AP looks at drug resistance worldwide
Filed under: Health policy, Hot Health Headline, Public health
The Associated Press has neatly wrapped up its wide-ranging look at drug resistance and the threat it poses to global health into a flash-based multimedia presentation. The presentation consists of stories, infographics, videos and a photo/audio slideshow.
The two videos explain drug-resistant strains of various infectious diseases. The first looks at the wide availability of powerful antibiotics without guidance or prescription, addresses the problem as it has emerged both in the United States and in locales like Mexico and the Philippines. The second, which is about the use of antibiotics in large-scale livestock operations, relies on just one source, Dr. Craig Rowles of Elite Pork Partnership.
The AP uses infographics to establish the spread and scope of the problem, relying heavily on various world maps. I particularly like the timeline that accompanies the malaria graphic (click “statistics” in the upper right, then “malaria”); it shows the span of time from when each malaria-fighting drug was introduced to the date at which a resistant strain emerged.
Finally, they drive the problem home with three strong anecdotes, including a Southeast Asian boy with drug-resistant malaria, a man fighting the drug-resistant tuberculosis that killed his HIV-positive partner, and a woman who lost an infant daughter to MRSA.
Stories in the series:
- New form of malaria threatens Thai-Cambodia border
- South African doctor sees drug-resistant HIV
- First case of highly drug-resistant TB found in US
- Solution to killer superbug found in Norway
The package is accompanied by this video.
More than 22,000 inmates are HIV-positive
Poynter’s Al Tompkins spotted a new U.S. Department of Justice report (PDF) on HIV in American prisons. Among other things, the report finds 22,000 HIV-positive inmates, a number which Tompkins points out may be even higher because fewer than half of American states test every inmate that comes through their doors. About 5,672 prisoners have confirmed AIDS, a disease whose complications killed 130 inmates in 2007, the most recent year for which numbers are available.
Here’s Tompkins quoting some particularly interesting numbers from DOJ:
The Justice Department said just three states account for 46 percent of all of the HIV cases in state prisons:
“Florida (3,626), New York (3,500) and Texas (2,450) reported the largest number of HIV/AIDS cases. While these three states account for 24 percent of the total state custody population, together they account for 46 percent of HIV/AIDS cases in state prison. New York continues to report large decreases (down 450) in the number of HIV/AIDS cases. Notable increases between 2007 and 2008 were in California (up 246), Missouri (up 169) and Florida (up 166).
The report breaks down how many HIV cases are in each state, by gender, how manyAIDS-related deaths were in each state and the circumstances under which inmates were tested.
Recognizing World AIDS Day
In honor of the 22nd annual World AIDS Day, we’ve rounded up a few interesting and useful resources and recent stories. This year’s theme is “Universal Access and Human Rights.”
- The UN released its latest update on the epidemic in late November. The Wall Street Journal’s Gordon Fairclough reports that worldwide infection numbers have leveled out in recent years. New infections peaked around 1996 and have slowly declined since.
- Health Affairs recently released a Bill & Melinda Gates Foundation-supported series focusing on the HIV/AIDS pandemic. Among other things, articles in the series forecast a looming funding shortfall and explore ways to prevent it. A related set of policy briefs on the pandemic can be found here.
- HIV is the biggest killer of younger women, NPR Health Blog’s Scott Hensley reports. See the full WHO report here.
- “The South leads the nation in the percentage of AIDS-related deaths. Yet, the region ranks last when it comes to overall federal dollars spent on an HIV-infected person at $6,565 a year,” AP’s Shelia Byrd reports. On a hopeful note, Byrd adds that the situation may improve thanks to the president’s signing of the $2.2 billion Ryan White HIV/AIDS extension act.
- The National Institutes of Health recommend HIV testing for Americans ages 13 to 64, the Rochester Post-Bulletin’s Jeff Hansel reports. The CDC’s recommendations can be found here.
- In related news, WebMD Health News’ Charlene Laino reported on a Johns Hopkins study that found home-testing for HIV is easy and accurate, with the researchers even going so far as to compare it to pregnancy testing. The home tests matched lab tests in 400 of 402 cases, which makes for better than 99 percent accuracy. Currently, only the The Home Access HIV-1 Test System and the Home Access Express HIV-1 Test System are approved by the FDA, and both require that blood samples taken at home be sent to a laboratory for evaluation. The express kit’s currently $59.99 on Amazon.com.
AHCJ resources
Tip sheets and articles
- Reporting on HIV in Africa
- AHCJ member reports from Malawi, Zambia
- Updates: HIV/AIDS - A Potpourri of Clinical Aspects
Award-winning pieces
- Delivering AIDS Drugs – The Long Journey (2009)
- Divine Intervention: U.S. AIDS Policy Abroad (2007)
- Living Positive: HIV/AIDS in East Tennessee (2006)
Slip of the needle brings fallout, tough decisions
Filed under: Hospitals, Hot Health Headline, Nursing
Writing for The New York Times, AHCJ member Sibyl Shalo Wilmont shares the chain of events that followed when she accidentally injected herself with a drop of a patient’s blood.
A quick test showed the patient was likely negative for HIV, but Wilmont still had to decide whether or not to undergo post-exposure prophylaxis, a grueling cycle of treatment that would continue for at least a month. Wilmont had covered post-exposure prophylaxis as a journalist and her knowledge for that helped guide her decision.
UN: Africa plagued by counterfeit malaria/HIV pills
Filed under: Hot Health Headline, Public health, Studies
A recent assessment by the United Nations Office on Drugs and Crime found that weak and or/useless drugs have proliferated across Africa and Asia, with malaria-ridden West Africa being the hardest hit (102-page PDF). Smugglers, organized criminals and shady manufacturers in more developed countries are getting rich at the expense of individuals and countries with little capacity to distinguish between fraudulent pharmaceuticals and the real thing.
From the accompanying press release:
As much as 50-60 per cent of anti-infective medicines tested in Asia and Africa have been found to have insufficient amounts of the active ingredients. Medicines with low levels of active ingredients pose a greater hazard than those with none, because substandard antibiotics and anti-malarial drugs can promote the development of drug resistant strains, or “super bugs” that can spread beyond the region.
The UN report calls for immediate action, including the naming, shaming and banning of companies producing the faux pills and stronger government regulatory efforts.
‘Virus hunter’ stays ahead of outbreaks
Writing for Men’s Journal, Tom Clynes followed Nathan Wolfe — the virological and epidemiological equivalent of a rock star — to remote regions of Cameroon (PDF), one of the raw frontiers in the transmission of disease between animals and humans and the place where some scientists believe HIV may have made its way to humans more than a century ago.
Supported by generous grant funding from heavyweights like Google.org and the United States Department of Defense, Wolfe travels the world visiting places — from East Asian poultry and wild animal markets to bush meat hunters in central African rain forests — known as hotbeds of animal-to-human disease transmission. Clynes’ sometimes-graphic account follows Wolfe, head of the Global Viral Forecasting Initiative, as he visits African subsistence hunters to take blood samples and to educate them about safe hunting practices.
Clynes writes that Wolfe has pioneered a new, immersive model of disease detection that gives him a fighting chance of detecting the next big human pandemic before it gets out of control.
GVFI’s method flies in the face of the “parachute science” approach that has long typified data collection in the Third World. Wolfe thinks he’s got the system down, and he believes that, with the right collaborators, his model can be scaled up and repeated anywhere in the world.
Working like this, one village at a time, Wolfe has quickly accumulated one of the most comprehensive blood collections on Earth, some 25,000 human and 16,000 animal samples that are available to researchers around the globe. “I can guarantee that these repositories of samples will be treasure troves of information for the future,” says Michael Worobey, of the University of Arizona.
The global health community believes the dangers Wolfe and his team and others in the field are working to detect are very real, lending an urgency to GVFI’s work.
The SARS outbreak killed more than 700, but it could have been far worse. A massive international containment effort, led by the WHO, averted a doomsday scenario and quickly controlled the outbreak. What worries people like Dr. Michael Ryan, coordinator of the WHO’s Global Outbreak Alert and Response Network, is that SARS may have been just a rehearsal for something worse. “We winged it with SARS,” says Ryan, “and we got away with it, because the core countries had the capacity to deal with it. But if SARS had happened in rural Africa we’d still be dealing with it. And I think it’s inevitable that we’ll be hit with something new that will be harder to put back in its box.”
Obama releases documents from advocacy groups
Jennifer LaFleur at ProPublica points out that “President-elect Barack Obama’s transition team seems to be following through with its promise of transparency by posting documents from its meetings with industry and advocacy groups.”
There are some health-related documents among the postings:
AIDS in America: An agenda endorsed by 15 national organizations that calls for “the development of a National AIDS Strategy for the U.S. that is designed to lower HIV incidence, increase access to HIV care, and reduce racial disparities in the epidemic and integrate HIV with STD, viral hepatitis and TB programs at the local level.”
Asian Pacific Islander American Health Forum: “Priorities for the new administration to improve the health and well-being of Asian Americans, Native Hawaiians and Pacific Islanders”
Analysis of HIV/AIDS Priority Issues for Immediate Action: List of issues for “immediate action” from the AIDS Action Council
Advancing Reproductive Rights and Health in a New Administration: Agenda from a coalition of about 60 medical, public health, research, religious and religiously affiliated, women’s health, legal, and other advocacy organizations.
National Water Policy Dialogue: The American Water Resources Association, the Environment and Water Resources Institute of the American Society of Civil Engineers and the National Wildlife Federation submitted a summary of the National Water Policy Dialogues conducted by AWRA at the request of 10 federal water agencies. Water quality is among their concerns.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
