WASHINGTON: India has shortage of an estimated 600,000 doctors and 2 million nurses, say scientists who found that lack of staff who are properly trained in administering antibiotics is preventing patients from accessing live-saving drugs.
Even when antibiotics are available, patients are often unable to afford them. High out-of-pocket medical costs to the patient are compounded by limited government spending for health services, according to the report by the Center for Disease Dynamics, Economics & Policy (CDDEP) in the US
In India, 65 per cent of health expenditure is out-of-pocket, and such expenditures push some 57 million people into poverty each year.
The majority of the world’s annual 5.7 million antibiotic-treatable deaths occur in low- and middle-income countries where the mortality burden from treatable bacterial infections far exceeds the estimated annual 700,000 deaths from antibiotic-resistant infections.
Researchers at CDDEP in the US conducted stakeholder interviews in Uganda, India, and Germany, and literature reviews to identify key access barriers to antibiotics in low-, middle-, and high-income countries.
Health facilities in many low- and middle-income countries are substandard and lack staff who are properly trained in administering antibiotics.
n India, there is one government doctor for every 10,189 people (the World Health Organization (WHO) recommends a ratio of 1:1,000), or a deficit of 600,000 doctors, and the nurse:patient ratio is 1:483, implying a shortage of two million nurses.
“Lack of access to antibiotics kills more people currently than does antibiotic resistance, but we have not had a good handle on why these barriers are created,” said Ramanan Laxminarayan, director at CDDEP.
The findings of the report show that even after the discovery of a new antibiotic, regulatory hurdles and substandard health facilities delay or altogether prevent widespread market entry and drug availability,” Laxminarayan said in a statement.
“Our research shows that of 21 new antibiotics entering markets between 1999 and 2014, less than five were registered in most countries in sub-Saharan Africa. Just the mere existence of an effective antibiotic does not mean that they are available in countries where they are most needed,” said Laxminarayan.
Worldwide, the irrational use of antibiotics and poor antimicrobial stewardship lead to treatment failure and propagate the spread of drug resistance which, in turn, further narrows the available array of effective antibiotics.
Research and development for new antimicrobials, vaccines, and diagnostic tests has slowed since the 1960s as profitable investment in this area is limited by low sales volumes, short duration of treatment, competition with established products and less expensive generics, and the possibility that resistance will rapidly emerge.
Researchers at the Technion–Israel Institute of Technology have developed a glue gun to put the human body back together when it has been seriously injured. The pins and stitches currently used to treat serious injuries come with drawbacks: They can be painful, they leave scars, they require high skill from the doctor, and they sometimes have to be removed after the tissues heal. Suture on the intestine, lungs or blood vessels often leak and therefore require a sealant. The medical glue that the researchers have developed is a “two in one,” said Prof. Boaz Mizrahi, head of the Biomaterials Laboratory of the Technion. It replaces both stitches and the sealant, and is good for both external and internal injuries, he said. All sorts of medical glues are already being used in dermatology, surgery, and other areas. Israeli startup Nanomedic Technologies Ltd., for example, has developed a medical device that it says can dress burns and other wounds with nano materials that mimic human tissue and peel off once the skin below is regenerated. Still, the glues currently in use to replace sutures and staples are limited by their mechanical properties and toxicity, the researchers said. Because they are very toxic, they can be utilized only on the surface of the skin. In addition, hardening of the glue may make the organ less flexible or the adhesion may not be sufficiently strong. With these limitations in mind, researchers have been on the hunt for a glue that is suitable for different tissues, nontoxic, and flexible after hardening. Such a glue would also need to decompose in the body after the tissue is fused together. Mizrahi worked together with doctoral student Alona Shagan and came up with what they say is a “very strong, nontoxic tissue adhesive that remains flexible even after solidification.” Their study...
Pinnacle Ventures has launched a pharmacogenomics programme to enable genetic testing to drive personalised prescribing decisions. The innovation arm of Pinnacle Midlands Health Network, a not-for-profit primary health care management company in New Zealand, is also working on embedding biomarker information into electronic health records and linking it to a clinical-decision support prescribing tool that can help prescribers by providing direct access to international pathways and guidelines. Pharmacogenetics involves prescriptions being tailored to a person’s genetic make-up, as people metabolise drugs in different ways, which can have a significant impact on a drug’s effectiveness. Ventures plans to do about 5,000 pharmacogenetic tests over the next 12 months, says chief executive John Macaskill-Smith. Some will be self-funded because individuals are struggling with their medications and others will be fully funded by Ventures, targeting specific groups within the Midlands population. Macaskill-Smith says it is a simple test that covers 65–70 per cent of medications frequently prescribed in New Zealand. “The New Zealand health system is under strain but using testing like this you could reduce the trial and error of prescribing and prevent adverse reactions to medications,” he said. Ethnicity plays a big part in how a person metabolises drugs, but the clinical trials that prescribing information are based on very rarely involve Māori or Pasifika test subjects. Macaskill-Smith said Ventures is partnering with key kiwi groups, Auckland University and Otago University medical schools and Callaghan Innovation to support research and develop a better understanding of how unique New Zealand populations respond to different medications. People who have a pharmacogenetic test can choose to consent to contributing their non-identifiable demographic information to researchers. Embedding the biomarker information into EHRs ensures a patient’s results are used for both current and future prescribing decisions, he said. Macaskill-Smith says a lot of direct-to-consumer online genetic-testing tools involve people...
Surgery students spend so much time on screens that they have lost the ability to perform simple tasks such as stitching and sewing up patients, a professor has warned. Roger Kneebone, a professor of surgical education at Imperial College, London, says the focus on academic knowledge has come at the expense of craftsmanship. “It is important and an increasingly urgent issue,” Kneebone told the BBC. “It is a concern of mine and my scientific colleagues that whereas in the past you could make the assumption that students would leave school able to do certain practical things – cutting things out, making things – that is no longer the case.” The professor, who teaches surgery to medical students, believes that this is down to an increase in technology which takes away the experience of handling materials and developing skills. ”An obvious example is of a surgeon needing some dexterity and skill in sewing or stitching,” he explained. ”A lot of things are reduced to swiping on a two-dimensional flat screen” Kneebone adds that a growing number of students are becoming “less competent and less confident” in using their hands, resulting in young professionals who “have very high exam grades but lack tactile general knowledge”. The professor will be speaking on Tuesday at the V&A Museum of Childhood in east London, at the launch of a report, published by the Edge Foundation, calling for more creativity in the curriculum. The report warns that entries to creative subjects have fallen by 20 per cent since 2010, including a 57 per cent fall in design and technology GCSE. Tristram Hunt, director of the Victoria and Albert Museum, who will be speaking alongside Professor Kneebone added: “Creativity is not just for artists. “Subjects like design and technology, music, art and drama are vitally important for...