Excessive use of antimicrobials in intensive livestock farming as One Health issue

One of a series of blogs written by CABI editors for One Health Day November 3rd 2016

Most antibiotics in livestock farming are used in aquaculture, but significant amounts are also used in terrestrial livestock species, particularly in poultry and pigs.

Livestock

Most antibiotics in intensive livestock farming are used for non-therapeutic purposes

Approximately 70% of antibiotics are used for non- therapeutic purposes, i.e. many antibiotics are used in sub- therapeutic doses and over prolonged periods, which leads to the development of genes that confer antimicrobial resistance to animal pathogens. These genes can subsequently be transferred to human pathogens and it is estimated that 75% of recently emerging diseases in humans are of animal origin.

Antimicrobial resistance (AMR) problems are further exacerbated by the fact that antibiotic resistance genes were found in bacteria long before antibiotics were ever used on super-pathogens in farm animals.

AMR is a worldwide problem, which clearly affects both animal and human health, and hence it is truly One Health issue.

 

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The ethics of tobacco packaging

It’s a surreal moment when you realise that packaging is an ethical issue. Where does the packaging end up after you have consumed the product (landfill or recycled or exported to become someone else’s problem)? Did the advertising on the packaging influence your choice of one food brand over another?

The choices you made, and your government allowed, affect your environment & your health. But I’m not about to tell you about improved food labelling on packaging to combat obesity. This is the week of the World NO Tobacco Day (31st May) and this blog addresses tobacco packaging: the use of standardized packaging to further reduce consumption and address the world's leading agent of death…tobacco.

Cigarette

 

Despite the  WHO Framework Convention on Tobacco Control,  taxation policies and bans on tobacco advertising, promotion, and sponsorship, MORE needs to be done.

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Dengue situation in a Southern Indian state (Andhra Pradesh) – Gaps and opportunities in Community Awareness

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Photo: WHO/J.Gusmao. Used tyes are an ideal habitat and breeding ground for mosquitoes carrying dengue

Our guestblogger is Dr Manoj Aravind, a researcher in Community Medicine, Hyderabad, India and member of the health information forum HIFA2015.  Under World Health Day 2014's theme "Small bite, big threat" with its goal of better protection against vector-borne diseases, he describes the case for community action against dengue in his home state of Andras Pradesh. He can be contacted directly by email: aravindbm@gmail.com

Dengue is the fastest growing vector-borne disease (VBD) worldwide, and Andhra Pradesh (a Southern Indian state) is no exception. Here, the cases of dengue reported have been steadily rising from 313 in 2008 to 2299 in 2012. The issue of missed cases due to the partial reporting of dengue positive cases by private hospitals and clinics, which are the most commonly used heathcare facilities in our state, make us sceptical of the true burden of this potentially deadly disease. Having a tropical climate, with increasing urbanization, mostly unplanned, and not much “people participation” in health issues increases our cause for concern.1

Mosquitoes are the most common insects today that city dwellers encounter and one species, Aedes aegypti,  are the vector for dengue, transmitting the disease to people via their bite: they are day-biting and breed in clean water collected inside and around houses, especially in urban areas.2 As dengue does not have vaccine or cure, the emphasis is on prevention. The World Health Organization is using this year's World Health Day to build awareness about VBDs and reinforce the need for community empowerment in terms of protecting against these small creatures which are a huge threat to the health of the entire community.3 Andhra Pradesh’s state health machinery is using this opportunity to reach out & empower different stakeholders with effective communication and information.

Awareness of people regarding dengue

When there is no biological vaccine for a disease, knowledge of how this disease spreads and how to prevent this becomes very important. It may then be apt to say that health education leading to healthy behaviours acts as a social vaccine.

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The 2014 World Health Day focuses on Vector-Borne diseases

WHO_SHollyman_woman&net Tanzania
Image : WHO/S.Hollyman

From guest blogger: Dr Joseph Ana, Editor-in-Chief, BMJ West Africa and member of the steering group of the health information forum HIFA2015 . He can be contacted directly by email: jneana@yahoo.co.uk

It
is right that the World Health Organisation (WHO) should focus on vector borne diseases this year, and by so doing raise awareness, disseminate information and improve, hopefully prompt, more effort at preventing and managing the myriad diseases that vectors inflict on man, especially in the Tropics and Sub-tropics.

Whether it is from the arthropod invertebrates of mosquitoes (malaria, dengue, yellow fever), sandflies (skin and systemic Leishmaniasis), bugs (Louse-borne typhus), and ticks (Lyme disease); or from crabs/crayfish (paragonimiasis) and snails (schistosomiasis), or from vertebrate vectors like bats (rabies, ebola disease), vectors are responsible for a large chunk of the disease burden thathealth systems across the globe have to deal with, particularly in the poorer tropical and sub-tropical parts. There is a popular saying that the Traditional African way of cooking all meals ‘well done’ and avoiding eating raw sea food (crabs and crayfish) has helped to keep to a minimum diseases from these vectors.  Snail is also a very popular delicacy which is served ‘well cooked’ for the same reason.

The World has experienced increased incidence of arthropod borne disease since the 1970s 1,2,4, especially in the regions with the weakest health systems such as the tropics and subtropics. But for several reasons the temperate parts of the globe are also affected, which is why it is apt and timely that the WHO is focusing world attention on vector-borne diseases this year (2014). The reasons that account for the global nature of the menace of vector-borne diseases include increased travel by all modes; poor public health practice and infrastructure; massive population increases with urbanization and slums; poor surveillance and control measures; changing agricultural practices and deforestation; lack of effective drug and insecticide control leading to resistant vectors and pathogens; inadequate political will;  etc.

The World should recognize, support and assist those countries where good public health practice has shown that control (and elimination) of vectors leads to decrease in vector borne diseases and help to extend such best practices to regions that are lagging behind. A good example of such best practice in the tropics is Cross River State of Nigeria which has a deliberate Public Health Policy of making its major urban areas ‘Clean and Green’ beginning from Calabar, the state capital.

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Mental Health – What can we learn from low and middle income countries?

Children running
“Turning the World Upside Down – Mental Health Challenge” is an open competition to celebrate projects and ideas from low and middle income countries (LIC) which could effectively be applied to major health challenges faced by high income countries.  Four case studies were pitched in a Dragon’s Den style challenge on Wednesday 27th November at the London School of Hygiene and Tropical Medicine.  The event was also broadcast live as a webinar. The goal was to collect, promote and celebrate the approaches towards mental health (MH) from low and middle income countries.

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You have a Right to Mental Health

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Image: King College London,  project Emerald (emerging mental health systems in low- and middle-income countries)

One of the key sessions  I attended at the second day of “The world in denial: Global mental health matters”( March 26-27, 2013, Royal Society of Medicine, London) highlighted the existing legal tools available to achieve international recognition of the Right to Health,  AND the problems of getting mental health included in this framework.  In particular how including it under disability has implications for access to treatment. This blog summarizes the session and puts information into context with current events, including the 66th World Health Assembly recommendations.

There was much I learnt that day, yet  of much I was already aware, as CABI’s Global Health
database has 20,000 records on mental health, 25% of them
focussed on developing countries. One of the eye-openers for me was an
understanding of the various legal tools dealing with international
recognition of the Right to Health
and the problems of getting mental health included in this framework;
how including it under disability has implications for access to
treatment.

This is what I learnt, put simply, from talks given by Professor Norman Sartorius (President of World Psychiatric Association) and Gunilla Backman (Former health adviser SIDA & Editor, The right to health: theory and practice).

 

Basic Human rights: these are not defined or not universally accepted

AND

There are 5 categories of  documents related to human rights

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NICE people lend a helping hand

Wee boy helpinghand2

“Nice” is not a word often used in scientific research and when it appears in the UK media, it’s now associated with NICE, National Institute for Health & Clinical Excellence.

More often than not this government organisation makes headlines with bad news: the press reports quickly when a drug is not approved for general use by the NHS. Occasionally the news concerns a drug approval, after a long campaign by an individual and their family.

So attending the Global Health 2011 at the BMA, London, made a very NICE change.  It was an eye-opener to see that an offshoot of NICE, “NICE International”, is making a real positive difference to health systems in many countries.

Funded solely by their client countries and international donors (World Bank, DFID and IADB, to name a few), NICE International has sent its adviser teams into Latin America, China, Georgia and India to improve clinical practice  and help them develop relevant guidelines. These countries may even set up their very own NICE organisation.

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