How the global health community is fighting the rise of superbugs
Here are the leading solutions to antibiotic resistance, the next major global health threat.
JILL INVERSO: Antibiotics have revolutionized healthcare. They represent the hidden backbone of modern medicine by enabling medical advances such as surgical procedures, organ transplants, and chemotherapy. They have saved countless lives from death and disease caused by bacterial infections. Alarmingly, anti-infectives are losing their effectiveness because pathogens change and find ways to resist the effects of antibiotics, leading to the development of superbugs.
Antimicrobial resistance, or AMR, is widely recognized as one of the biggest threats to global health today. It has the potential to affect anyone, at any age, in any country. AMR causes 700,000 deaths annually across the globe, a number projected to skyrocket to 10 million by the year 2050 if new interventions are not developed.
At Pfizer, we take this growing threat very seriously. Driven by our desire to protect global public health and address the medical needs of patients suffering from infectious diseases, we are committed to being a leading provider of solutions to both help prevent and treat infections.
We remain committed to developing diverse solutions to address AMR. This includes: expanding our diverse portfolio of anti-infective medicines and vaccines to treat and help prevent serious infections around the world; growing our innovative surveillance tool, ATLAS, to help physicians better understand evolving resistance patterns; advancing good stewardship to ensure patients receive the correct antibiotic only if it is needed and for the right duration; advancing global policy leadership to facilitate antibiotic development and proper use; applying responsible manufacturing practices that minimize impact on human health and the environment.
It is imperative to preserve the effectiveness of existing antibiotics through good stewardship and treatment practices, and effectively monitoring antibiotic resistance globally through surveillance.
Pfizer is proud to sponsor one of the largest AMR surveillance programs in the world, which was recently recognized by the Access to Medicines Benchmark Report on AMR as a standout "among all surveillance programs." Our global bacterial surveillance program, ATLAS, which stands for Antimicrobial Testing Leadership and Surveillance, was established in 2004 to monitor real-time changes in bacterial resistance and track trends in multi-drug resistance longitudinally over time.
Today, ATLAS includes source information from more than 760 hospitals across 73 countries, including emerging market countries in Africa, Asia, and Latin America. Overall, it has generated 14 years of continuous global bacterial susceptibility data. ATLAS data serve to inform health care practitioners and researchers on changing resistance trends in their regions and countries, and also supports global health authorities in developing antimicrobial stewardship programs. These data are available to all—free of charge—through a publicly available website and through a mobile application.
Antimicrobial stewardship practices can help to reduce the spread of AMR by applying greater oversight of appropriate antibiotic usage to enable more rational and judicious prescribing practices. Pfizer encourages the responsible use of its antimicrobial products by promoting the selection of appropriate patients for treatment and by using the optimal drug regimen, dose, and duration of treatment. We are also addressing stewardship through our support of appropriate education and training programs for physicians and hospitals around the world.
But there are actions that every individual can take to help as well. When you are prescribed an antibiotic, don't miss doses, and please finish the course of medication. Never take an antibiotic prescribed for someone else or prescribed to you for a different infection. And keep vaccinations up to date for you and your family. 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, and preventing bacterial infections which may, in turn, prevent antimicrobial resistant infections from developing. By improving vaccination rates, we can reduce the burden of infectious diseases and limit the need for antibiotic treatments.
We believe governments and public health communities must work together with industry to take further action and support measures that will enable continued innovation in the development of new antibiotics and vaccines to help curb the spread of AMR.
- Antimicrobial drugs are losing their effectiveness because pathogens change and find ways to resist the effects of antibiotics, leading to the development of superbugs.
- Antimicrobial resistance (AMR) causes 700,000 deaths annually across the globe, a number that is projected to skyrocket to 10 million by the year 2050 if new interventions are not developed.
- Antibiotics are crucial in treating minor infections and curing serious infectious diseases, enabling minor and complex surgeries, as well as managing illnesses such as cancer and HIV/AIDS.
- Pfizer is committed to help lead the fight against AMR. It sponsors ATLAS, one of the largest AMR surveillance programs in the world, which sources global bacterial susceptibility data and makes it freely available to the public.
- Vaccines play a beneficial role in the reduction of AMR, as they prevent infectious diseases and reduce antibiotic use.
- Other tools in the fight are good stewardship and global policy leadership. Through advocacy and training around the globe, Pfizer helps ensure patients receive the correct antibiotic only if needed and for the right duration.
- Individuals can also take action against AMR superbugs by practicing good stewardship and basic sanitation. Jill Inverso shares simple things the everyday person can do to fight antibiotic resistance.
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An open letter predicts that a massive wall of rock is about to plunge into Barry Arm Fjord in Alaska.
- A remote area visited by tourists and cruises, and home to fishing villages, is about to be visited by a devastating tsunami.
- A wall of rock exposed by a receding glacier is about crash into the waters below.
- Glaciers hold such areas together — and when they're gone, bad stuff can be left behind.
The Barry Glacier gives its name to Alaska's Barry Arm Fjord, and a new open letter forecasts trouble ahead.
Thanks to global warming, the glacier has been retreating, so far removing two-thirds of its support for a steep mile-long slope, or scarp, containing perhaps 500 million cubic meters of material. (Think the Hoover Dam times several hundred.) The slope has been moving slowly since 1957, but scientists say it's become an avalanche waiting to happen, maybe within the next year, and likely within 20. When it does come crashing down into the fjord, it could set in motion a frightening tsunami overwhelming the fjord's normally peaceful waters .
The Barry Arm Fjord
Camping on the fjord's Black Sand Beach
Image source: Matt Zimmerman
The Barry Arm Fjord is a stretch of water between the Harriman Fjord and the Port Wills Fjord, located at the northwest corner of the well-known Prince William Sound. It's a beautiful area, home to a few hundred people supporting the local fishing industry, and it's also a popular destination for tourists — its Black Sand Beach is one of Alaska's most scenic — and cruise ships.
Not Alaska’s first watery rodeo, but likely the biggest
Image source: whrc.org
There have been at least two similar events in the state's recent history, though not on such a massive scale. On July 9, 1958, an earthquake nearby caused 40 million cubic yards of rock to suddenly slide 2,000 feet down into Lituya Bay, producing a tsunami whose peak waves reportedly reached 1,720 feet in height. By the time the wall of water reached the mouth of the bay, it was still 75 feet high. At Taan Fjord in 2015, a landslide caused a tsunami that crested at 600 feet. Both of these events thankfully occurred in sparsely populated areas, so few fatalities occurred.
The Barry Arm event will be larger than either of these by far.
"This is an enormous slope — the mass that could fail weighs over a billion tonnes," said geologist Dave Petley, speaking to Earther. "The internal structure of that rock mass, which will determine whether it collapses, is very complex. At the moment we don't know enough about it to be able to forecast its future behavior."
Outside of Alaska, on the west coast of Greenland, a landslide-produced tsunami towered 300 feet high, obliterating a fishing village in its path.
What the letter predicts for Barry Arm Fjord
Moving slowly at first...
Image source: whrc.org
"The effects would be especially severe near where the landslide enters the water at the head of Barry Arm. Additionally, areas of shallow water, or low-lying land near the shore, would be in danger even further from the source. A minor failure may not produce significant impacts beyond the inner parts of the fiord, while a complete failure could be destructive throughout Barry Arm, Harriman Fiord, and parts of Port Wells. Our initial results show complex impacts further from the landslide than Barry Arm, with over 30 foot waves in some distant bays, including Whittier."
The discovery of the impeding landslide began with an observation by the sister of geologist Hig Higman of Ground Truth, an organization in Seldovia, Alaska. Artist Valisa Higman was vacationing in the area and sent her brother some photos of worrying fractures she noticed in the slope, taken while she was on a boat cruising the fjord.
Higman confirmed his sister's hunch via available satellite imagery and, digging deeper, found that between 2009 and 2015 the slope had moved 600 feet downhill, leaving a prominent scar.
Ohio State's Chunli Dai unearthed a connection between the movement and the receding of the Barry Glacier. Comparison of the Barry Arm slope with other similar areas, combined with computer modeling of the possible resulting tsunamis, led to the publication of the group's letter.
While the full group of signatories from 14 organizations and institutions has only been working on the situation for a month, the implications were immediately clear. The signers include experts from Ohio State University, the University of Southern California, and the Anchorage and Fairbanks campuses of the University of Alaska.
Once informed of the open letter's contents, the Alaska's Department of Natural Resources immediately released a warning that "an increasingly likely landslide could generate a wave with devastating effects on fishermen and recreationalists."
How do you prepare for something like this?
Image source: whrc.org
The obvious question is what can be done to prepare for the landslide and tsunami? For one thing, there's more to understand about the upcoming event, and the researchers lay out their plan in the letter:
"To inform and refine hazard mitigation efforts, we would like to pursue several lines of investigation: Detect changes in the slope that might forewarn of a landslide, better understand what could trigger a landslide, and refine tsunami model projections. By mapping the landslide and nearby terrain, both above and below sea level, we can more accurately determine the basic physical dimensions of the landslide. This can be paired with GPS and seismic measurements made over time to see how the slope responds to changes in the glacier and to events like rainstorms and earthquakes. Field and satellite data can support near-real time hazard monitoring, while computer models of landslide and tsunami scenarios can help identify specific places that are most at risk."
In the letter, the authors reached out to those living in and visiting the area, asking, "What specific questions are most important to you?" and "What could be done to reduce the danger to people who want to visit or work in Barry Arm?" They also invited locals to let them know about any changes, including even small rock-falls and landslides.
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