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Removing antimicrobial resistance from the WHO’s ‘pandemic treaty’ will leave humanity extremely vulnerable to future pandemics

Drug-resistant microbes are a serious threat for future pandemics, but the new draft of the WHO’s international pandemic agreement may not include provisions…

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Antimicrobial resistance is now a leading cause of death worldwide due to drug-resistant infections, including drug-resistant strains of tuberculosis, pneumonia and Staph infections like the methicillin-resistant Staphylococcus aureus shown here. (NIAID, cropped from original), CC BY

In late May, the latest version of the draft Pandemic Instrument, also referred to as the “pandemic treaty,” was shared with Member States at the World Health Assembly. The text was made available online via Health Policy Watch and it quickly became apparent that all mentions of addressing antimicrobial resistance in the Pandemic Instrument were at risk of removal.

Work on the Pandemic Instrument began in December 2021 after the World Health Assembly agreed to a global process to draft and negotiate an international instrument — under the Constitution of the World Health Organization (WHO) — to protect nations and communities from future pandemic emergencies.


Read more: Drug-resistant superbugs: A global threat intensified by the fight against coronavirus


Since the beginning of negotiations on the Pandemic Instrument, there have been calls from civil society and leading experts, including the Global Leaders Group on Antimicrobial Resistance, to include the so-called “silent” pandemic of antimicrobial resistance in the instrument.

Just three years after the onset of a global pandemic, it is understandable why Member States negotiating the Pandemic Instrument have focused on preventing pandemics that resemble COVID-19. But not all pandemics in the past have been caused by viruses and not all pandemics in the future will be caused by viruses. Devastating past pandemics of bacterial diseases have included plague and cholera. The next pandemic could be caused by bacteria or other microbes.

Antimicrobial resistance

Yellow particles on purple spikes
Microscopic view of Yersinia pestis, the bacteria that cause bubonic plague, on a flea. Plague is an example of previous devastating pandemics of bacterial disease. (NIAID), CC BY

Antimicrobial resistance (AMR) is the process by which infections caused by microbes become resistant to the medicines developed to treat them. Microbes include bacteria, fungi, viruses and parasites. Bacterial infections alone cause one in eight deaths globally.

AMR is fueling the rise of drug-resistant infections, including drug-resistant tuberculosis, drug-resistant pneumonia and drug-resistant Staph infections such as methicillin-resistant Staphylococcus aureus (MRSA). These infections are killing and debilitating millions of people annually, and AMR is now a leading cause of death worldwide.

Without knowing what the next pandemic will be, the “pandemic treaty” must plan, prepare and develop effective tools to respond to a wider range of pandemic threats, not solely viruses.

Even if the world faces another viral pandemic, secondary bacterial infections will be a serious issue. During the COVID-19 pandemic for instance, large percentages of those hospitalized with COVID-19 required treatment for secondary bacterial infections.

New research from Northwestern University suggests that many of the deaths among hospitalized COVID-19 patients were associated with pneumonia — a secondary bacterial infection that must be treated with antibiotics.

An illustrative diagram that shows the difference between a drug resistant bacteria and a non-resistant bacteria.
Antimicrobial resistance means infections that were once treatable are much more difficult to treat. (NIAID), CC BY

Treating these bacterial infections requires effective antibiotics, and with AMR increasing, effective antibiotics are becoming a scarce resource. Essentially, safeguarding the remaining effective antibiotics we have is critical to responding to any pandemic.

That’s why the potential removal of measures that would help mitigate AMR and better safeguard antimicrobial effectiveness is so concerning. Sections of the text which may be removed include measures to prevent infections (caused by bacteria, viruses and other microbes), such as:

  • better access to safe water, sanitation and hygiene;
  • higher standards of infection prevention and control;
  • integrated surveillance of infectious disease threats from human, animals and the environment; and
  • strengthening antimicrobial stewardship efforts to optimize how antimicrobial drugs are used and prevent the development of AMR.

The exclusion of these measures would hinder efforts to protect people from future pandemics, and appears to be part of a broader shift to water-down the language in the Pandemic Instrument, making it easier for countries to opt-out of taking recommended actions to prevent future pandemics.

Making the ‘pandemic treaty’ more robust

Measures to address AMR could be easily included and addressed in the “pandemic treaty.”

In September 2022, I was part of a group of civil society and research organizations that specialize in mitigating AMR who were invited the WHO’s Intergovernmental Negotiating Body (INB) to provide an analysis on how AMR should be addressed, within the then-draft text.

They outlined that including bacterial pathogens in the definition of “pandemics” was critical. They also identified specific provisions that should be tweaked to track and address both viral and bacterial threats. These included AMR and recommended harmonizing national AMR stewardship rules.

In March 2023, I joined other leading academic researchers and experts from various fields in publishing a special edition of the Journal of Medicine, Law and Ethics, outlining why the Pandemic Instrument must address AMR.

The researchers of this special issue argued that the Pandemic Instrument was overly focused on viral threats and ignored AMR and bacterial threats, including the need to manage antibiotics as a common-pool resource and revitalize research and development of novel antimicrobial drugs.

Next steps

While earlier drafts of the Pandemic Instrument drew on guidance from AMR policy researchers and civil society organizations, after the first round of closed-door negotiations by Member States, all of these insertions, are now at risk for removal.

The Pandemic Instrument is the best option to mitigate AMR and safeguard lifesaving antimicrobials to treat secondary infections in pandemics. AMR exceeds the capacity of any single country or sector to solve. Global political action is needed to ensure the international community works together to collectively mitigate AMR and support the conservation, development and equitable distribution of safe and effective antimicrobials.

By missing this opportunity to address AMR and safeguard antimicrobials in the Pandemic Instrument, we severely undermine the broader goals of the instrument: to protect nations and communities from future pandemic emergencies.

It is important going forward that Member States recognize the core infrastructural role that antimicrobials play in pandemic response and strengthen, rather than weaken, measures meant to safeguard antimicrobials.

Antimicrobials are an essential resource for responding to pandemic emergencies that must be protected. If governments are serious about pandemic preparedness, they must support bold measures to conserve the effectiveness of antimicrobials within the Pandemic Instrument.

Susan Rogers Van Katwyk is a member of the WHO Collaborating Centre on Global Governance of Antimicrobial Resistance at York University. She receives funding from the Wellcome Trust and the Social Sciences and Humanities Research Council of Canada.

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International

DAX – PMIs paint a bleak picture for manufacturing but China offers hope

Manufacturing remains in trouble China seeing some growth but unconvincing Bearish confirmation for DE30 index Manufacturing PMIs released throughout the…

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  • Manufacturing remains in trouble
  • China seeing some growth but unconvincing
  • Bearish confirmation for DE30 index

Manufacturing PMIs released throughout the day have made for pretty miserable reading and even those in China barely registered any growth after a lengthy period of contraction.

The Chinese data did offer some cause for hope at least, despite ultimately barely sitting in growth territory. The trajectory is positive and boosted by targeted stimulus measures that are seemingly working. External demand remains a problem but a bump in domestic demand is promising.

The sector in Europe is looking particularly grim with demand remaining extremely weak, backlogs falling and layoffs expected to accelerate over the months ahead. That’s unless we can see a rebound in activity which is looking very unlikely at this stage with the global economy struggling for any positive momentum against the backdrop of high interest rates.

The PMIs from the US were a little better, particularly the ISM reading which significantly beat expectations but even here, it remains below 50 and therefore in contraction territory. With interest rates set to remain “higher for longer”, things aren’t likely to dramatically improve for the sector.

A very bearish signal for the DAX

The DE30 turned lower again today after staging a mild recovery in recent sessions and the move could reinforce bearish views on the index.

DE30 Daily

Source – OANDA on Trading View

The reason is that the move lower came after a retest of the 200/233-day simple moving average band, following the breakout last week. The rotation lower now could be viewed as confirmation of the breakout and therefore a bearish signal.

The next potential area of support could be seen around 15,000 where prior support and resistance falls around the bottom of the descending channel.

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International

Can An ‘Independent’ Kennedy Destroy “The Whole Left-Right Demon-Driven Pyschodrama”

Can An ‘Independent’ Kennedy Destroy "The Whole Left-Right Demon-Driven Pyschodrama"

Authored by James Howard Kunstler via Kunstler.com,

Three-Way?

“Intents…

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Can An 'Independent' Kennedy Destroy "The Whole Left-Right Demon-Driven Pyschodrama"

Authored by James Howard Kunstler via Kunstler.com,

Three-Way?

“Intents have been overtaken by events.”

- Jacob Dreizin

You have to wonder what took Bobby Kennedy, Jr. so long to recognize that the Democratic Party was a home that he had long ago been turned out of, like a dog that has peed on the carpet too many times.

At the end of last week, Mr. Kennedy intimated that he might run for president on an independent line.

If he manages to get that line on the state ballots - and you can easily imagine New York and California trying to thwart him - it will change all the current calculations about the 2024 election.

As of right now, the Party of Chaos is living up to its name. They continue to present an obviously false and ridiculous consensus among themselves that “Joe Biden” is running for reelection. In fact, “the Big Guy” is about to get run through a wringer of the most abject public disgrace as his already-well-known crimes of bribery and treason get conscientiously laid out for all to see with cold and implacable decorum. Even the mind-fucked spawn of the Ivy League, toiling away on their CIA-owned newspapers and cable news networks, might find themselves forced to spin their narrative in a new direction.

“Joe Biden” is now a monumental embarrassment and a liability to our country, let alone to the degenerate party that owns him. Sub rosa efforts must be in motion to persuade him to resign before the impeachment inquiry spotlights all those telltale bank records, but they will fail to overcome his demented pride. He’ll ride this thing out to the bitter end, when he can use the last tool at his disposal to officially pardon everyone involved in his family’s racketeering operation. The longer the party pretends to support him, the closer the party itself skates toward self-destruction. Also consider: if allowed to play out, the impeachment inquiry will implicate the DOJ and the FBI in obstruction of justice — exposing many Deep State blob players to danger of prosecution.

Gov Gavin Newsom dangles himself above the fray as the deus ex machina who can touch down in DC and make all the Democrat’s problems go away. Such an attractive fellow! Great teeth and hair! Tall as a sequoia! And such a smooth talker! The woked-up suburban ladies who comprise the party’s main voting bloc grow moist in anticipation of Gov. Newsom landing on-stage like a demigod out of a Mozart opera.

But how do you think he’ll make out in an election when the airwaves are filled with oppo ads showing his toothy and hairy visage inset against scenes of homeless junkies and looting flash mobs? Try blaming that on climate change.

What else does he stand for? Censorship? Forced vaccinations? Child sex mutilations? Open borders? News-flash: these are increasingly unpopular, except among an easily-identified depraved elite.

Indeed, the whole Left-Right demon-driven psychodrama is proving impossible to live in as it throbs and pulsates toward something like civil war. And it has obscured the truly potent idea that the nation might actually be capable of solving its problems by facing up to them and changing how we act. That potent idea might be what voters will see in Bobby Kennedy if he can get their attention. Mr. Kennedy would dismantle the heinous partnerships between private corporations and the US government that loosed the Covid-19 op on the world and asset-strips the middle-class. He favors closing the border and a reevalution of immigration policy. He aims to negotiate an end to the ignoble Ukraine war project. He’s determined to disassemble the security state apparatus that’s destroying the US Constitution and citizens natural rights with it.

Mr. Kennedy says he can bring divided Americans together on these dire matters. It’s conceivable that his message might go over with enough rancor-weary voters to pull off a tour-de-force plurality in a three-way race, where nobody wins enough electoral votes to settle the contest, which then moves to the House, like in the old days of Jefferson and Burr. The rest is election mechanics, some of it very sinister when you consider all the election-rigging booby-traps already in-place such as mass mail-in ballot harvesting, no voter ID requirements, and the still-mysterious hookups of vote-counting machines to the Internet. But, at least, Mr. Kennedy running on an independent line will be a hard whap upside the Democratic Party’s thick skull, maybe even a death-blow to the party. They made a big mistake trying to un-person him. He’s on a hero’s journey at a moment in history when America dearly needs a hero.

*  *  *

Support his blog by visiting Jim’s Patreon Page

Tyler Durden Mon, 10/02/2023 - 16:20

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Government

Small Business Bankruptcies Surge In 2023, Five Reasons Why

Small Business Bankruptcies Surge In 2023, Five Reasons Why

Authored by Mike Shedlock via MishTalk.com,

Small business bankruptcies are at…

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Small Business Bankruptcies Surge In 2023, Five Reasons Why

Authored by Mike Shedlock via MishTalk.com,

Small business bankruptcies are at a much higher pace than any year since the Covid pandemic...

Small business bankruptcies from the American Bankruptcy Institute via the Wall Street Journal

The Wall Street Journal reports There’s No Soft Landing for These Businesses

Nearly 1,500 small businesses filed for Subchapter V bankruptcy this year through Sept. 28, nearly as many as in all of 2022, according to the American Bankruptcy Institute.

Bankruptcy petitions are just one sign of financial stress. Small-business loan delinquencies and defaults have edged upward since June 2022 and are now above prepandemic averages, according to Equifax.

An index tracking small-business owners’ confidence ticked down slightly in September, driven by heightened concerns about the economy, according to a survey of more than 750 small businesses. Fifty-two percent of respondents believed that the country is approaching or in a recession, said the survey by Vistage Worldwide, a business-coaching and peer-advisory firm.

Robert Gonzales, a bankruptcy attorney in Nashville, said he’s now getting four times as many calls as he did a year ago from small businesses considering a bankruptcy filing.

“We are just at the front end of the impact of these dramatically higher interest rates,” Gonzales said. “There are going to be plenty of small businesses that are overleveraged.”

Five Reasons for Surge in Bankruptcies

  • Rising Interest Rates

  • Surging Wages

  • Tighter Bank Credit

  • Overleverage

  • Work-at-Home Curtailing Demand

Fed Rate Interest Rate Hike Expectations Are Still Higher for Even Longer

The Fed has hiked interest rates to 5.25% to 5.50%. It’s the highest in 22 years.

And Fed Rate Interest Rate Hike Expectations Are Still Higher for Even Longer

Surge in Wages

Minimum wages have surged. Unions are piling on. Small businesses have to offer prevailing wages or they cannot get workers.

In California, Minimum Wage for Fast Food Workers Jumps 30% to $20 Per Hour. Governor Gavib Newsom called it a “big deal”, I responded:

A Big Deal Indeed, Expect More Inflation

Yes, governor, this is very big deal. It will increase the cost of eating out everywhere.

The bill Newsom signed only applies to restaurants that have at least 60 locations nationwide — with an exception for restaurants that make and sell their own bread, like Panera Bread (what’s that exception all about?)

Nonetheless, the bill will force many small restaurants out of business or they will pony up too.

30 Percent Raise Coming Up!

If McDonalds pays $20, why take $15.50 elsewhere?

The $4.50 hike from $15.50 to $20 is a massive 30 percent jump.

Expect prices at all restaurant to rise. Then think ahead. This extra money is certain to increase demands for all goods and services, so guess what.

Other states will follow California.

Biden Newsome Tag Team

Biden’s energy policies have made the US less secure on oil, more dependent on China for materials needed to make batteries, fueled a surge in inflation, and ironically did not do a damn thing for the environment, arguably making matters worse.

See  The Shocking Truth About Biden’s Proposed Energy Fuel Standards for discussion of the administration’s admitted impacts of Biden’s mileage mandates.

Newsom is doing everything he can to make things even worse.

The tag team of Biden and Newsom is an inflationary sight to behold.

Bank Credit and Over-Leverage

In the wake of the failure of Silicon Valley Bank, across the board small regional banks are curtailing credit.

The regional banks over-leveraged on interest rate bets. And businesses overleveraged too, getting caught up in work-from-home environments that curtailed demand for some goods and services.

The bankruptcies will fall hard on the regional banks.

Add it all up and things rate to get worse.

Tyler Durden Mon, 10/02/2023 - 15:40

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