Sunday, July 8, 2012

Diseases defying flood of life-saving drugs

Diseases defying flood of life-saving drugs


The report says drug resistance is a growing and deadly problem that is getting rapidly worse. (Reuters: Sukree Sukplang)

We may be living at the end of a golden age - one where drugs actually worked.

A report from the Centre for Global Development says the increased availability of drugs to treat diseases like HIV, tuberculosis and malaria is in fact causing more people to die.

According to Rachel Nugent, who wrote the report, drug resistance is a growing and deadly problem that is getting rapidly worse.

"It's a lot bigger problem for two reasons," she said.

"One is that as people use more and more drugs, resistance grows faster and faster. The pathogens respond to the amount of drugs that they're faced with. So resistance is accelerating.

"The other reason is we are not producing new drugs anywhere near as quickly as we used to, so the pipeline is running dry."

The problem is particularly bad in developing countries, which have been flooded with drugs through the goodwill of aid groups and donors.

Dr Nugent calls HIV, malaria and tuberculosis (TB) the big three because they are the ones that get the most funding for treatment.

Yet all three diseases are showing resistance to the main drugs used to fight them.

"Sometimes to the level that there are some pathogens that are untreatable. Some forms of those diseases that are untreatable," she said.

"Malaria, for instance - there is only one effective drug that remains to treat malaria. TB - we're seeing strains of TB for which we have no effective drug treatment."

Then there are the major childhood diseases like diarrhoea and pneumonia that kill five million children a year.

Dr Nugent says the cheap available antibiotics used to treat these diseases simply do not work and the problem is made worse by sloppy supply practices.

"They may get repeated treatment with the same drug," she said.

"Then perhaps the dispenser, the doctor, will switch drugs and they'll get treated with another drug and there are a couple of common antibiotics that will be recommended for diarrhoea again.

"There are parts of the world where all three major antibiotics for diarrhoea are not working on children anymore and then they don't have anything.

"Or perhaps they don't have a good lab that can tell them exactly what the strain will be sensitive to and so they just keep getting treatments that don't work and the child dies."

The report has offered four solutions: the collection and sharing of information about drug resistance, better quality products and practices, new drugs and regional networks to monitor the drugs that are doled out.

"In developing countries the drug regulators are notoriously weak and often corrupt and so we're proposing that there be regional networks of regulators," she said.

"We want them to work together ... bringing them together will create some peer accountability, some check on that corruption."

The report condemns the lack of leadership, saying no effort has gone into ensuring drugs continue to work.

Dr Nugent says much of the blame lies with the World Health Organisation, which has failed to coordinate all the players in the drugs chain: pharmaceutical companies, governments, aid groups, hospitals, doctors, pharmacies and patients.

"One of the things that we've lacked, aside from WHO leadership, which certainly has not been what it should be, but we have lacked a coordinated effort on this," she said.

"That's one of the things that we're calling for, leadership - but [also] more coordination among those that lead."

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