scholarly journals National and international policies to mitigate disease threats

2012 ◽  
Vol 367 (1604) ◽  
pp. 2893-2900 ◽  
Author(s):  
Christopher Dye
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Public Interest ◽  
Policy Making ◽  
Policy Instruments ◽  
Drug Resistant ◽  
Political Opportunity ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
International Policies

To devise and implement effective health policy, we must define the problem, choose the tools, craft the policy, build consensus, set goals and deadlines, raise funds and take action. Success or failure depends on the perception of risk, the strength of the underlying science, the efficacy of the technology, ownership and intellectual property, the conflict between individual and public health, the choice of weaker (guidelines) and stronger (law) policy instruments, the level of public interest, political opportunity, institutional inertia, mechanisms for enforcement and who foots the bill. All these things considered, this paper is a brief policy-making guide by example, illustrating some achievements and disappointments with reference to cholera, drug-resistant tuberculosis, HIV/AIDS and rabies.

scholarly journals Through the Quarantine Looking Glass: Drug-Resistant Tuberculosis and Public Health Governance, Law, and Ethics

2007 ◽  
Vol 35 (4) ◽  
pp. 616-628 ◽  
Author(s):  
David P. Fidler ◽  
Lawrence O. Gostin ◽  
Howard Markel
Keyword(s):  
Public Health ◽  
Communicable Disease ◽  
Policy Instruments ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Actual Application ◽  
Resistant Tuberculosis ◽  
Governance Systems ◽  
Law And Ethics ◽  
Public Health Governance

Dramatic events involving dangerous microbes often focus attention on isolation and quarantine as policy instruments. The incident in May-June 2007 involving Andrew Speaker and drug-resistant tuberculosis (TB) joins other communicable disease crises that have forced contemplation or actual application of quarantine powers. Implementation of quarantine powers, which encompasses authority for both isolation and quarantine actions, is important not only for the handling of a specific event but also because the use of such authority provides a window on broader issues of public health and the legal rules, ethical principles, and governance systems that support it. Debates about quarantine powers reflect political and social attitudes about public health that often tell us more about this policy endeavor than acts of isolation and quarantine themselves.

scholarly journals Pre-detection history of extensively drug-resistant tuberculosis in KwaZulu-Natal, South Africa

2019 ◽  
Vol 116 (46) ◽  
pp. 23284-23291 ◽  
Author(s):  
Tyler S. Brown ◽  
Lavanya Challagundla ◽  
Evan H. Baugh ◽  
Shaheed Vally Omar ◽  
Arkady Mustaev ◽  
...  
Keyword(s):  
Public Health ◽  
Public Health Surveillance ◽  
Health Surveillance ◽  
Whole Genome ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Kwazulu Natal ◽  
History Of

Antimicrobial-resistant (AMR) infections pose a major threat to global public health. Similar to other AMR pathogens, both historical and ongoing drug-resistant tuberculosis (TB) epidemics are characterized by transmission of a limited number of predominant Mycobacterium tuberculosis (Mtb) strains. Understanding how these predominant strains achieve sustained transmission, particularly during the critical period before they are detected via clinical or public health surveillance, can inform strategies for prevention and containment. In this study, we employ whole-genome sequence (WGS) data from TB clinical isolates collected in KwaZulu-Natal, South Africa to examine the pre-detection history of a successful strain of extensively drug-resistant (XDR) TB known as LAM4/KZN, first identified in a widely reported cluster of cases in 2005. We identify marked expansion of this strain concurrent with the onset of the generalized HIV epidemic 12 y prior to 2005, localize its geographic origin to a location in northeastern KwaZulu-Natal ∼400 km away from the site of the 2005 outbreak, and use protein structural modeling to propose a mechanism for how strain-specific rpoB mutations offset fitness costs associated with rifampin resistance in LAM4/KZN. Our findings highlight the importance of HIV coinfection, high preexisting rates of drug-resistant TB, human migration, and pathoadaptive evolution in the emergence and dispersal of this critical public health threat. We propose that integrating whole-genome sequencing into routine public health surveillance can enable the early detection and local containment of AMR pathogens before they achieve widespread dispersal.

scholarly journals Antimicrobial drug resistance and infection prevention/control: lessons from tuberculosis

2021 ◽  
Author(s):  
J. Peter Cegielski ◽  
Carrie Tudor ◽  
Grigory V. Volchenkov ◽  
Paul A. Jensen
Keyword(s):  
Public Health ◽  
Drug Resistance ◽  
Infection Prevention ◽  
Antimicrobial Drug ◽  
Infection Prevention And Control ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Antimicrobial Drug Resistance ◽  
The Past ◽  
Resistant Tuberculosis

Antimicrobial drug resistance (AMR) is increasing rapidly worldwide, causing an estimated 700,000 deaths annually over the past decade, en route to becoming the leading global threat to public health by 2050 with an estimated 10 million deaths per year (more than heart disease, cancer, and stroke), while reducing global wealth by US$100 trillion. Yet AMR has not received the attention and action required to change this trajectory. Appropriate infection prevention and control (IPC) measures are needed to prevent transmission of infections to healthcare workers (HCWs), other patients, families, and the general public. In this review, we discuss a notable case study of AMR: highly drug-resistant tuberculosis (TB) has emerged repeatedly over the past 70 years as new drugs have been introduced, leading to new diagnostics, therapeutics, funding, public health strategies, and, in high-income countries, effective IPC measures that curtailed transmission. We review current efforts to control and prevent AMR using the example of drug-resistant tuberculosis to highlight important themes including laboratory systems, surveillance, control and prevention of healthcare-associated infections (especially among HCWs), better coordination across disciplines and diseases, and powerful advocacy/social change initiatives grounded in social and behavioral sciences. These strategies are the foundation of an effective response to the AMR threat to public health.

scholarly journals Translating basic science insight into public health action for multidrug- and extensively drug-resistant tuberculosis

Respirology ◽  
2012 ◽  
Vol 17 (5) ◽  
pp. 772-791 ◽  
Author(s):  
NICHOLAS D. WALTER ◽  
MICHAEL STRONG ◽  
ROBERT BELKNAP ◽  
DIANE J. ORDWAY ◽  
CHARLES L. DALEY ◽  
...  
Keyword(s):  
Public Health ◽  
Basic Science ◽  
Drug Resistant ◽  
Public Health Action ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant ◽  
Health Action ◽  
Insight Into

scholarly journals Managing an extensively drug-resistant tuberculosis outbreak: the public health face of the medal

2014 ◽  
Vol 45 (1) ◽  
pp. 292-294 ◽  
Author(s):  
Luigi R. Codecasa ◽  
Giorgio Ciconali ◽  
Ester Mazzola ◽  
Maurizio Ferrarese ◽  
Daniela Cirillo ◽  
...  
Keyword(s):  
Public Health ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
The Public ◽  
Resistant Tuberculosis ◽  
Extensively Drug Resistant

scholarly journals Drug Resistant Tuberculosis: An Emerging Public Health Threat in Yemen, 2014-2016

2018 ◽  
Author(s):  
Jihan Abdulmughni ◽  
E Mahyoub ◽  
A Al Agabri ◽  
Y Abdulwareth ◽  
A Al-Serouri
Keyword(s):  
Public Health ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Health Threat ◽  
Resistant Tuberculosis ◽  
Public Health Threat
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