WASHINGTON, Apr 13 2011 (IPS) – While the curtain was being raised Tuesday on a U.S. Department of Health and Human Services (HHS) initiative to pour one billion dollars of federal funding into the Partnerships for Patients Act – a new project designed to save thousands of lives and millions of dollars – the Journal of the American Medical Association (JAMA) held a media briefing here simultaneously presenting studies from their theme issue on Infectious Diseases and Immunology .
A day prior to the release of JAMA s Apr. 13 issue, which addresses an expansive array of diseases and medical and biological immunity, top-dogs from the medical community gathered here to share endeavours at combating the global proliferation of various diseases.
Christian Liendhart, a senior scientific advisor at the World Health Organization (WHO), presented the findings of a study conducted across 11 sites in Africa, Asia and Latin America on the efficacy and safety of a 4-drug Fixed-dose combination (FDC) treatment, use of which could potentially lower the risk of patients developing and disseminating drug-resistant bacteria.
It is essential that FDCs are made available worldwide, Liendhardt said at the National Press Club Tuesday. While new regimens of drugs are being developed for the treatment of tuberculosis, it is essential that strategies are developed for their introduction in national TB control programmes.
However, some say pouring resources into such stopgap solutions reveals a kind of desperation in the established medical community to hold onto a paradigm that many scientists say is deeply flawed.
Alternative Models
Buhner’s call for a drastic paradigm shift fits neatly into a movement for alternative medical systems and practices that is rapidly gaining momentum worldwide. At Duke University’s Global Health Initiative (GHI) Global Health Exchange series last year, representatives from scores of organisations gathered to discuss the use of Traditional, Complementary and Alternative Medicine (TCAM).
Speaking at an event there some months ago, Gerard Bodeker, chair of the Global Initiative for Traditional Systems of Health, said that TCAM use has raised public awareness, influenced the agendas of medical researchers, regulators and economists and lately resulted in increased public financing.
“There’s already solid evidence of the mainstreaming and formalisation of these approaches and TCAM is now official policy of the WHO,” Bodekar said.
Researchers have been laying the blueprint for such a movement for years. An article by Stuart Levy, a professor of microbiology at Tufts University, published by Scientific American back in the early 1990s, asked, “How did we end up in this worrisome, and worsening, situation? Several interacting processes are at fault. Analyses of them point to a number of actions that could help reverse the trend, if individuals, businesses and governments around the world can find the will to implement them.”
“One component of the solution,” Levy wrote, “is recognizing that bacteria are a natural, and needed, part of life; they often protect us from disease, because they compete with, and thus limit, the proliferation of, pathogenic bacteria – the minority of species that can multiply aggressively (into the millions) and damage tissues or otherwise cause illness. The benign competitors can be important allies in the fight against antibiotic-resistant pathogens.”
What the mainstream medical community is calling XDRTB – Extensively Drug-Resistant Tuberculosis – is a problem that places like the Gates Foundation is putting a lot of money into, but only for fairly conventional treatments, Stephen Buhner, a medical author and researcher of the New Mexico- based Foundation for Gaian Studies, told IPS.
The focus on combination therapy basically mimics plant medicines, which have several hundred constituents in them and are often more effective for resistant organisms than a pharmaceutical might be, he added.
Given the dynamics of the way technological societies are set up, money will continue to be misspent in protecting the old paradigm but in my perspective they are not exactly addressing the real problem. The medical establishment believes it can exterminate all disease organisms by using pharmaceuticals, an assumption that has been proved false, because the initial assumptions about the nature of bacteria were just wrong, he concluded.
Buhner is certainly not alone in his prognosis that radical change is required.
About two months ago we published a commentary by Dr. James Hughes from the Centers for Disease Control (CDC) in which he pointed out the lack of research and development for new antimicrobial agents, Phil Fontanarosa, the executive editor of JAMA, told IPS.
If the 10-year timeline on antibiotic effectiveness is true, coupled with the absence of a total freeze on new drugs to deal with the resistant strains that are absolutely inevitable, we all could be facing real challenges in dealing with both bacterial and viral infections, he added.
Some believe that even JAMA s modest attempts at addressing increasingly solid evidence of an imminent medical catastrophe are largely inadequate.
There s s big difference between science and politics, Buhner told IPS.
If you look at the majority of newspaper articles, or even television reports, about infectious diseases, bacteria and microbial resistance, they will invariably discuss the horrors of an outbreak and follow it up with the assurance that officials have it under control, he added, stressing that JAMA stays true to a years long media and political culture that posits the current medical paradigm as something that can be reformed.
Hospitals as a breeding ground for the next pandemic
Camille Sabella, an associate professor of pediatrics at the Cleveland Clinic Lerner College of medicine, discussed the downward spiraling conditions of safe-havens-turned-breeding grounds.
According to Sabella, 5.6 percent of hospital patients contract some form of health care-associated infections (HAIs), which account for 1.7 million preventable infections annually and results in over 99,000 deaths every year. This hospital-born outbreak also ratchets up a thumping bill of 28 to 33 billion dollars annually, hijacking much-needed resources that could be funneled instead into research or providing better primary healthcare.
Sabella, whose study on the differences between adult and pediatric patients regarding the appropriate treatment of HAIs also appears in JAMA s Apr. 13 issue, stressed at the press briefing that immunocompromised children, such as cancer patients, premature babies and transplant patients in hospitals are particularly vulnerable to the horrors of HAIs.
Along with his co-author Charles Foster, Sabella s commentary claims precise definitions need to be established [and] rigorous research needs to be performed the expectation that adult criteria can be used to define, track and eliminate HAI in children is problematic.
Echoing those sentiments across the hallway of the National Press Club, HHS Secretary Kathleen Sebelius was joined by leaders of major hospitals, physicians, nurses and patient advocates here Tuesday when she announced the Partnerships for Patients initiative that hopes to avoid 60,000 deaths caused by preventable hospital injuries and complications, as well as save up to 35 billion dollars, including 10 billion dollars in Medicare.
With over 500 hospitals, along with scores of medical practitioners and employers across the country already committed to the initiative, 500 million dollars have already been made available through the Community-based Care Transitions Program and 500 million more will be dedicated from the Centers for Medicare and Medicaid Services (CMS).
