-resistant Staphylococcus aureus) are estimated to be 64% more likely to die than people with a non-resistant form of the infection.

There are many cases of patients being infected by MRSA in hospitals.

The report also gives useful information on the worrisome building up of resistance in four serious diseases — tuberculosis, malaria, HIV and influenza.

A major factor accelerating resistance is in the animal husbandry sector, where there is a liberal use of antibiotics mainly to promote the growth of the animals used for food, for commercial purposes.

This builds up resistance in the bacteria present in the animals.

These resistant germs are passed on to humans who consume the meat.

The report has a small section on the animal-food chain, which has been identified as a major problem.

The European Union has banned the use of antibiotics as growth promoters in animals, but it is still allowed in other countries.

A WHO press release on the report calls for some actions. These include:

> Setting up basic systems in countries to track and monitor the problem;

> Preventing infections from happening in the first place to reduce the need for antibiotics;

> Only prescribing and dispensing antibiotics when they are truly needed, and prescribing and dispensing the right antibiotic(s) to treat the illness;

> Patients using antibiotics only when prescribed by a doctor and completing the full prescription; and

> Developing new diagnostics, antibiotics and other tools to stay ahead of emerging resistance.

Contributed by Global Trends by Martin Khor

Martin Khor is executive director of the South Centre, a research centre of 51 developing countries, based in Geneva. You can e-mail him at director@southcentre.org. The views expressed are entirely his own.

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Do You need jabs, antibiotics?

OUR population is getting more and more educated and knowledgeable. With the convenience of internet and smart phone, information can be assessed anytime and anywhere.

Facebook and Google have become the source of reference for most people. Many can now be “experts” in many specialised fields, including engineering, law and even medicine.

Nowadays, the medical practitioners enounter some patients who are so-called internet savvy, and refuse antibiotics and vaccines.

This issue arose due to the spread of such information in the internet, claiming antibiotics could lead to “superbug” and are associated with many adverse effects, while vaccines could cause autism or death.

Well, the risks of administration of both drugs are certainly debatable.

What we know for a fact is that since Alexander Flemming discovered penicillin and the pox vaccine, many lives were saved.

Nevertheless, I am not in the position to comment on the good and bad of both antibiotics and vaccines. But, it is more important for the general public to understand more about the need for antibiotics and vaccines.

Antibiotics or more specifically antibacterial, is a medicine indicated to kill (bactericidal) or inhibit the growth (bacteriostatic) of the bacteria.

There are various types of antibiotics with different mode of actions and indications. Strictly speaking, the mechanism of action for antibiotics is rather complicated.

However, it works mainly to counter attack the rapid reproduction of bacterial colonies, so that our immune system has enough time to defeat the illness.

Thus, the usage of antibiotics is strictly limited to the bacterial infection. In common clinical conditions, like acute exudative tonsillitis, abscess formation and urinary tract infection, antibiotics are strongly prescribed.

It must be understood that antibiotics have no role in curing diseases caused by fungus, virus or other parasites.

Therefore, it should not be overprescribed in cases like common cough and cold, flu and fungal infection of skin.

As for vaccines, they are biological preparations that help to boost immunity. Its primary focus is on disease prevention. It is always better to prevent a disease than to treat it.

Vaccines work by introducing the weakened form of “disease germ” into the body. The body will respond by producing antibodies to fight these invaders. At this stage, technically, the immune system is being sensitised. If the actual disease germ attacks the body, more antibodies will be produced to destroy the real enemy.

Vaccines are responsible for the control of many infectious diseases that were once common in this country and around the world, including polio, measles, diphtheria, pertussis (whooping cough), rubella (German measles), mumps, tetanus, Hepatitis B and Haemophilus influenzae type b (Hib).

Many patients question the need for further vaccination as diseases such as diphtheria, pertussis are very rare these days.

Furthermore, there are people that do not get vaccination, yet able to live healthily until old age. This is the myth behind “herd immunity”.

Herd immunity serves as a preventive barrier as most of the population had been vaccinated, thus, the disease is contained from spreading. If herd immunity is compromised, the widespread of the disease may occur.

A piece of advice to all, a little knowledge is a dangerous thing. Before you start to tell doctors about the negative effects of antibiotics and vaccines, why not, give them a chance to explain to you before you make a decision.

Contributed by DR H.B. CHEE, Muar, Johor The Star/Asia News Network

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