Latest news with #antimicrobialResistance
Mail & Guardian
09-07-2025
- Health
- Mail & Guardian
Microplastics act as ‘rafts', increasing the threat to environmental and public health
African countries, including South Africa, have limited waste infrastructure and uneven water treatment systems, which exacerbates the problem of antibiotic resistance. Photo: Sustainable Seas Trust While antimicrobial resistance (AMR) is commonly linked to the overuse of antibiotics in hospitals and animal farming, an environmental contributor is increasingly coming into focus: microplastics. These small plastic particles, typically less than 5mm in diameter, are increasingly recognised not only as environmental pollutants but also as active vectors in the evolution and dissemination of antimicrobial-resistant bacteria. Although the crisis is unfolding worldwide, low- and middle-income countries are especially vulnerable because of limited infrastructure and inadequate waste management systems. A perfect storm for AMR These plastic surfaces create ideal conditions for the formation of microbial communities known as biofilms. Within these clusters, bacteria can exchange genetic material more efficiently, including antimicrobial resistance genes. Moreover, microplastics tend to adsorb antibiotics and heavy metals from their surroundings, increasing the selective pressure that favors resistant bacteria. As a result, microplastics are transforming natural ecosystems into incubators of resistance. And these resistant bacteria do not remain confined. They can spread through water, air, food, and even within the human body. A global crisis with local vulnerabilities According to recent estimates, One illustrative example is the Further south, South Africa presents a particularly telling case. Despite being one of the continent's most developed countries, its waste management infrastructure continues to face serious problems. A 2024 study conducted in Health systems on the front line The African continent bears a high burden of infectious diseases, many of which are still treated with older, widely available antibiotics. If AMR continues to spread unchecked, the consequences will be severe. This includes not only loss of human life but also increased pressure on already fragile healthcare systems. Microplastics are complicating efforts to control resistant infections in ways that are not yet fully understood or reflected in current policies. Environmental reservoirs of resistance are rarely included in surveillance systems, and when they are, microplastics are often overlooked as a contributing factor. Towards sustainable solutions Addressing this complex and interconnected crisis requires action on multiple fronts. First, it is essential to reduce plastic production and improve waste management, especially in urban areas. Policies such as bans on single-use plastics and incentives for recycling can make a meaningful difference, provided they are properly implemented and enforced. Second, environmental monitoring systems should begin to include both microplastics and antimicrobial resistance genes as indicators of ecosystem health. This would allow policymakers to detect hotspots and take action before resistance spreads further. Third, the scientific community must broaden its focus. Although most research on AMR has concentrated on clinical and agricultural settings, the environment must now be recognised as a critical front. This shift requires interdisciplinary collaboration among microbiologists, environmental scientists, engineers, and public health professionals. Encouragingly, several promising innovations are emerging. Nature-based solutions such as constructed wetlands, which use plants and microorganisms to clean wastewater, have shown potential to reduce both microplastic pollution and the prevalence of antimicrobial resistance genes. These systems are cost-effective, adaptable, and well suited to the needs of many African regions. The role of public awareness Perhaps most importantly, we must acknowledge that this is not solely a scientific matter. It is also a social and political issue. People need to be involved in and empowered to reduce plastic consumption, demand improved sanitation, and understand the connections between environmental pollution and human health. Educational campaigns, particularly those aimed at young people and urban populations, can help shift behaviours and build public momentum for change. Public interest media play a vital role in making these connections visible and accessible to the broader public. Dr Jose L Balcazar is Senior microbiologist at the Catalan Institute for Water Research (ICRA-CERCA), Spain. His research explores the mechanisms and factors that promote antimicrobial resistance.
Zawya
08-07-2025
- Health
- Zawya
Malawi Launches Second Edition of Pathogen Genomic Surveillance Strategy and Implementation Plan
The Malawi Ministry of Health, launched its updated plan for the implementation of its Genomic Surveillance Strategy that was produced with technical support from the Africa Centres for Disease Control and Prevention – Africa Pathogen Genomics Initiative (Africa PGI) on 3 July. As pathogen genomics provides a powerful approach towards the investigation, management, and surveillance of infectious diseases, the plan is geared to include integration of multi-pathogen genomic surveillance into existing public health systems, research and development. The second version of the plan is aligned to Africa CDC Pathogen Genomics Surveillance Policy Framework and identified priority list of pathogens and use cases for genomic surveillance in Malawi and the region. The strategy has a robust, comprehensive, fully integrated, harmonized and well-coordinated mechanisms to guide monitoring of the implementation of the plan and evaluate impact. The improved plan has a National Genomics Committee comprising of a steering committee, advisory group and laboratories from public, private and academia. The first genomic strategy was launched in 2023 and runs to 2030 In his opening remarks, Secretary for Health Dr. Samsom Kwazirira Mndolo emphasized the critical role of genomics in monitoring antimicrobial resistance, disease outbreak detection, response and prevention as well in precision medicine. He underscored the role of the plan as a roadmap for implementing a robust one health genomic surveillance system across the country with different multi stakeholders, ministries and partners. 'We have been front runners in genomics, but we lost the opportunity to learn from others, so we decided to revisit and update the 2023 plan,' said Dr Mndolo. 'This moment marks the dawn of a new era, where science, innovation, and determination converge to build a stronger, more resilient health system for all starting from Malawi by leveraging genomic sequencing power to identify and track pathogens enabling early detection, tracking and characterization of pathogens,' said Dr Lul Riek, Director for the Southern Africa Regional Coordinating Centre. Dr Riek said by integrating pathogen genomic sequencing into its healthcare infrastructure, it aims to enhance its health security and swiftly respond to emerging and reemerging threats effectively. 'This makes Malawi one step ahead of other countries in disease detection and response,' he said. 'In the face of several emerging and reemerging health threats including Disease X ' a hypothetical emerging pathogen, from the COVID-19 pandemic to the resurgence of Mpox, Marburg, Cholera and other epidemics, we have witnessed firsthand the urgent need for resilient public health surveillance systems that can provide timely and actionable data,' said Dr Francis Chikuse, Senior Technical Officer for Public Health at Africa CDC. 'The National Multi Pathogen Genomic Surveillance Strategy is not just a response to these challenges but a proactive step toward building a robust system that leverages the power of molecular diagnostics and sequencing to safeguard the health of the of Malawians and beyond,' said Dr Chikuse. He said, Africa CDC in partnership with public, private and philanthropic sectors is enhancing continent-wide sample referral and data sharing strategy, systems, and governance to promote trusted, quality assured and timely data sharing as well as support the design and pilot implementation of high-impact public health priority genomic surveillance and use-cases and facilitate the utility of genomics data for policy, decision making, research and development of pandemic materials. In 2025, the World Health Assembly adopted the historic Pandemic Agreement to enhance global collaboration and to create a more equitable response to future pandemics. Africa CDC is working with 16 Member States including the Democratic Republic of Congo, Uganda, Mozambique, Ethiopia, Cameroon, Malawi, Zambia, Republic of Congo, Zimbabwe, Ghana, Morocco, Togo, South Africa, Tanzania, Rwanda, Namibia, to develop their national pathogen genomics strategies. Through this collaboration, Malawi becomes the second country after Zambia to launch their genomic strategy. Distributed by APO Group on behalf of Africa Centres for Disease Control and Prevention (Africa CDC).
Medscape
30-06-2025
- Health
- Medscape
More Days, More Resistance: Time to Rethink Antibiotics
'One of the most universally accepted beliefs around the world,' said Brad Spellberg, MD, chief medical officer at Los Angeles General Medical Center, 'is that when you take antibiotics, you must complete the prescribed course — 7, 10, or 14 days — even after you start feeling better, in order to eliminate every last bacterium and prevent a future relapse.' 'But that recommendation doesn't make sense. There's no data to support it,' Spellberg noted in a virtual lecture at the 2025 Argentine Society of Infectious Diseases Congress, held in Mar del Plata from June 12 to 14. 'That's not how antibiotics work. Every additional day you take an antibiotic increases resistance,' he emphasized. Spellberg cited two quotes from Louis Rice, MD, chair of the Department of Medicine at the Warren Alpert Medical School of Brown University, Providence, Rhode Island, and former president of the Infectious Diseases Society of America: 'The most viable strategy for reducing antimicrobial selective pressure is to treat infections only for as long as is necessary.' '[Completing the prescribed antibiotic regimen] may be excellent advice when one wants to have patients take an adequate course to treat an infection, but it is poor advice for preventing resistance.' 'We should tell patients: 'If you're taking antibiotics, and you feel better but still have a few days left, call me, and we'll decide whether to stop,'' Spellberg advised. He added that if you prescribe 14 days of antibiotics for an infection, the patient is still taking them for a week after symptoms resolve. 'But if you prescribe 5-7 days, stopping early isn't a problem. So, we can resolve everything simply by switching to short-course therapy.' 'Shorter Is Better' Spellberg's stance isn't new. A decade ago, he coined the mantra 'shorter is better,' challenging the dogma that longer antibiotic regimens are more effective — a notion since disproven by dozens of clinical trials. As he told Medscape's Spanish edition in 2016, 'Providing short antibiotic courses based on evidence reduces the risk that patients will feel better before completing therapy and minimizes leftover pills.' He reported that over 150 randomized controlled trials across 24 infection types have demonstrated that short antibiotic courses yield the same clinical outcomes as longer ones. For example, in cases of community-acquired pneumonia, 14 studies have shown that 3-5 days of antibiotic therapy are as effective as 5-14 days. Similarly, for urinary tract infections or pyelonephritis, 13 studies indicate that 5-7 days of treatment are just as effective as 10-14 days. In intra-abdominal infections, three studies have found that 4 days of antibiotics are comparable in efficacy to 8-10 days of treatment. However, in suspected cases of ventilator-associated pneumonia (not microbiologically confirmed), a retrospective study could not establish a difference between 'ultrashort' 3-day regimens and those lasting 2-3 weeks. 'If you're going to treat patients without infection with antibiotics,' he added, 'at least keep it brief.' Paradigm Shift in Practice Ezequiel Córdova, MD, session moderator and infectious diseases specialist at Hospital Cosme Argerich and HIV clinical investigator at Fundación IDEAA in Buenos Aires, Argentina, noted that Spellberg's message challenges a long-standing dogma passed down through generations regarding standard antibiotic durations. 'Lately, we've seen that shorter treatments can be just as effective,' Córdova told Medscape's Spanish edition . 'That not only reduces adverse effects but also limits resistance. Treatments should be as long as necessary — no more, no less.' He noted that soft tissue infections were once routinely treated with 14-day courses, 'but today, if we see clinical improvement after 5 days, the treatment can be safely stopped. The same applies to pneumonia. Previously it was 10-14 days of antibiotics, but now 5 days is often enough if the patient improves.' When asked whether further shortening is feasible in current practice, Córdova replied, 'There may be a limit where shorter durations compromise clinical outcomes — but we haven't reached it yet. We need to keep educating.' Spellberg and Córdova declared having no relevant financial conflicts of interest.
Forbes
26-06-2025
- Health
- Forbes
Cancer Patients Face Silent Crisis From Superbugs, New Research Shows
Over the last six months, several major studies have laid bare the threat posed by antimicrobial ... More resistance (AMR) to cancer patients. In the past 20 years, cancer medicine has been revolutionized by an array of new treatments, ranging from monoclonal antibodies to novel immunotherapies like CAR T-cell therapy, and targeted therapies like tyrosine kinase inhibitors. Some have played such a major role in improving survival rates that they have now been added to the WHO Model List of Essential Medicines. But in parallel, a silent crisis has been brewing, one which threatens to reverse much of the progress that has been achieved. Over the last six months, a couple of major studies have laid bare the threat posed by antimicrobial resistance (AMR) to cancer patients. Published by the Cancer AMR Consortium - a new partnership between the AMR Action Fund, the Union for International Cancer Control (UICC) and medtech company Becton Dickinson – these studies have revealed that infections are the second leading cause of death in cancer patients, often driven by drug-resistant bacteria. In particular, hospitalized cancer patients are also 1.5-2 times more likely to have infections caused by various gram-negative or gram-positive bacteria, which are resistant to multiple antibiotics, than hospitalized patients without cancer. (Full disclosure, I sit on the board of the AMR Action Fund, a global initiative that aims to bring two to four new antibiotics to patients by 2030.) Antimicrobial resistance has been a known health threat for some time, with studies suggesting that such bacteria have claimed one million lives each year since 1990. But as Michael Satlin, Clinical Director of the Transplantation-Oncology Infectious Diseases Program at Weill Cornell, points out, cancer patients are particularly vulnerable as both the nature of their illness and many treatments actively suppresses the immune system, making infections more likely. Chemotherapy, for example, can destroy the protective lining of the gut wall, making it more likely that drug-resistant pathogens will end up circulating in the blood, while patients are often fitted with a peripherally inserted central catheter (PICC line) to deliver drugs or nutrition, something which also comes with a raised infection risk. 'Antimicrobial resistance disproportionately impacts patients with cancer, because many have weakened immune systems that make them completely reliant on effective antibiotics,' says Satlin. According to Shalini Jayasekar Zürn, Senior Advocacy Manager at the UICC, the growing burden of resistant infections is also making it harder to treat many people with cancer. For example, when patients undergo surgery to remove a tumour, they are often given prophylactic antibiotics to prevent post-operative infections. But if those drugs do not work so well, this can greatly delay recovery. 'You can also have people living with cancer, on treatment with chemotherapy, but if they develop a multi drug-resistant infection and require an extended hospital stay, their treatment is delayed, giving the cancer time to progress,' she says. 'Sometimes you get patients who actually die of the infection before the cancer.' New Antibiotics and Greater Recognition The oncologists interviewed for this article said that while AMR has long been recognized as a public health threat, the impact on cancer care has yet to be acknowledged by many of the leading cancer organizations and conferences. Zürn says there are many cases where a drug-resistant infection has directly caused the fatality, but the cause of death is still listed as cancer. Yehoda Martei, an oncologist and assistant professor of medicine at the Hospital of the University of Pennsylvania, described this phenomenon as an example of the damaging silos that often exist in medicine. 'Oncologists send blood samples to be cultured all the time, and see patients infected with multiple AMR organisms, so the issue is very apparent on an individual patient level,' she says. 'What's missing is a global acknowledgement that a crisis of AMR is a crisis of cancer care delivery.' But in addition to acknowledgment, what can be done to better combat this threat? Scientists feel that the data released by the Cancer AMR Consortium points to an urgent need for better diagnostics to quickly identify an infection, relay information about drug resistance, and determine which medications are more likely to work. 'Right now, this can take days or longer in most labs,' says David Greenberg, professor of infectious diseases and microbiology, at the University of Texas Southwestern Medical Center. 'With resistance rates increasing, this time delay means the chances that I put a patient on the wrong antibiotic only increase. So speeding up this process and finding new ways to detect antibiotic resistance is critical.' There is also a grave need for new antibiotics, a pipeline which has long been notoriously sparse. It has often been highlighted that the last time a novel class of antibiotics reached the market was back in 1987, with one of the primary reasons being a lack of commercial incentives for drug developers. Several countries have begun experimenting with creative ideas like subscription models, a concept dubbed 'Netflix for antimicrobials,' in which national health services pay a subscription fee to pharmaceutical companies in exchange for access to new antimicrobial drugs. Zürn says that more of these ideas are needed. 'Right now, developing antibiotics is a loss-making venture for many companies, which is why the sector has lacked innovation,' she says. 'Although progress is being made, much more is needed. We need stronger incentives and clearer pathways that not only encourage development but also ensure equitable access to these medicines, with a focus on addressing pressing public health needs.' Ultimately solutions must be found, as otherwise high-income countries like the U.S., Germany, and the U.K. could find themselves in a drastic situation where oncologists are not able to safely administer lifesaving treatments such as CAR T-cell therapy, because the risks of contracting a deadly infection are simply too great. 'In parts of Africa and other low and middle-income countries where there isn't good infection control or access to antibiotics, doctors can't do bone marrow transplants, because they can't support those patients adequately through their period of immunosuppression,' says Martei. 'If AMR continues to increase, and the pipeline of antibiotics and other antimicrobials isn't being replenished, we could end up in a similar situation where we have to rethink how we treat patients, and what therapies we can actually administer safely.' Let this new research galvanize policymakers to reform the broken policy incentives for antibiotic-resistant medications so that biopharma will invest in replenishing the pipeline. Cancer patients – and so many others -- are you to David Cox for additional research and reporting on this article.
Zawya
14-06-2025
- Health
- Zawya
Tunis hosts landmark One Health Conference to tackle interconnected health challenges in MENA
Tunis, Tunisia – The Government of Tunisia will host the MENA Region One Health Conference on June 14–15, 2025, in Tunis, in partnership with the World Bank and the Quadripartite collaboration on One Health comprising the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Programme (UNEP), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH). Over the course of this two-day high-level regional conference, government ministers, health sector experts, development partners, and community representatives will be present to discuss and work together on the issue of collaboration across human, animal, and environmental health. The participants will address the most significant challenges such as antimicrobial resistance (AMR), climate-related health risks, food insecurity, zoonotic diseases, and the urgent need for integrated surveillance systems. The opening session will feature representatives from the Government of Tunisia and the organizing partners, as well as a high-level ministerial session with participating partner countries. 'This conference is not just an event, but a moment of collective awareness. 'One Health' is no longer a theory; it is a reality we are living and must confront together. The challenges are immense — from pandemics to food security, to antimicrobial resistance — and no individual response can be sufficient. Tunisia is fully committed to this approach and is proud to host this gathering of all those who believe in a united, shared health system, resolutely moving toward the future', said Minister of Health Dr. Moustafa Ferjani. The conference will feature several sessions on the implementation of One Health around the globe with a special focus on the MENA region. Key interventions will include remarks from Ms. Shobha Shetty, Global Director of the World Bank, Ms. Emmanuelle Soubeyran, WOAH Director General, Dr. Abdulhakim Elwaer, FAO Assistant Director-General and Regional Representative for the Near East and North, and Mr Abdul-Majeid Haddad, Deputy Regional Director of UNEP in West Asia, as well as a recorded message from Dr. Hanan Balkhy, WHO regional director. 'One Health requires breaking down silos and building a shared vision', said Ahmadou Moustapha Ndiaye, Division Director for the Maghreb and Malta at the World Bank. 'The World Bank reaffirms its commitment to supporting Tunisia and partner countries in the region in developing resilient, integrated, and inclusive cross-sectoral systems'. Dr. Ibrahim EL-ZIQ, WHO Tunisia representative, noted: 'This conference provides an excellent opportunity to accelerate the adoption and operationalization of the 'One Health' approach in the MENA region countries. By meeting here in Tunisia, the various actors are demonstrating their shared determination to act jointly to address complex and interconnected threats to human, animal, and environmental health. Strengthened coordination, constant political commitment and sustainable investment are key to success. We are pleased to join forces with the Tunisian government and the World Bank to co-organize this conference and remain committed to enable countries of the region in transforming this shared vision into concrete action for more resilient and healthier societies'. The conference agenda features thematic sessions on integrated surveillance, laboratory resilience, conservation and climate, and cross-border collaboration. Practitioners will share real-world applications of One Health, while interactive sessions will offer pathways to mainstream One Health at both policy and operational levels. Highlights include: The launch of the Carthage Declaration, setting out a regional roadmap to operationalize One Health. An interactive closing session with the Quadripartite and World Bank representatives outlining next steps and support mechanisms. The formal launch of a MENA One Health Community of Practice, led by Tunisia's Ministry of Health. One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. The approach mobilizes multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development. [1] Learn more and access the full agenda at:
