Sunday, 04 September 2016
20:30 – 21:30 SAST (14:30 EST, 19:30 BST)
Moderator: Vanessa Carter
The Story of ONE HEALTH
During 2014, the World Health Organization reported that antibiotic resistance “is now a major threat to public health,” and warned of a return to a pre-antibiotic era, where “common infections and minor injuries which have been treatable for decades can once again kill.” World health leaders have described antibiotic resistant microorganisms as “nightmare bacteria” that “pose a catastrophic threat” to people in every country in the world.
Antibiotics were introduced in the 1940’s and today are central to modern healthcare. They are used for treating patients with serious infections to preventing infections after surgery, protecting cancer patients and people with compromised immune systems, and promoting growth and preventing disease in livestock and other food animals.
Decreasing antibiotic effectiveness is a global threat, regardless of a country’s income or the sophistication of its healthcare system. Some pathogens are resistant to more than one antibiotic, and new, last-resort antibiotics are expensive and often out of reach for those who need them.
Antibiotic resistance is a direct result of antibiotic use. The greater the volume of antibiotics used, the greater the chances that antibiotic-resistant populations of bacteria will prevail.
Antibiotic Resistance: A Public Health Crisis | Victoria J. Fraser, MD | TEDxStLouisWomen
The story of ONE health
What is being done about antibiotic resistance?
The US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) have launched initiatives to help address antibiotic resistance. The FDA has issued drug labelling regulations and recommends judicious prescribing of antibiotics by health care providers.
The FDA is also encouraging new and ongoing research into effective antibiotic regimens, vaccines and diagnostic tests. However, antibiotic resistance is a global epidemic that everyone – health care providers, patients and caregivers – can help to prevent.
Article reference: What can you do to help prevent Antibiotic Resistance
Antibiotic Resistance directly affects these other conditions which pose a substantial public health threat globally:
- Antimicrobial resistance threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.
- It is an increasingly serious threat to global public health that requires action across all government sectors and society.
- Antimicrobial resistance is present in all parts of the world. New resistance mechanisms emerge and spread globally.
- In 2012, WHO reported a gradual increase in resistance to HIV drugs, albeit not reaching critical levels. Since then, further increases in resistance to first-line treatment drugs were reported, which might require using more expensive drugs in the near future.
- In 2013, there were about 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB). Extensively drug-resistant tuberculosis (XDR-TB) has been identified in 100 countries. MDR-TB requires treatment courses that are much longer and less effective than those for non-resistant TB.
- In parts of the Greater Mekong subregion, resistance to the best available treatment for falciparum malaria, artemisinin-based combination therapies (ACTs), has been detected. Spread or emergence of multidrug resistance, including resistance to ACTs, in other regions could jeopardize important recent gains in control of the disease.
- There are high proportions of antibiotic resistance in bacteria that cause common infections (e.g. urinary tract infections, pneumonia, bloodstream infections) in all regions of the world. A high percentage of hospital-acquired infections are caused by highly resistant bacteria such as methicillin-resistant Staphylococcus aureus(MRSA) or multidrug-resistant Gram-negative bacteria.
- Treatment failures due to resistance to treatments of last resort for gonorrhoea (third-generation cephalosporins) have been reported from 10 countries. Gonorrhoea may soon become untreatable as no vaccines or new drugs are in development.
- Patients with infections caused by drug-resistant bacteria are generally at increased risk of worse clinical outcomes and death, and consume more health-care resources than patients infected with the same bacteria that are not resistant.
Why does storytelling matter to ICT innovation and to identify gaps?
I am recognised as a Facial Difference advocate by most of my colleagues, in 2004 I had a severe car accident that caused damage to my face. What most people don’t know is that during my ten years of surgeries I developed an Antibiotic-Resistant Bacteria known as MRSA (Methicillin-Resistant Staphylococcus Aureus). I had several prosthetic implants to restore the facial appearance, one of these was a 3D-printed Alloplastic prosthetic. There was so much excitement in 2009 between the doctors and I because of this emerging technology, I was in awe of the possibilities as I held a life-like printed replica of my skull before surgery, however, several weeks later my body rejected the implant and I developed a complex infection. We had to perform multiple surgeries in an attempt to salvage it but the damage caused to my face from infection was so severe that the prosthetic had to be removed and I was set back by several years.
I was fortunate that the bacteria had colonised on the implant and not entered into my bloodstream which could have been fatal. I questioned how this had happened to me and wondered whether there could have been better resources available to empower me to manage my MRSA better. One obvious resource I had limited access to was reliable education.
Once my surgeries were complete, I became an ePatient speaker and shared my story in Paris at The Doctors 2.0 and You conference. I am also an advisor to Infection Control tips and I recently participated in the European EyeforPharma Summit in London in a panel discussion to help identify ways to improve clinical trial recruitment. I am not a doctor or a pharmacist, I am a concerned citizen who is no longer able to rely on antibiotics. Stories won’t change the crisis, but they can help to identify issues in the system to improve prevention measures.
These were some of my challenges from a patient perspective:
1. The “complete the course” sticker
The antibiotic boxes only had a small “complete the course” sticker and the inserts were not patient-friendly, nor did they address barriers such as literacy and language differences
2. Lack of support
The first people I turned to for advice were my pharmacists, nurses and doctors, but some of them were not versed enough to educate me about MRSA.
3. Limited access to online advice
Pharmaceutical companies consumer services were not efficient at answering my concerns. Real-time support online would have been valuable.
4. Vague, ambiguous marketing
Hospital posters were not directly informative as to how and why antibiotics are causing superbugs. Some were designed with very vague messages which only emphasised to complete a course. Many of the public hospitals do not have central education channels or websites which would be useful to patients finding resources as opposed to searching widely on the internet. Animated videos with audio in different languages would address many barriers. Medication packaging and dispensaries are also an important contact point for consumer education, we should re-design inserts so that they are patient-friendly, but also brand the outer packaging with associated risks.
5. Communication gaps between multi-disciplinary teams
My facial reconstruction required a multi-disciplinary team, they worked in silos and each referred me to the