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Wednesday, 21 March 2012

Are antibiotics an end to modern medicine?

A warning by the head of WHO that antibiotic resistance is so serious that it may lead to an end to modern medicine should alert health authorities to contain this most serious health crisis.

A schematic representation of how antibiotic r...
A schematic representation of how antibiotic resistance is enhanced by natural selection (Photo credit: Wikipedia)
LAST week, the head of the World Health Organisation (WHO) sounded a large alarm bell on how antibiotics may in future not work anymore, due to resistance of bacteria to the medicines.

Antibiotic resistance has been a growing problem for some time now. From time to time, there will be news reports of the outbreak of diseases, old and new, that cannot be treated because the bacteria have grown more powerful than the antibiotics used against them.

And experts have been warning about how the wrong use of antibiotics has given the bacteria the opportunity to develop resistance, enabling them to become immune to the medicines.

What is needed, of course, is a multi-prong strategy to prevent the abuse and wrongful use of antibiotics. Drug companies should not over-market their products. Doctors should not over-prescribe. And antibiotics should not be used on animals that are not sick but to fatten them and thus enable higher profits.

Now, the Director-General of the WHO has given a big warning that the growing threat of resistance may mean an end to modern medicine, and the entry of the post-antibiotic era.

Speaking at a meeting of infectious disease experts in Copenhagen last week, Dr Margaret Chan said there was a global crisis in antibiotics caused by rapidly evolving resistance among microbes responsible for common infections that threaten to turn them into untreatable diseases.

Every antibiotic ever developed was at risk of becoming useless.

“A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat or a child’s scratched knee could once again kill. For patients infected with some drug resistant pathogens, mortality has increased by around 50%,” she said.

“Some sophisticated interventions, like hip replacement, organ transplants, cancer chemotherapy and care of pre-term infants, would become far more difficult or even too dangerous to undertake.”

Dr Chan called for action to restrict the use of antibiotics in food production. “Worldwide, the fact that greater quantities of antibiotics are used in healthy animals than in unhealthy humans, is a cause for great concern,” she said.

She called for measures — doctors prescribing antibiotics appropriately, patients following their treatments — and restrictions on the use of antibiotics in animals.

These actions have, in fact, been suggested for many years, including by the health group REACT, based in Sweden, by health networks such as Health Action International, and locally, by the Consumers’ Association of Penang.

The WHO itself has the scope to do much more in alerting health authorities and in building the capacity, especially of developing countries, to act.

There are forms of TB that have become untreatable because of multi-drug resistance. The TB pathogen has become immune to many antibiotics. This has resulted in a resurgence of the deadly disease. The story is the same for many other pathogens causing other diseases.

As Global Trends reported in June 2011, a worrying development is the discovery of a gene, known as NDM-1, that has the ability to alter bacteria and make them highly resistant to all known drugs, including the most potent antibiotics.

In 2010, there were reports of many such cases in India and Pakistan and in European countries. At the time, only two types of bacteria were found to be hosting the NDM-1 gene – E coli and Klebsiella pneumonia.

But it was then feared that the gene would transfer to other bacteria as well, since it was found to easily jump from one type of bacteria to another. If this happened, antibiotic resistance would spread rapidly, making it difficult to treat many diseases.

These concerns have been proven to be justified. In May 2011, the Times of India published an article based on interviews with British scientists from Cardiff University who had first reported on NDM-1’s existence.

The scientists found that the NDM-1 gene has been jumping among various species of bacteria at “superfast speed” and that it “has a special quality to jump between species without much of a problem”.

While the gene was found only in E coli when it was initially detected in 2006, now the scientists have found NDM-1 in more than 20 different species of bacteria. NDM-1 can move at an unprecedented speed, making more and more species of bacteria drug-resistant.

Since there are very few new antibiotics in the pipeline, when the resistance grows among the whole range of bacteria to the existing drugs, human beings will be more and more at the mercy of the increasingly deadly bacteria.

In May 2011, there was an outbreak of a deadly disease caused by a new strain of the E coli bacteria that killed more than 20 people and affected another 2,000 in Germany.

They were affected by a new strain of the already rare 0104 type of E coli. There are other common types of E coli which normally cause only a mild ailment. The WHO said the variant had “never been seen in an outbreak situation before”.

Although the “normal” E coli usually produces mild sickness in the stomach, the new strain of E coli 0104 causes bloody diarrhoea and severe stomach cramps, while in some of the more serious cases so far, it also causes haemolytic-uraemic syndrome (HUS), which damages blood cells and the kidneys.

A major problem is that the bacterium is resistant to antibiotics. Eradication of these kinds of bacteria is impractical partly because they are able to evolve so rapidly, according to medical experts.

Now that the WHO chief has sounded the alarm bell, health authorities should redouble their efforts to contain the crisis. An “end to modern medicine” and a “post-antibiotic era” are predictions too horrible to imagine.

By  GLOBAL TRENDS By MARTIN KHOR

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Tuesday, 20 March 2012

Cyber-attacks on China

 The Register® — Biting the hand that feeds IT By Phil Muncaster

India, Asia #1 world's top weapons importer!

 A study has found India to be the biggest weapons importer.

STOCKHOLM AFP— Asia leads the world when it comes to weapon imports, according to a study released Monday by the Stockholm International Peace Research Institute (SIPRI).

 World arms trade (AFP Graphic)

Globally the volume of international transfers of major conventional weapons was 24 percent higher in the period 2007-11 compared to the 2002-06 period, the report said.

Over the past five years, Asia and Oceania accounted for 44 percent in volume of conventional arms imports, the institute said.

That compared with 19 percent for Europe, 17 percent for the Middle East, 11 percent for North and South America, and 9 percent for Africa, said the report.

India was the biggest arms importer in the period covered, 2007-11, accounting for 10 percent in weapons volume.

 India is the world's largest arms importer (AFP/File, Raveendran)
File photo shows Indian soldiers firing a Bofors gun 

It was followed by South Korea (6 percent), China and Pakistan (both 5 percent), and Singapore (4 percent), according to the independent institute which specialises in arms control and disarmament matters.

These five countries accounted for almost a third, 30 percent, of the volume of international arms imports, said SIPRI.

"India's imports of major weapons increased by 38 percent between 2002-06 and 2007-11," SIPRI said.

"Notable deliveries of combat aircraft during 2007-11 included 120 Su-30MKs and 16 MiG-29Ks from Russia and 20 Jaguar Ss from the United Kingdom," it said.

While India was the world's largest importer, its neighbour and sometime foe Pakistan was the third largest.

Pakistan took delivery of "a significant quantity of combat aircraft during this period: 50 JF-17s from China and 30 F-16s," the report added.

Both countries "have taken and will continue to take delivery of large quantities of tanks," it also noted.

"Major Asian importing states are seeking to develop their own arms industries and decrease their reliance on external sources of supply," said Pieter Wezeman, senior researcher with the SIPRI Arms Transfers Programme.

China, which in 2006 and 2007 was the world's top arms importer, has now dropped to fourth place.

"The decline in the volume of Chinese imports coincides with the improvements in China's arms industry and rising arms exports," according to the report.

 File photo shows Chinese People's Liberation Army (PLA) …

But "while the volume of China's arms exports is increasing, this is largely a result of Pakistan importing more arms from China," it added.

"China has not yet achieved a major breakthrough in any other significant market."

China is however the sixth largest world exporter of weapons behind the United States, Russia, Germany, France and Britain.

In Europe, Greece was the largest importer between 2007 and 2011, the institute said.

Between 2002 and 2011, Syria increased its imports of weapons by 580 percent -- the bulk supplied by Russia -- while Venezuela boosted its imports over the same period by 555 percent, it reported.

Throughout the Middle East as a whole, weapons imports decreased by eight percent over the period of the survey.

However SIPRI warned "this trend will soon be reversed."

Tunisia, where mass protests ousted strongman Zine El Abidine Ben Ali early last year, launched the so-called Arab Spring and inspired similar movements in Egypt, Libya and elsewhere.

"During 2011, the governments of Bahrain, Egypt, Libya, Tunisia and Syria used imported weapons in the suppression of peaceful demonstrations among other alleged violations of human rights and international humanitarian law.

"The transfer of arms to states affected by the Arab Spring has provoked public and parliamentary debate in a number of supplier states," the report said.

The volume of deliveries of "major conventional weapons" to African nations increased by a massive 110 percent in 2007-2011 over the previous five-year period, with deliveries to North Africa up by 273 percent.

Morocco saw its own imports increase by 443 percent, the report added.

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