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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What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.
- Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
- Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
- Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.
A recent study gives new meaning to the saying "fake it 'til you make it."
- The study involves four experiments that measured individuals' socioeconomic status, overconfidence and actual performance.
- Results consistently showed that high-class people tend to overestimate their abilities.
- However, this overconfidence was misinterpreted as genuine competence in one study, suggesting overestimating your abilities can have social advantages.
Is this proof of a dramatic shift?
- Map details dramatic shift from CNN to Fox News over 10-year period
- Does it show the triumph of "fake news" — or, rather, its defeat?
- A closer look at the map's legend allows for more complex analyses
Dramatic and misleading
Image: Reddit / SICResearch
The situation today: CNN pushed back to the edges of the country.
Over the course of no more than a decade, America has radically switched favorites when it comes to cable news networks. As this sequence of maps showing TMAs (Television Market Areas) suggests, CNN is out, Fox News is in.
The maps are certainly dramatic, but also a bit misleading. They nevertheless provide some insight into the state of journalism and the public's attitudes toward the press in the US.
Let's zoom in:
- It's 2008, on the eve of the Obama Era. CNN (blue) dominates the cable news landscape across America. Fox News (red) is an upstart (°1996) with a few regional bastions in the South.
- By 2010, Fox News has broken out of its southern heartland, colonizing markets in the Midwest and the Northwest — and even northern Maine and southern Alaska.
- Two years later, Fox News has lost those two outliers, but has filled up in the middle: it now boasts two large, contiguous blocks in the southeast and northwest, almost touching.
- In 2014, Fox News seems past its prime. The northwestern block has shrunk, the southeastern one has fragmented.
- Energised by Trump's 2016 presidential campaign, Fox News is back with a vengeance. Not only have Maine and Alaska gone from entirely blue to entirely red, so has most of the rest of the U.S. Fox News has plugged the Nebraska Gap: it's no longer possible to walk from coast to coast across CNN territory.
- By 2018, the fortunes from a decade earlier have almost reversed. Fox News rules the roost. CNN clings on to the Pacific Coast, New Mexico, Minnesota and parts of the Northeast — plus a smattering of metropolitan areas in the South and Midwest.
Image source: Reddit / SICResearch
This sequence of maps, showing America turning from blue to red, elicited strong reactions on the Reddit forum where it was published last week. For some, the takeover by Fox News illustrates the demise of all that's good and fair about news journalism. Among the comments?
- "The end is near."
- "The idiocracy grows."
- "(It's) like a spreading disease."
- "One of the more frightening maps I've seen."
- "LOL that's what happens when you're fake news!"
- "CNN went down the toilet on quality."
- "A Minecraft YouTuber could beat CNN's numbers."
- "CNN has become more like a high-school production of a news show."
Not a few find fault with both channels, even if not always to the same degree:
- "That anybody considers either of those networks good news sources is troubling."
- "Both leave you understanding less rather than more."
- "This is what happens when you spout bullsh-- for two years straight. People find an alternative — even if it's just different bullsh--."
- "CNN is sh-- but it's nowhere close to the outright bullsh-- and baseless propaganda Fox News spews."
"Old people learning to Google"
Image: Google Trends
CNN vs. Fox News search terms (200!-2018)
But what do the maps actually show? Created by SICResearch, they do show a huge evolution, but not of both cable news networks' audience size (i.e. Nielsen ratings). The dramatic shift is one in Google search trends. In other words, it shows how often people type in "CNN" or "Fox News" when surfing the web. And that does not necessarily reflect the relative popularity of both networks. As some commenters suggest:
- "I can't remember the last time that I've searched for a news channel on Google. Is it really that difficult for people to type 'cnn.com'?"
- "More than anything else, these maps show smart phone proliferation (among older people) more than anything else."
- "This is a map of how old people and rural areas have learned to use Google in the last decade."
- "This is basically a map of people who don't understand how the internet works, and it's no surprise that it leans conservative."
A visual image as strong as this map sequence looks designed to elicit a vehement response — and its lack of context offers viewers little new information to challenge their preconceptions. Like the news itself, cartography pretends to be objective, but always has an agenda of its own, even if just by the selection of its topics.
The trick is not to despair of maps (or news) but to get a good sense of the parameters that are in play. And, as is often the case (with both maps and news), what's left out is at least as significant as what's actually shown.
One important point: while Fox News is the sole major purveyor of news and opinion with a conservative/right-wing slant, CNN has more competition in the center/left part of the spectrum, notably from MSNBC.
Another: the average age of cable news viewers — whether they watch CNN or Fox News — is in the mid-60s. As a result of a shift in generational habits, TV viewing is down across the board. Younger people are more comfortable with a "cafeteria" approach to their news menu, selecting alternative and online sources for their information.
It should also be noted, however, that Fox News, according to Harvard's Nieman Lab, dominates Facebook when it comes to engagement among news outlets.
CNN, Fox and MSNBC
Image: Google Trends
CNN vs. Fox (without the 'News'; may include searches for actual foxes). See MSNBC (in yellow) for comparison
For the record, here are the Nielsen ratings for average daily viewer total for the three main cable news networks, for 2018 (compared to 2017):
- Fox News: 1,425,000 (-5%)
- MSNBC: 994,000 (+12%)
- CNN: 706,000 (-9%)
And according to this recent overview, the top 50 of the most popular websites in the U.S. includes cnn.com in 28th place, and foxnews.com in... 27th place.The top 5, in descending order, consists of google.com, youtube.com, facebook.com, amazon.com and yahoo.com — the latter being the highest-placed website in the News and Media category.
If you thought your mother was pushy in her pursuit of grandchildren, wait until you learn about bonobo mothers.
- Mother bonobos have been observed to help their sons find and copulate with mates.
- The mothers accomplish this by leading sons to mates, interfering with other males trying to copulate with females, and helping sons rise in the social hierarchy of the group.
- Why do mother bonobos do this? The "grandmother hypothesis" might hold part of the answer.
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