from the world's big
Antimicrobial resistance is a growing threat to good health and well-being
Antimicrobial resistance is growing worldwide, rendering many "work horse" medicines ineffective. Without intervention, drug-resistant pathogens could lead to millions of deaths by 2050. Thankfully, companies like Pfizer are taking action.
Pfizer Corporate Responsibility develops programs that help expand global access to medicines by providing direct assistance to underserved populations. Our initiatives include providing product donations and steep discounts that help patients access the medicine they need. We also collaborate with Pfizer business teams and nonprofit organizations to help shape sustainable business models that address affordability and the vast differences in economies around the world.
- Antimicrobial-resistant pathogens are one of the largest threats to global health today.
- As we get older, our immune systems age, increasing our risk of life threatening infections. Without reliable antibiotics, life expectancy could decline for the first time in modern history.
- If antibiotics become ineffective, common infections could result in hospitalization or even death. Life-saving interventions like cancer treatments and organ transplantation would become more difficult, more often resulting in death. Routine procedures would become hard to perform.
- Without intervention, resistant pathogens could result in 10 million annual deaths by 2050.
- By taking a multi-faceted approach—inclusive of adherence to good stewardship, surveillance and responsible manufacturing practices, as well as an emphasis on prevention and treatment—companies like Pfizer are fighting to help curb the spread.
Antibiotics have revolutionized healthcare.
With the advent of modern medicine, life threatening diseases such as smallpox, pertussis (whooping cough), tetanus (lockjaw) and measles have essentially been eradicated. More importantly, complicated procedures that increase our risk of infections—including plastic surgery, joint replacement, cancer treatments, and organ transplant, among others—have become routine because any resulting infection can be treated effectively.
But modern medicine depends on antibiotics to treat and cure many kinds of infections—infections that could impact anyone from the premature baby to the elderly. Unfortunately, antimicrobial resistance (AMR) has made some infections impossible and others increasingly difficult to treat, threatening the progress we have worked so hard to achieve.
AMR causes 700,000 deaths annually across the globe, a number projected to skyrocket to 10 million by 2050 without intervention.
What is antimicrobial resistance?
Antimicrobial drugs target the microorganisms that cause infection, such as bacteria, viruses, fungi, and parasites, and either kills them or inhibits their growth.
Anytime an antibiotic is used, either appropriately or inappropriately, the 30 trillion or more bacteria that live in or on our bodies undergo selective pressure to become resistant. Any that are sensitive to the antibiotic are killed, while those that remain are resistant or immune from the effects of that antibiotic. This is called AMR. Once a bacterial pathogen has reached a state of resistance to several types of antibiotics, it is colloquially referred to as a "superbug."
The consequences of AMR can be stated simply: Commonly used antibiotics are rendered ineffective against that pathogen. If an infection caused by resistant bacteria is treated by that antibiotic, the bacteria are unaffected, resulting in disease persistence, worsening of the infection and/or even death. Treatments for both minor and serious infections are compromised, surgeries and other routine procedures become riskier, and the treatment of diseases like pneumonia and tuberculosis becomes very complicated. For example, according to the World Health Organization, resistance in Klebsiella pneumoniae—a common intestinal bacterium that is a major cause of hospital-acquired infections, bloodstream infections, and infections in newborns and intensive-care unit patients—has spread to all regions of the world. In some countries, because of resistance, carbapenem antibiotics (often the "last resort" treatments) do not work in more than half of people treated for these types of infections. This results in prolonged hospitalization, increased medical costs and higher rates of death for infections that were easily treated only a few years ago.
"What's more, AMR is a truly global issue—it can affect anyone, of any age, in any country," Jill Inverso, Pfizer's Vice President of Global Medical Affairs and Anti-Infectives, told Big Think.
AMR causes 700,000 deaths annually across the globe, a number projected to skyrocket to 10 million by 2050 without intervention. The rise of resistant pathogens is causing many countries to accrue significantly higher healthcare costs due to longer duration of illness, additional tests, and the need for different medicines to treat patients.
And these costs add up. The World Bank Group estimates that AMR could reduce annual global gross domestic product from 1.1–3.8 percent depending on severity, with up to $10.8 trillion in additional health expenditures.
At Pfizer, we take this growing threat very seriously and are driven by our desire to protect global public health and address the medical needs of people suffering from infectious diseases.
Giving antimicrobial resistance a helping hand
The development of bacterial resistance to antibiotics is a natural process. Unlike almost every other class of drugs, antibiotics drive their own obsolescence by selecting antibiotic-resistant bacteria, even when used appropriately according to guidelines. When this happens, resistant bacteria survive and continue to multiply, causing the infection to worsen. These resistant bacteria can then also spread to other patients, causing new infections with these bacteria that are difficult to treat.
Overuse and misuse of antibiotics accelerates this process without providing any benefit to the patient. This happens when patients take a drug without need, do not finish their dose or stop taking the medication mid-course; it could also happen when a drug is either overprescribed or prescribed for the wrong duration/type of illness. All of these misuses create environments in which pathogens are exposed to drugs more often, allowing them to acclimate and breed resistance without any benefit to the patient.
Hence, antibiotics must be used wisely and sparingly.
Fighting the resistance
WHO calls AMR an "increasingly serious threat to global public health" and one that "requires action across all government sectors and society." Its widespread growth is threatening the United Nations General Assembly's Sustainable Development Goal of Good Health and Well-Being.
Companies like Pfizer are heavily committed to the fight against AMR, taking action across a variety of areas such as surveillance, stewardship, and prevention and treatment.
On the surveillance front, Pfizer is proud to sponsor one of the largest AMR surveillance programs in the world, the Antimicrobial Testing Leadership and Surveillance (or ATLAS). ATLAS monitors real-time changes in bacterial resistance and tracks these trends in real-time. Gathering information from more than 760 hospitals across 73 countries in many underserved areas, ATLAS has generated 14 years of continuous global data on bacteria. Researchers and healthcare professionals can access ATLAS's data—free of charge—to study resistance trends, even in emerging market countries like Africa, Asia, and Latin America.
"At Pfizer, we take this growing threat very seriously," Inverso added, "and are driven by our desire to protect global public health and address the medical needs of people suffering from infectious diseases."
Pfizer also encourages good stewardship practices and supports education and training programs to help ensure patients receive the correct antibiotic only if needed, at the right dose and for the right duration.
"We believe that everybody can play a part in AMR stewardship by not taking an antibiotic unless provided by a healthcare professional, sticking to antibiotic regimens when prescribed, and keeping their vaccinations up to date," said Inverso. She added, "Vaccines are administered to help prevent infections from happening in the first place, thereby reducing the need for antibiotic usage that can lead to the development of resistance."
To date, several studies have demonstrated the beneficial role vaccines play in the reduction of AMR, such as reducing the use of antibiotics by preventing bacterial infections which may, in turn, prevent antimicrobial resistant infections from developing. Pfizer is committed to continue the development of new, innovative vaccines to help prevent infectious diseases globally.
We believe that everybody can play a part in AMR stewardship by not taking an antibiotic unless provided by a healthcare professional, sticking to antibiotic regimens when prescribed, and keeping their vaccinations up to date.
Given this, we should ask ourselves the following:
- Have I ever not finished an antibiotic given to me by my doctor?
- Have I ever used an antibiotic given to someone else?
- Am I up-to-date on my vaccinations that prevent infections that would need antibiotics?
- Have I ever demanded an antibiotic for myself or a child that the doctor thought was caused by a virus?
- Have I ever saved antibiotics given to me for one infection and used it at a different time?
The key takeaway? AMR is a pervasive, growing threat that cannot be tamed without the collective efforts of government, industry, health systems, society and others. Working together, we may have a fighting chance.
Pandemic rumors and information overload make separating fact from fancy difficult, putting people's health and lives at risk.
The dark side of the information age<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMzU1NzYwMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNjE3MzY3Nn0.0HveQP16MbMkj9HXE8miohSHXETOak7oFDtBdXtE7lM/img.jpg?width=1245&coordinates=0%2C400%2C0%2C256&height=700" id="60d48" class="rm-shortcode" data-rm-shortcode-id="9085c1a7d5b3f81344c3002acdf1df68" data-rm-shortcode-name="rebelmouse-image" />
A South Korean church became a viral hotspot after church officials sprayed a salt water "cure" in congregants mouths, without disinfecting the nozzle between uses.
The cure for bad information is good<div class="rm-shortcode" data-media_id="e0tfZ3YB" data-player_id="FvQKszTI" data-rm-shortcode-id="601aa46855087a4dfcf02a67a160e0c4"> <div id="botr_e0tfZ3YB_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/e0tfZ3YB-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/e0tfZ3YB-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/e0tfZ3YB-FvQKszTI.js"></script> </div> <p><strong></strong><strong></strong>That doesn't mean we are defenseless. The best cure for rumors, stigma, and conspiracy theories is good, evidence-based information. We just have to know how to recognize it when we find it. Unfortunately, that's difficult in the center of the infodemic vortex.</p><p>"Information overload is incredibly anxiety-provoking—which is true even when the information is accurate," Jaimie Meyer, a Yale Medicine infectious diseases specialist, <a href="https://www.yalemedicine.org/stories/covid-19-infodemic/" target="_blank">told <em>Yale Medicine</em></a>. "But here, if people get the wrong information from unreliable sources, we may have more trouble slowing the spread of the virus. And we can't afford to get this wrong."</p><p>In their study, the researchers concluded that governments and health agencies should study the patterns of pandemic rumors, track the misinformation, and develop communication strategies to circumvent these messages. </p><p>In the <em>Yale Medicine </em>article, Meyer provides advice for helping individuals deal with information overload. She recommends looking at data and graphs carefully, considering how individual studies connect with established facts, and considering the whole story (not just the eye-catching headline). </p><p>When it comes to garnering information from social media, proceed with caution.</p><p>"Everything looks the same on Twitter," Meyer said. "When you have a tweet from Anthony Fauci, MD, director of the National Association of Allergy and Infectious Diseases, next to a tweet that says the opposite thing from a celebrity or some random person—and they all appear similar, you have to weigh the credibility of your sources." </p><p>She recommends following health agencies like <a href="https://twitter.com/who?lang=en" target="_blank" rel="noopener noreferrer dofollow">the WHO</a>, <a href="https://twitter.com/CDCgov?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor" target="_blank" rel="noopener noreferrer dofollow">the Centers for Disease Control and Prevention</a>, and your local and state health agencies. When you come across a pandemic rumor or something that seems suspect, you can double-check it against these authoritative sources, such as the WHO's <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters" target="_blank" rel="noopener noreferrer dofollow">COVID-19 mythbusters page</a>. And if you find yourself stressing out over the news and your social media feed, <a href="https://bigthink.com/mind-brain/mental-health-activities-coronavirus-lockdown" target="_self" rel="dofollow">take a mental break</a>.</p><p>We all would like a return to some form of normalcy, but that return will not emanate from a miracle cure. It will be a slow, steady course of handwashing, social distancing, and learning to navigate the infodemic.</p>
Carbon locked in soils can be emitted by bacteria.Turning up the heat on them releases more carbon.
- A new study shows that an increase in temperature can increase the amount of carbon released by the soil.
- This is in line with previous studies, though this one demonstrates a larger increase than the older experiments.
- The risk is that increasing temperatures cause a positive feedback loop.
The dirty details of an aggravated carbon cycle<div class="rm-shortcode" data-media_id="CabkeAzx" data-player_id="FvQKszTI" data-rm-shortcode-id="169377c88f392a86f6c42180b74820a5"> <div id="botr_CabkeAzx_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/CabkeAzx-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/CabkeAzx-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/CabkeAzx-FvQKszTI.js"></script> </div> <p>There is a lot of carbon in the dirt. The world's soil contains more carbon than the atmosphere, all the plants, or all the animals<a href="https://blogs.ei.columbia.edu/2018/02/21/can-soil-help-combat-climate-change/" target="_blank"></a>. A third of this trove of carbon resides in the soils of the <a href="https://www.sciencetimes.com/articles/26866/20200813/tropical-soils-highly-sensitive-climate-change.htm" target="_blank">tropics</a>. Under normal circumstances, this works as a carbon <a href="https://earthobservatory.nasa.gov/features/CarbonCycle" target="_blank">sink</a>, keeping carbon in storage and out of the atmosphere. Some of this carbon is used by bacteria in the soil to provide the building blocks of new microbes. They expel surplus carbon into the atmosphere in the form of carbon dioxide. </p><p>Many of these microbes are known to be more active when exposed to higher temperatures. To determine what this could mean for carbon emissions, a team from The University of Edenborough and the Smithsonian Tropical Research Institute turned up the heat in tropical soils to see what would happen. </p><p>The researchers went to an undisturbed plot of forest on Barro Colorado Panama, the home of the Smithsonian's Tropical Research Institute. They placed heating rods just over a meter into the soil and turned up the heat, warming the earth by four degrees centigrade. They then measured the carbon emissions from the heated ground and another nearby patch left at ambient temperature. These measurements covered two years.</p><p>Their findings, published in <a href="https://www.nature.com/articles/s41586-020-2566-4" target="_blank">Nature</a>, show that the heated soil emitted 55% more carbon than the control plot<a href="https://www.sciencedaily.com/releases/2020/08/200812144102.htm" target="_blank" rel="noopener noreferrer dofollow"></a>. <br> <br> Study lead author Andrew Nottingham commented on these findings to the <a href="https://phys.org/news/2020-08-global-tropical-soils-leak-carbon.html" target="_blank" rel="noopener noreferrer dofollow">AFP</a>. "Carbon held in tropical soils is more sensitive to warming than previously recognized. Even a small increase in respiration from tropical forest soils could have a large effect on atmospheric CO<sub>2</sub> concentrations, with consequences for global climate."</p><p>You can probably also spot the potential feedback loop here: If the global temperature increases too much, more carbon will be released from tropical soils, which then increase the greenhouse effect, which causes global temperatures to rise. </p>
Once is happenstance, twice is a coincidence, thrice is evidence of a pattern.<div class="rm-shortcode" data-media_id="8PLWDgcM" data-player_id="FvQKszTI" data-rm-shortcode-id="378380d273bf4a1c9606370acea15e58"> <div id="botr_8PLWDgcM_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/8PLWDgcM-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/8PLWDgcM-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/8PLWDgcM-FvQKszTI.js"></script> </div> <p>Previous studies on this topic point in the same direction. Those studies and the models they inspired suggested that increased temperatures could increase soil-based carbon emissions, but they all underestimated how much carbon would be involved.</p><p>A 2016 study focusing on temperate soils also concluded that increasing soil temperatures would increase their carbon <a href="https://www.nature.com/articles/nature20150" target="_blank">emissions</a>. They predicted that, if left unchecked, these emissions would equal the amount produced by a country similar to the United States over the next few <a href="https://www.ucsusa.org/resources/each-countrys-share-co2-emissions" target="_blank" rel="noopener noreferrer dofollow">decades</a>. Another experiment in Colorado found similar <a href="https://science.sciencemag.org/content/355/6332/1420" target="_blank" rel="noopener noreferrer dofollow">results</a>. Both of these studies found lower increases in carbon emissions by percentage than the study on Barro Colorado. </p><p>However, these studies did not take place in the tropics, and the differences in the soils between temperate and tropical zones could explain the differences between the studies. Moreover, the dirt on Barro Colorado Island differs from the dirt in the Amazon and may be more inclined to produce more emissions when the heat is turned up. The same can be said of tropical soils <a href="https://www.nytimes.com/2020/08/12/climate/tropical-soils-climate-change.html?searchResultPosition=3&utm_campaign=Hot%20News&utm_medium=email&_hsmi=93170710&_hsenc=p2ANqtz-8McWKRhE8U9ChcWW2qkqNyp2Qndzr1aJmGlrMUwK_h1bM8RDQukWcM8r2OcBKW2Y0bWlRr9o4WUixKDzIo4HzKkVv19g&utm_content=93170710&utm_source=hs_email" target="_blank" rel="noopener noreferrer dofollow">elsewhere</a>. </p><p>Another <a href="https://www.forestwarming.org/" target="_blank" rel="noopener noreferrer dofollow">experiment</a>, very similar to the one in Panama, is currently underway in Puerto Rico. However, this experiment is taking the extra step of also heating the plants near the heated soil to see what the effect of warmer temperatures is on their ability to absorb carbon.</p><p>The current study also did not heat the soil past the one-meter mark and cannot provide us with predictions of what more comprehensive heating of the soil would do to emissions. It was also comparatively short, and the effect may be reduced in the long run as the nutrients in the soil are depleted by the increased activity of the microbes, which are using the carbon and other resources to <a href="https://www.nature.com/articles/d41586-020-02266-9" target="_blank" rel="noopener noreferrer dofollow">reproduce</a>. </p><p>The team behind the most recent study will continue their experiment to try and understand how tropical ecosystems respond to increased <a href="https://www.earth.com/news/billions-of-tons-of-co2-could-be-released-from-tropical-soils/" target="_blank" rel="noopener noreferrer dofollow">temperatures</a> over more extended periods of time. </p><p>As we increase our understanding of the planet and its various environmental systems, the potential consequences of climate change become clearer and more horrifying. This new study supports previous findings that suggest disrupting soils can increase carbon emissions. While it may be too soon to tell if the eye-popping increases found by this study are typical or an outlier, they do re-enforce the notion that a breakdown in the systems that keep the climate stable is possible if nothing changes. </p>
A study published Friday tested how well 14 commonly available face masks blocked the emission of respiratory droplets as people were speaking.
- The study tested the efficacy of popular types of face masks, including N95 respirators, bandanas, cotton-polypropylene masks, gaiters and others.
- The results showed that N95 respirators were most effective, while wearing a neck fleece (aka gaiter) actually produced more respiratory droplets than wearing no mask at all.
- Certain types of homemade masks seem to be effective at blocking the spread of COVID-19.
Fischer et al.<p>A smartphone camera recorded video of the participants, and a computer algorithm counted the number of droplets they emitted. To establish a control trial, the participants spoke into the box both with and without a mask. And to make sure that the droplets weren't in fact dust from the masks, the team conducted more tests by "repeatedly puffing air from a bulb through the masks."</p>
Fischer et al.<p>The results, published Friday in <a href="https://advances.sciencemag.org/content/early/2020/08/07/sciadv.abd3083" target="_blank">Science Advances</a>, showed that some masks are pretty much useless. In particular, neck fleeces (also called gaiters) actually produced more respiratory droplets compared to the control trial — likely because the fabric breaks down big droplets into smaller ones.</p><p>The top three most effective masks were N95 respirators, surgical masks and polypropylene-cotton masks. Bandanas performed the worst, but were slightly better than wearing no mask at all.</p>
Fischer et al.<p>Research on mask efficacy is still emerging. But the new results seem to generally align with <a href="https://newsroom.wakehealth.edu/News-Releases/2020/04/Testing-Shows-Type-of-Cloth-Used-in-Homemade-Masks-Makes-a-Difference" target="_blank" rel="noopener noreferrer dofollow">prior tests</a>. For example, a study from June published in <a href="https://aip.scitation.org/doi/10.1063/5.0016018" target="_blank" rel="noopener noreferrer dofollow">Physics of Fluid</a> found that bandanas (followed by folded handkerchiefs) were least effective at blocking respiratory droplets. That same study also found, as <a href="https://newsroom.wakehealth.edu/News-Releases/2020/04/Testing-Shows-Type-of-Cloth-Used-in-Homemade-Masks-Makes-a-Difference" target="_blank" rel="noopener noreferrer dofollow">others have</a>, that masks made from multiple layers of quilter's fabric were especially effective at blocking droplets.</p><p>The researchers hope other institutions will conduct similar experiments so the public can see how well different masks can block the spread of COVID-19.</p><p style="margin-left: 20px;">"This is a very powerful visual tool to raise awareness that a very simple masks, like these homemade cotton masks, do really well to stop the majority of these respiratory droplets," Fischer told CNN. "Companies and manufacturers can set this up and test their mask designs before producing them, which would also be very useful."</p>
SMARTER FASTER trademarks owned by The Big Think, Inc. All rights reserved.