Less talk, more action needed to avoid silent superbug tsunami

[webfact]

OPINION

Less talk, more action needed to avoid silent superbug tsunami

By Busakorn Lerswatanasivalee,  
Thomas Cueni 
Special to The Nation

 

On a TripAdvisor Bangkok forum Gary asks “Can I purchase antibiotics [in Thailand] without a prescription if I run out?” 
 

RoverEngland replies: “Yes I get my antibiotics no problem without doctors note in Bangkok. Also they are ¼ price of what I would pay in UK.” 

“Whatever antibiotics you want ... any pharmacies will sell,” another poster confirms. 

 

This kind of advice and the reality it reflects is one reason why two people every hour die from multidrug-resistant bacterial infections in Thailand.

 

Worldwide, at least 700,000 people a year die from drug-resistant infections. If we don’t act now, this number is projected to jump to 10 million a year by 2050. This will cost the global economy up to $100 trillion and push a further 28.3 million people into extreme poverty.

 

Unfortunately, many developing countries permit the sale of antibiotics without a prescription. As a result, antibiotics are not used in the way that they are intended, and this is contributing to the rise of resistance.

 

Today microorganisms that cause tuberculosis, malaria, urinary tract infections, and pneumonia are becoming increasingly resistant to a wide range of antibiotics. This emergence and spread of antimicrobial resistance (AMR) could force us back to a time when common infections and minor surgery could prove fatal.

 

Antibiotic-resistant superbugs have been on the radar for decades, recognised as among the most serious public health threats worldwide. AMR has been discussed at G20 and G7 Summits, and is a priority for the World Health Organisation.

 

Just last year, the Thai government together with the UK, Ghana and the Wellcome Trust called for international initiatives to reduce inappropriate antibiotic use, improve access to existing and new antibiotics and treatments, and build new partnerships across industry, governments and civil society. 

 

Global battle comes to Bangkok

 

This week, public health experts, academics, NGOs and businesses are gathering in Bangkok for the Prince Mahidol Award Conference 2018, where discussion will focus on how to make the world safe from the threats of emerging infectious diseases.

 

Despite the rising concern, we still have not seen anything equivalent to the alarm shown for other pandemics. One reason may be that AMR lacks the recognisable “face” of a disaster like an Ebola or Zika outbreak, which has the power to scare us all. AMR is more of a silent killer. 

 

To move from talk to action, over 100 biotechnology, diagnostic, generics and research-based biopharmaceutical companies and trade associations have united to combat antimicrobial resistance. Companies working together under the banner of the AMR Industry Alliance have released a report tracking the action being taken by the life sciences industry. It shows that in 2016 alone, AMR Industry Alliance companies invested at least US$2 billion in R&D to counter the threat.

 

The private sector investment is good news, as are the more than 40 new products in late-stage development, but these moves are nowhere near sufficient. High-risk investments for new and desperately needed antibiotics will be difficult to sustain under current conditions where the new drugs should remain on shelves and only be used as a last resort, meaning there is no economic return on these products. To avoid a looming public health disaster, there is an urgent need for action on sustainable R&D incentives that reward success.

 

We can be more upbeat in terms of actions that safeguard how we use existing antibiotics more effectively. The Alliance report shows that 80 per cent of all responding companies are engaged in activities to support appropriate use. For example, one company has created IDStream.asia, a video-streaming platform for Thai healthcare professionals and policymakers which provides information on complicated bacterial and invasive fungal infections.

 

Also notable is the Antibiotics Smart Use (ASU) programme which emphasises that the common cold with sore throat, acute diarrhea and simple wounds do not require antibiotic treatment. Another company has teamed up with the Thai government on a four-year plan to tackle multi-drug resistant tuberculosis, with drug donations, as well as educational workshops, drug resistant treatment guidelines and active pharmacovigilance.

 

To address the free availability highlighted in the TripAdvisor forum, one company has developed a patient-education campaign to combat overuse of antibiotics, including a self-diagnosis product for sore throat, and displays and brochures in pharmacies to help patients differentiate viral from bacterial infections. 

 

We applaud the Thai government for its global leadership and the measures it is taking to tackle AMR. Thailand’s national strategic action plan on AMR has some impressive goals, including achieving a 50-per-cent reduction in AMR deaths by 2021. It can rest assured that the AMR Industry Alliance companies intend to live up to their commitments – leading the way on how the private sector can act to fight antimicrobial resistance.

Busakorn Lerswatanasivalee is CEO of PreMA.

 

Thomas Cueni is chairperson of the AMR Industry Alliance. The Prince Mahidol Award Conference 2018 runs until Saturday at Centara Grand Convention Centre, CentralWorld, Bangkok. 

 

Source: http://www.nationmultimedia.com/detail/opinion/30337566

 

-- © Copyright The Nation 2018-01-31

[wakeupplease]

14 minutes ago, webfact said:

RoverEngland replies: “Yes I get my antibiotics no problem without doctors note in Bangkok. Also they are ¼ price of what I would pay in UK

What a load of >hit NHS you pay so little if under 60 and free over 60 and it does not come much cheaper than free, BullS>>> comment. maybe fake antibiotics so then you have to pay if you want rubbish>

Edited January 30, 2018 by wakeupplease

[matsellah]

Remember the days when they would throw an antibiotic at everything?  Supplementing your own immune system is one thing, replacing it with a synthetic version because you don't want to deal with fighting the symptoms, is another. And now we're beginning to pay the price.

Lots of homeopathic talk about gut flora and how we're all carrying around a sack of bacteria, a lot of it actually good for our health.

 

Antibacterial meds aren't "aware" so they strip out all bacteria, forcing your system to rebuild every time you take it.  In the meantime, your body is missing things it needs to maintain health.

 

Or this is how it was explained to me.

[ALLSEEINGEYE]

Over the counter anti biotics are not nearly the only cause of superbugs.

 

Non compliance is the exact same issue whether you were prescribed the medication or not. If you stop taking your meds before the bacteria is fully killed off then they produce hormones against meds.

 

Also having our beef, pork, chicken and even farmed fish, fed massive amounts of anti biotics to increase profits is a huge part of the problem as well. Yet the pharmaceutical companies don't speak out about that as it cuts into their profits, just as they don't speak out about openly addicting the world to opioid addiction for their own gain. 

[thaibeachlovers]

Sorry, but people caused this by abuse and non compliance, and people will die because they did so.

The ultimate self inflicted injury.

 

The consequences will be severe, and I doubt many understand this. Don't worry about nuclear tipped missiles killing a few hundred thousand people, as unless the pharma companies come up with something soon, possibly millions are going to die of diseases that used to be easily cured. Don't forget that millions died of flue after WW1.

It's going to be like it was before Penicillin was discovered.

What doesn't help is that because of trying to live in a "clean" environment, children are growing up without decent immune systems. Apparently even a caesarean section birth prevents children getting the bugs they need to develop immune systems, and many women opt for those now.

 

I have to wonder if this is Gaia's opening solution to human overpopulation.

 

I also don't understand why this isn't more widely publicised, unless the authorities are worried about panic, or know they can't do anything in time.

[hanuman2543]

."Don't forget that millions died of flue after WW1."

 

The "Spanish Flu" you are referring to was caused by a virus like every real influenza. Antibiotics killing only bacteria but not viruses. 

[IAMHERE]

I wash my hands with antibacterial soap. If I don't wash until all the bugs are dead, won't that create a superbug? Same with gargle liquid and not doing it long enough to kill all those bugs.

[ballpoint]

And people still refuse to believe in evolution.

[overherebc]

look at the average person who goes to the pharmacy out here with a runny nose or a doze of the sh-ts. They walk out with a bag containing 2 or 3 kinds of anti-biotics.

[rickudon]

On 1/31/2018 at 3:56 PM, IAMHERE said:

I wash my hands with antibacterial soap. If I don't wash until all the bugs are dead, won't that create a superbug? Same with gargle liquid and not doing it long enough to kill all those bugs.

No, not really. soap is just chemicals that rapidly attack the bacteria and destroy them by crude chemical reactions. Resistance requires specific genes to be selected for that block the actions of antibiotics, which usually just attack individual metabolic reactions. Soap is more like using a club, brute force trauma compared to a stiletto, which has to hit a vital point.  There are a few things which would make bacteria more resistant to soaps, like maybe thicker cell walls, but these would probably put such a strain at a big competitive disadvantage. Soap rarely kills all bacteria, just most - and it is all over in a minute. They then rapidly repopulate again, resistant bacteria then have to compete with many others, of the same species and other species. Antibiotics are taken for a longer time and remain in your system, bacteria have to contend with this for 24 hours or many days, this allows resistant bacteria to multiply and dominate susceptible ones. Then they can spread ......

 

This is just a crude simple explanation. It is a whole scientific subject in itself.