March 2010

Dear Colleague,

Earlier this month, the World Health Organization released new guidelines for the treatment of malaria which urge pre-treatment testing and add artemisinin-based combination treatment (ACTs) to the list of recommended treatments. According to the BMJ, these guidelines are expected to “enhance earlier and accurate diagnosis, halt the emergence of drug resistance, and reduce the use of unnecessary treatment.” Implementation of new guidelines is the big challenge here, but we believe this change will ultimately prove beneficial to drug resistance prevention. 

This month we also welcome news that the first African pharmaceutical plant (in Uganda) was pre-qualified by WHO for production of anti-HIV and anti-malarial drug products.  

Finally, as most of you know, last Wednesday, March 24th, was World TB day – please see the guest column by our Stop TB colleagues below to learn the most recent global statistics on drug resistant TB.

As always, we welcome your thoughts at [email protected].
 
Regards,
 
Rachel Nugent
Deputy Director for Global Health
Center for Global Development

GLOBAL M/XDR-TB SITUATION AND TRENDS

By Mario Raviglione and Matteo Zignol, Stop TB Department

On the occasion of World TB Day 2010, the World Health Organization (WHO) issued a new report "Multidrug and extensively drug-resistant (M/XDR-TB): 2010 global report on surveillance and response," which documents the highest levels of MDR-TB ever recorded. Both MDR and XDR-TB are taking a huge global toll in terms of risk of infectious cases spreading out of control, draining of current limited resources, investments in health, and lives needlessly lost.

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LATEST DRUG RESISTANCE RESEARCH

• HIV Drug Resistance Surveillance Using Pooled Pyrosequencing (PloS ONE.  Hezhao J et al)
• Timing of Initiation of Antiretroviral Drugs during Tuberculosis Therapy (New England Journal of Medicine, Salim S. Abdool Karim et al)
• Detection of Molecular Markers of Drug Resistance in 2009 Pandemic Influenza A (H1N1) Viruses by Pyrosequencing. (Antimicrobial Agents and Chemotherapy.  Varough M. Deyde et al) 
• Efflux-Pump-Derived Multiple Drug Resistance to Ethambutol Monotherapy in Mycobacterium tuberculosis and the Pharmacokinetics and Pharmacodynamics of Ethambutol (Journal of Infectious Diseases.  Srivastava S. et al.  Abstract only)
• Call of the Wild: Antibiotic Resistance Genes in Natural Environments (Nature Reviews Microbiology.  Heather K. Allen. Abstract only)
• Evidence of increasing antibiotic resistance gene abundances in archived soils since 1940 (Environmental Science and Technology.  Knapp CW et al. Abstract only)
• Treatment Outcomes and Survival Based on Drug Resistance Patterns in Multidrug-resistant Tuberculosis (American Journal of Respiratory and Critical Care Medicine.  DH Kim et al. Abstract only)

IN THE NEWS

• Superbugs in developed countries (New York Times)

• The global health risk of resistant TB (Washington Post)
• Drug-resistant TB in Asia (Australia Network News)
• Speeding development of new drugs to fight TB (PR Newswire)
• Data is lacking – it is unclear whether drug-resistant TB is worsening globally (AP News)
• Coping with MDR-TB in Kenya (Daily Nation)

Malaria

• Overview of WHO’s updated malaria guidelines (Kaiser Daily Global Health Policy Report)
• Q&A about anti-malarial drug resistance (Thomson Reuters Foundation)
• Risk of malaria returning to the developed world (Sign on San Diego)
• Is malaria eradication really within our reach?  (Guardian.co.uk)
• Genetic clues around antimalarial drug resistance (Thaindian News)
• Poor quality antimalarials primarily in the private sector in Uganda (All Africa.com)
• Drug resistance in Cambodia (Reuters)
• Coartem stocks running out in Uganda (Independent)

HIV

• Lack of funding impeding implementation of new treatment guidelines (Plus News)
• Need for a clear funding commitment (Aidsmap.com)
• Kampala lab will monitor HIV resistance (The East African)
  

Other

• Global Anti-Infectives Market to Reach $103 Billion by 2015 (PR Web.com)
• Nigeria inaugurates anti-corruption federal taskforce (All Africa.com)

PARTNER RESOURCES

• Read WHO’s newly published “Guidelines for good practice in the procurement and purchase of antimalarials”
• Peruse a series of performance improvement continuing education programs focused on antimicrobial resistance in hospitals
• View the 16 March edition of the UNION e-newsletter
• Log on to browse archived materials from the Patient Safety Virtual Global Discussion Forum held from 1 – 12 March

RECENT/UPCOMING EVENTS

• Learn about a 20 April Geneva Health Forum session and debate that Rachel Nugent will co-chair on “Should the Development of New Antibiotics Be a Public Health Priority”. View entire conference program
• Submit an abstract to the 48th Annual IDSA meeting (21 – 24 October in Vancouver) before the 19 May deadline
• Submit an abstract by 4 May for the American Society of Tropical Medicine and Hygiene Annual Meeting (3 – 7 November in Atlanta)

Call for papers

• Download a preliminary announcement for the Third International Conference on Improving Use of Medicines (10 – 14 April 2011 in Alexandria, Egypt)
  

MULTIMEDIA

• Listen to Terry Gross’s 23 March National Public Radio interview with Mary McKenna, the author of Superbug: The Fatal Menace of MRSA Order book