Hands wearing blue surgical gloves hold brightly coloured pharmaceutical medication, including antibiotics, paracetamol, Ibuprofen and cold relief tablets, manufactured by a variety of companies in this arranged photograph in London, U.K., on Friday, April 27, 2018. Pharmaceutical companies may see approval times cut to 14 months vs. 19 and about $370 million of sales brought forward per antibiotic after global regulators aligned rules to combat bacterial resistance. Photographer: Chris Ratcliffe/Bloomberg
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Antimicrobial resistance, described this week as a "global health emergency” and “a problem with disastrous ramifications,” could kill 5m people a year in Asia alone by 2050, and cause economic damageon a par with the global financial crisis.

The plethora of warnings for World Antibiotic Awareness Week included a report from the World Health Organization detailing consumption across 65 countries. Some are overusing antibiotics but in other areas they are desperately lacking. Pneumonia caused by bacteria can be treated with antibiotics, for example, but only a third of those sufferers get the drugs they need.

Experts have also raised the alarm about the overuse of antibiotics in farming, a key driver of the increase in antibiotic resistance. Whole herds of animals are sometimes treated with antibiotics as a preventive measure, even when only one is sick. 

Expect the drumbeat of warnings and dramatic language to continue. The most alarming so far comes from England's chief medical officer. We are “at risk of putting medicine back in the dark ages”.


World disease snapshot The Global Burden of Disease Study, an annual audit of world health, showed a worrying slowdown in improvements and the increasing role of diet in early deaths. The study “should be an electric shock, galvanising national governments and international agencies not only to redouble their efforts to avoid the imminent loss of hard-won gains but also to adopt a fresh approach to growing threats.” (The Lancet, Guardian)

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News round-up

Sexual and reproductive health An initiative to increase the use of modern contraceptives said it would fall short of its target to reach 120m more women in the world's poorest countries by 2020, although there is still a 30 per cent increase on pre-2012 levels. A separate report estimates 20m sexually active young women in developing regions have an unmet need for modern contraception.

The subject has also become a political hot potato: family planning schemes in some African countries have been accused of “pushing a western agenda”. In the US a storm has arisen over the terminology of sexual health in US programmes abroad. And the World Bank has pulled a loan from Tanzania because of pregnant girls being banned from schools. (Devex, FP2020, Guttmacher Institute, Al Jazeera video, Politico, Guardian)

Vaccine victory Italy's populist new government has ditched its scepticism over vaccines in the face of a “measles emergency”. The number of cases has risen from 850 in 2016 to 5,000 last year. (Telegraph)

Pneumonia warning “Forward motion has slowed substantially” said a progress report on the fight against pneumonia and diarrhoea. The two kill more than 1.3m children each year, around one in four of total deaths under five. The authors highlighted the need for better data collection, improved targeting of treatments, and stronger promotion of breastfeeding as well as more investment. (Stop Pneumonia)

DIY drugs Desperate people in China are smuggling — or making their own — drugs for deadly diseases like cancer or diabetes, thanks to unaffordable prices and long delays for new medicine approvals. Increasing pressure on politicians to solve the problem has been reflected in “Dying to Survive,” a hit film depicting a Chinese leukaemia patient smuggling generic drugs from India. (New York Times)

Drug spending US spending on drugs remains high thanks to the lack of government controls evident in other countries. It began to diverge sharply in the late 1990s, due to a record number of new drugs emerging. Another spike began in 2014 as a new wave of speciality drugs such as biologics came on the scene, with very little competition. (New York Times) 

Brexit brouhaha A “no deal” Brexit could cost the NHS in England £2.3bn a year as the costs of supplies rise, eating up “all the funding available to improve patient care next year and the year after”. The medical establishment jointly issued a stark warning: “Brexit will damage health”. The BMJ examines the scenarios for stockpiling drugs. (FT, Nuffield Trust, BMJ) 

Tobacco tussles The UK medical establishment urged the government to provide tobacco dependence treatment for every smoker. British American Tobacco shares were hit by news of US restrictions on menthol cigarettes, a product which has many African-Americans hooked, and Juul, the leading US ecigarette company, pulled its sweeter flavours to curb youth use. A UK study put ecigarettes in a more positive light, saying they did not “renormalise” smoking. (BMJ, FT, Reuters, NYT, BMC Medicine)

Data privacy The transfer of control of DeepMind's UK health business to its parent Google sparked fears over the privacy of patient data. The artificial-intelligence company has a five-year partnership with 10 NHS hospitals to process the medical data of 1.6m patients. Advances in wearable medical technology have also raised concerns about data privacy, as well as worries that continuous monitoring of healthy patients could lead to overtreatment. (FT)

Diet wars “Nutrition and human physiology is much more complicated than nuclear physics,” says one of the US scientists trying to resolve the “fat versus carbs” diet wars. Super-sweet “freakshakes” are the latest target for anti-sugar campaigners. Some contain almost 40 teaspoons of sugar, the equivalent of more than four cans of cola. (Guardian). 

Mind-reading computers An audacious experiment has been described as the brain surgeon's Everest: a brain-computer interface that could enable people with a spinal cord injury, locked-in syndrome, or other paralysing condition to talk again. (Stat)

Femtech fight An estimated $1bn of investment has gone into women’s health technology such as period trackers over the past three years and the “femtech” market is estimated to be worth $50bn by 2025. Products are, however, primarily designed “for marketers, for men, for hypothetical unborn children, and perhaps weirdest of all, a kind of voluntary surveillance stance”. (Vox)

Lessons from history Last weekend's first world war centenary commemorations brought home the horror of mechanised warfare. Many of today's methods for dealing with post-traumatic stress disorder stem from “shell-shock” treatments developed in the conflict. The war also saw the birth of plastic surgery and modern anaesthetic techniques. (The Conversation)

Best from the journals

Vaccine verdict The WHO's “Decade of Vaccines” that began in 2010 has seen advances but gains remain fragile, argues a Lancet editorial. “The global health community will need to shift its focus: more muscular efforts must be made to integrate investments in immunisation services into programmes for universal health coverage.” (The Lancet)

Lifestyle pressures Rises in blood pressure normally associated with age may have more to do with elements of a “western” lifestyle, such as exposure to processed foods and salt. (Jama)

Air pollution London's low emission zone has improved air quality but has had little effect on the state of children's lungs. There are 200 such zones in place across Europe. (The Lancet) 

Weight-depression link A large genomic analysis is the first to conclude that being overweight can cause depression in itself, even where no other health problems exist. (International Journal of Epidemiology, Guardian)

Health inequalities A critique of the UK health secretary's new emphasis on people taking personal responsibility for their health says it ignores the effects of wider environmental factors and does nothing to correct the socio-economic disparities that lead to health inequalities. (BMJ)

Podcast of the week

Doctors, guns and lame ducks Discussion of the big issues in US healthcare including the effects of the midterm elections and a spat between doctors and the gun rights lobby. (KHN What the Health, 26m)

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Final thought

Stayin’ alive The Bee Gees hit has long been recommended as the perfect rhythmic tool for CPR but a new playlist gathers together up to 50 alternatives. Take your pick from Abba to Adele and the Beastie Boys to Beyoncé. (Washington Post)

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