Health
The Antibiotic Crisis: Rising Drug Resistance and Stagnant Innovation
As antimicrobial resistance (AMR) surges, new antibiotics are scarce. With global leaders set to discuss the crisis, why is the development pipeline so dry and what can be done to address the growing threat?
As the world faces an escalating crisis of antimicrobial resistance (AMR), the need for new antibiotics has never been more urgent. Yet, despite the looming threat of drug-resistant infections, the pipeline for novel treatments remains alarmingly thin. This paradox is set to be a focal point at the upcoming UN General Assembly, where global leaders will grapple with strategies to address AMR and revitalize antibiotic development.
The rise of drug-resistant infections is a stark reminder of how modern medicine’s triumphs are increasingly under threat. The death toll from drug-resistant bacteria reached 1.27 million in 2019, and the economic costs of AMR are projected to surpass $1 trillion by 2030. Sub-Saharan Africa bears a disproportionate burden, particularly among children under five, where drug resistance compounds an already dire public health situation.
The crisis is exacerbated by a troubling stagnation in antibiotic development. Since 1990, only one new class of antibiotics has been discovered, a significant drop from the more than 25 new classes identified between 1940 and 1979. This slowdown is largely due to severe financial constraints and disinterest from major pharmaceutical companies, which have pivoted to more profitable ventures.
One major issue is the financial model for antibiotics. Unlike chronic medications for conditions like diabetes or hypertension, which generate sustained revenue from long-term use, antibiotics are typically used for short durations. This transient use makes it challenging for companies to recoup the substantial costs associated with developing new drugs. As a result, many smaller companies involved in AMR research are struggling financially, with several facing bankruptcy despite their promising breakthroughs.
The landscape of antibiotic research and development is also fraught with difficulties. Of the 112 commercial institutions engaged in preclinical research on AMR, 97 have fewer than 50 employees. This fragility poses a significant risk to the continuity of research efforts and innovation.
To tackle the crisis, experts argue for the need to enhance incentives for both research and market introduction of new antibiotics. In the UK, a subscription model has been introduced, providing drug companies with a fixed annual fee for new antibiotics, regardless of usage. This model aims to ensure that critical drugs remain available while reducing the financial risks for companies.
However, similar approaches are still under consideration in other regions, and there are concerns about their potential impact on global access. Health campaigners fear that such models might drive up the costs of antibiotics worldwide, making it even harder for developing countries to obtain these essential medications.
Addressing the AMR crisis requires a multifaceted approach. Governments and the private sector need to collaborate on funding and incentives that support both early-stage research and the market introduction of new antibiotics. Moreover, efforts must be made to ensure that these innovations are accessible and affordable across all countries and populations.
The UN General Assembly’s discussions on AMR will be crucial in shaping the future of global health policy. As the world grapples with this mounting challenge, a renewed focus on innovation, investment, and equitable access will be essential to preserving the effectiveness of antibiotics and safeguarding public health.
In the face of this critical situation, the call to action is clear: the global community must rally to overcome the barriers to antibiotic development and ensure that life-saving treatments remain within reach for all.
Health
Mpox Outbreak in Congo’s Kamituga Town Hits Sex Workers Hard
Sex workers in Kamituga face health risks and stigma as mpox spreads through the mining hub, threatening livelihoods.
Sex workers in Kamituga, eastern Congo, are at the center of an mpox outbreak, grappling with health risks, stigma, and economic hardship. With around 40,000 sex workers in this mining hub, the majority of mpox cases are contracted through sexual contact, exacerbating vulnerabilities. Despite the outbreak, many sex workers continue working due to economic necessity, while facing stigma from clients and the wider community. The lack of vaccines and condoms, along with social and legal barriers, hinders efforts to control the virus’s spread. Health officials push for intervention, but the response remains limited.
The outbreak in Kamituga highlights broader systemic issues, such as poverty, the precarious situation of women, and the sex industry’s entanglement with mining economies. As sex work remains the primary income source for many women, particularly single mothers, stopping the spread of mpox without providing economic alternatives remains a challenge.
Health officials warn that without targeted support for sex workers, the virus could extend further into Congo and the region.
Confronting Mpox in East Africa’s Conflict Zones: Strategies for a Critical Response
Mpox Outbreak in Africa Risks Becoming the Next Global Pandemic
The Mpox Epidemic in the DRC: A Deepening Crisis with Global Implications
Drugs
Mental Health Issues Prevents Many Somalis From Seeking Treatment or Assistance
Health
From The Hargeisa Holocaust to The Lasanod Assault
Echoes of Trauma: Unmasking the Dark Legacy of Terrorism on Somaliland’s Psyche
For decades, the people of Somaliland have been subjected to horrific acts of violence and terror, leaving deep, indelible scars on their collective psyche. The latest chapter in this dark saga unfolded in Lasanod in 2022, but to fully grasp the gravity of the current trauma, one must first look back to the 1980s, when the Hargeisa Holocaust forever altered Somaliland’s fate.
In the early 1980s, under the iron-fisted rule of the Somali dictator Siad Barre, Somalilanders faced a brutal onslaught that mirrored the darkest periods of human history. Barre’s regime orchestrated a massacre against the people of Somaliland, killing an estimated half a million individuals. This genocidal campaign, characterized by mass killings and systematic violence, was not just an attack on a region but an attempt to erase an entire people from existence. The echoes of this atrocity resonate to this day, often likened to the Holocaust experienced by Jews under Hitler’s regime, reflecting the sheer scale of suffering inflicted upon Somaliland.
Fast forward to 2022, and the suffering of Somalilanders was reignited with the assault on Lasanod by Somali Darood clan terrorists. This attack, which targeted civilians and soldiers alike, was not merely a violent confrontation but a continuation of a historical pattern of terror aimed at breaking the spirit of the Somaliland people. The assault was marked by extreme brutality, including torture and execution of prisoners of war, depicted in harrowing footage and propaganda disseminated online. The terrorists’ propaganda campaigns, showcasing scenes of death and suffering, were designed to demoralize and incite fear among Somalilanders while furthering their violent agenda.
The psychological impact of these events on Somalilanders cannot be overstated. Our analysis reveals that the trauma inflicted by such propaganda and violence is profound and far-reaching. The repeated exposure to graphic content depicting the torture and murder of Somalilanders has resulted in a spectrum of psychological distress. Many have reported symptoms akin to post-traumatic stress disorder (PTSD), including severe anxiety, persistent nightmares, and acute emotional instability. This reaction is not merely a personal struggle but a collective trauma that reverberates through the community.
The recent research highlights that while Somalilanders’ reactions to terrorist propaganda vary, the common thread is the severe emotional and psychological toll it takes. Scenes of extreme violence and suffering trigger intense emotional responses, such as sadness, anger, and fear. The constant barrage of such content can lead to long-term mood disorders and disrupt daily life, affecting concentration, memory, and overall mental health.
Veterans of the Somaliland National Movement (SNM), who endured the Hargeisa Holocaust, display a heightened awareness of the dangers posed by such content. These individuals, having lived through the horrors of Barre’s regime, approach terrorist propaganda with a more cautious mindset compared to younger generations. Their experience underscores the need for a nuanced understanding of trauma and the importance of historical context in addressing current psychological impacts.
The experimental findings from our study further emphasize the urgency of addressing these issues. The biofeedback data indicates that those exposed to terrorist propaganda exhibit stronger emotional reactions and greater psychological distress compared to those who view less disturbing content. This suggests that the intensity of the visual stimuli plays a significant role in exacerbating trauma, highlighting the need for protective measures and mental health support.
The international community’s response to Somaliland’s plight has been woefully inadequate. The atrocities inflicted upon Somalilanders by both Barre’s regime and the recent Lasanod attackers deserve global condemnation and intervention. The lack of significant international support reflects a broader failure to address the psychological and humanitarian crises faced by this beleaguered region.
To mitigate the ongoing trauma, it is imperative for Somaliland to implement comprehensive mental health strategies. This includes enhancing support services, providing mental health training, and developing coping mechanisms to help individuals deal with the psychological impact of terrorist propaganda. Effective policies should also involve international cooperation to ensure that Somalilanders receive the necessary support to heal from their profound losses.
In conclusion, the suffering of Somalilanders is a stark reminder of the devastating impact of terrorism and violence. From the horrors of the Hargeisa Holocaust to the recent Lasanod attacks, the psychological scars remain deep and pervasive. The global community must recognize and address these issues with the urgency and compassion they demand, offering not just sympathy but tangible support to help Somalilanders reclaim their peace and dignity.
Health
Confronting Mpox in East Africa’s Conflict Zones: Strategies for a Critical Response
As Mpox Threatens to Worsen the Crisis, Key Actions Needed to Address the Outbreak Amidst Regional Conflicts
As the mpox outbreak continues to surge through East Africa, including Kenya, Rwanda, Burundi, and Uganda, the situation has reached a fever pitch. The epidemic, which began in the Democratic Republic of Congo in January 2023, was declared a public health emergency by the Africa Centres for Disease Control and the World Health Organization in August 2024. The spread of this viral disease is particularly alarming in regions plagued by conflict.
The intersection of mpox and ongoing or recent conflicts presents a grim scenario. War-torn countries in East Africa and the Horn, such as Sudan and Somalia, face catastrophic healthcare challenges. In Sudan, over a year of relentless conflict has crippled 70% of health facilities, leaving the remaining ones besieged by attacks and shortages. Similarly, Somalia, grappling with decades of strife, has one of the world’s lowest childhood immunization rates. Ethiopia, with its recent Tigray conflict, saw its healthcare system in tatters, a crisis that our research underscores.
The Tigray conflict (2020-2022) offers a sobering lesson. The federal blockade led to a collapse of the healthcare system, massive displacement, and severe damage to health facilities. Our research from 2021 revealed that 39% of infants received no basic vaccinations due to the war. This was further corroborated by a recent WHO report, highlighting simultaneous outbreaks of several infectious diseases in Sudan’s states.
These past experiences underscore the dire need for a robust response to the mpox outbreak in conflict zones. Here’s how we can effectively manage the situation:
1. Integrate Vaccine Distribution with Humanitarian Aid: Efficient deployment of mpox vaccines requires blending with broader humanitarian efforts. Coordination ensures that vaccines are delivered alongside other essential supplies, leveraging existing logistical frameworks to reach those in need.
2. Engage Local Communities: Building trust with local communities is crucial. By involving local leaders and residents, we can protect frontline workers from conflict-related dangers and foster acceptance of the vaccine. Establishing permanent vaccination teams from within these communities will enhance the response.
3. Collaborate with Military and Security Forces: Securing the safe delivery of vaccines may necessitate military escorts, similar to practices in humanitarian aid. This collaboration is vital to navigate conflict zones and ensure uninterrupted vaccine delivery.
4. Negotiate Access with Conflict Actors: Understanding and negotiating with the various factions controlling conflict areas can reduce operational risks. Securing physical access through dialogue with these groups is essential for effective vaccine distribution.
5. Address Transit and Cross-Border Vaccinations: Given the frequent displacement of populations in conflict zones, vaccinating at transit points is crucial. This approach will ensure that those moving across borders or fleeing violence are protected.
6. Deliver Vaccines to Refugee and Internally Displaced Person Camps: Special attention must be given to camps housing refugees and internally displaced persons. These areas are particularly vulnerable and require targeted vaccination efforts to prevent the spread of mpox.
In conclusion, the mpox outbreak in East Africa’s conflict zones demands a multifaceted response. By integrating vaccination efforts with humanitarian aid, engaging local communities, and collaborating with military forces, we can mitigate the impact of this deadly virus. The lessons from past conflicts, combined with strategic planning, will be pivotal in controlling the spread of mpox and safeguarding public health in these turbulent regions.
Editor's Pick
Swedish Government Initiates Swimming Training for Somali Women
The Swedish government, through the administration of Järva District in Stockholm, has launched a targeted swimming training program for Somali mothers. This initiative aims to enhance the safety and well-being of children during the swimming season and offer benefits to the mothers themselves. Scheduled to commence in early September, the program will span several months and has already attracted over twenty registrants.
The Swedish government is fully funding the cost of the courses, including payment for instructors. This initiative reflects a broader commitment to community health and safety. Abdirashid Mohamed, Järva District Commissioner, highlighted the origins of this program, noting that it was reinstated following requests from local mothers who recognized the value of swimming lessons for both themselves and their children.
While the program initially targeted Somali mothers, it is open to all women in the district, encompassing both Somali and non-Somali residents. Järva District, with a population of approximately 92,000, aims to extend this opportunity to all mothers. The goal is not only to provide essential swimming skills but also to foster social connections among the women, as their children often attend the same schools.
The primary aim of the swimming lessons is to ensure that mothers can confidently accompany their children to swimming areas during the hot season. This initiative is designed to alleviate fears and enhance mothers’ ability to support their children in water safely. Additionally, the program promotes socialization and community integration among the participants.
Swimming is recognized for its numerous health benefits. It contributes to cardiovascular health by improving arterial function and reducing the risk of heart disease. The exercise involved in swimming engages multiple muscle groups, which supports overall fitness and longevity. Studies suggest that regular swimming can lead to a longer life and improved joint health, underscoring its value as a holistic physical activity.
The swimming training program in Järva District represents a significant investment in community health and safety. By providing Somali mothers with the skills to support their children in swimming and encouraging broader social engagement, the Swedish government is addressing both practical and communal needs. The program’s emphasis on inclusivity and health benefits highlights its potential to positively impact the lives of many families in the district.
Health
Nigeria Receives Critical Mpox Vaccine Shipment from USAID
As Mpox Cases Surge Across Africa, Nigeria’s New Vaccine Arrival Marks a Key Step in Combating the Epidemic
In a significant boost to Nigeria’s efforts against the mpox outbreak, the country has received its first shipment of vaccines, courtesy of the United States. The donation, consisting of 10,000 doses of the Jynneos vaccine, arrives at a critical moment as the disease surges across Africa, with Nigeria itself grappling with a substantial increase in cases.
Mpox, previously known as monkeypox, has escalated into a severe public health threat, particularly across Central and West Africa. The Democratic Republic of Congo and several East African nations, including Burundi and Kenya, are at the epicenter of the outbreak. The World Health Organization recently categorized mpox as a global health emergency, intensifying international efforts to curb its spread.
Nigeria, one of the hardest-hit countries, has reported over 40 confirmed cases and approximately 830 suspected ones across 13 states. This alarming rise in infections has prompted urgent action. U.S. Ambassador Richard Mills highlighted Nigeria’s preparedness to deploy the vaccine effectively, noting the government’s detailed vaccination plan designed to maximize the impact of this crucial donation.
“The Nigerian government has crafted a comprehensive plan to use these vaccines strategically,” Mills stated. “This plan ensures that we achieve the greatest possible benefit from this initial 10,000-dose shipment.”
The vaccine’s arrival is particularly timely, as the Africa Centres for Disease Control and Prevention (Africa CDC) reported a staggering 22,863 mpox cases across the continent. Of these, 3,641 have been confirmed, with over 620 deaths documented in 13 African Union member states.
Nigeria’s primary health care director, Muyi Aina, revealed that the vaccine rollout will focus on states with the highest case numbers, predominantly in the southern regions. “We will prioritize these areas and collaborate with state officials to create tailored plans for vaccine distribution,” Aina explained.
Despite the urgency, vaccine hesitancy poses a significant challenge. WHO representative Walter Mulombo emphasized the importance of addressing misinformation. “The vaccine has proven effective against smallpox and shows promise for mpox,” he said. “We must rely on scientific evidence rather than succumb to unfounded fears.”
The international community is rallying to support Africa’s response to mpox. Germany is preparing to donate 100,000 vaccine doses to East Africa, further bolstering the region’s fight against the outbreak. Nigeria, while making strides, faces ongoing hurdles including vaccine shortages and delivery delays, underscoring the need for continued global assistance.
As Nigeria embarks on this crucial phase of its vaccination campaign, the stakes are high. The arrival of the mpox vaccines marks a pivotal moment in the battle against the disease, offering hope for containment and control in a region severely impacted by this evolving health crisis.
Health
IOM Appeals for $18.5 Million to Combat Mpox Crisis
International Organization for Migration Targets Vulnerable Populations and Strengthens Cross-Border Response
The International Organization for Migration (IOM) has issued an urgent appeal for $18.5 million to bolster health care services and preventive measures across East and Southern Africa. This substantial funding request aims to address the needs of migrants, internally displaced persons (IDPs), and host communities who are particularly vulnerable due to their precarious living conditions and limited access to health care.
The IOM’s appeal highlights the dire situation faced by these high-risk groups, whose mobile and often unstable lifestyles make them more susceptible to mpox. The funds will be used to support a comprehensive preparedness and response plan that focuses on infection prevention and control, particularly at crucial border points.
“The required $18.5 million will significantly enhance our ability to respond to the needs of these vulnerable populations,” the IOM stated. The plan includes initiatives to boost the capacity of national health care workers, fortify border health measures, and identify high-risk areas for effective disease monitoring and containment.
The Mpox Epidemic in the DRC: A Deepening Crisis with Global Implications
This appeal comes on the heels of declarations by the World Health Organization (WHO) and the Africa Centers for Disease Control and Prevention (CDC) that mpox constitutes a public health emergency of international and continental concern. As of the latest update, the Africa CDC has reported 17,541 cases and 517 deaths across 13 African countries.
The Democratic Republic of the Congo remains the epicenter of the outbreak, bearing the brunt with 96% of cases and 97% of deaths reported in 2024. The DRC has recorded a staggering 16,700 confirmed or suspected mpox cases, including over 570 fatalities. In contrast, South Africa has reported 24 cases and three deaths, while Cameroon has confirmed five cases with two deaths.
Other affected countries include Burundi with over 100 cases, Nigeria with 39 cases, Liberia with five, Rwanda with four, and Ivory Coast and Uganda with two each. Kenya has reported a single confirmed case.
The IOM’s proposed interventions aim to mitigate the disease’s impact on these vulnerable populations by improving their access to medical care, enhancing cross-border health coordination, and implementing robust infection control measures. With the situation growing more urgent, the IOM’s efforts represent a crucial step in containing the outbreak and safeguarding the health of millions across the region.
Mpox Outbreak in Africa Risks Becoming the Next Global Pandemic
EDITORIAL
How Human Actions Fuel the Spread of Deadly Animal Diseases
From COVID to Mpox: Unveiling the Alarming Truth Behind Zoonotic Diseases
The mystery of how diseases leap from animals to humans has never been more urgent. The world was blindsided by COVID-19, and now, mpox—a disease with its origins in the animal kingdom—has been declared a global health emergency. But what drives these pathogens to cross the species barrier? The answer might just be more startling than you think.
In his provocative new book, Fighting an Invisible Enemy, virologist Barry Schoub, a pioneer in communicable disease research, delves into the disturbing reality of zoonotic diseases. These are illnesses that make the leap from animals to humans, often with catastrophic consequences. Schoub’s revelations paint a grim picture of how our actions are not just influencing but actively accelerating these dangerous spillovers.
The process begins with a zoonotic spillover—a term that might sound clinical, but it’s anything but benign. Imagine a virus, lurking in an animal, suddenly finding a way into the human population. This isn’t just a rare occurrence; it’s becoming alarmingly common due to human encroachment on wild habitats. As we invade once-remote ecosystems or force wild animals into closer contact with human settlements, we create perfect conditions for these pathogens to jump species.
This leap isn’t straightforward. For a virus to infect a human, it must attach itself to specific receptor sites on our cells, much like a key fitting a lock. When this rare fit occurs, the virus invades, replicates, and starts a chain of infection. The virus then exits the initial host and moves on to infect others, potentially triggering an outbreak.
But what drives these spillovers? It’s not just the virus’s adaptability; it’s our relentless behavior. The global wildlife trade, both legal and illegal, continually brings exotic animals into contact with humans. Our agricultural expansion and deforestation force animals out of their natural habitats, pushing them into human spaces. Wet markets in various parts of the world, where live animals are sold and slaughtered, provide a perfect storm for viruses to jump to humans.
Adding fuel to the fire is climate change. Extreme weather, deforestation, and habitat destruction create conditions ripe for new diseases to emerge. The Nipah virus outbreak in Malaysia and Singapore in the late 1990s is a chilling example. Droughts and deforestation drove fruit bats into orchards, where they transmitted the virus to pigs, which then infected humans. This outbreak, which resulted in hundreds of deaths, was only controlled through mass slaughter of pigs.
Today, air travel accelerates the spread of these diseases, making what took months in the past happen in days. The 21st century’s rapid global connectivity, combined with human activities that damage our environment, mirrors the challenges faced by indigenous populations in the past. Just as Europeans introduced devastating diseases to the Americas centuries ago, modern humans are unwittingly creating conditions for new pandemics.
The stark reality is that as we continue to damage the planet and encroach on wildlife, we are not only risking our health but also paving the way for the next catastrophic outbreak. The invisible enemies are already among us, and our behavior could be the key to whether they become the next
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