Tuesday, October 1, 2019

Antimicrobial resistance is drastically rising

Date:
September 19, 2019
Source:
ETH Zurich
Summary:
Researchers have shown that antimicrobial-resistant infections are rapidly increasing in animals in low and middle income countries. They produced the first global of resistance rates, and identified regions where interventions are urgently needed.
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Chickens (stock image). | Credit: © Alexbedoya / stock.adobe.com
Chickens (stock image).
Credit: © Alexbedoya / Adobe Stock
The world is experiencing unprecedented economic growth in low- and middle-income countries. An increasing number of people in India, China, Latin America and Africa have become wealthier, and this is reflected in their consumption of meat and dairy products. In Africa, meat consumption has risen by more than half; in Asia and Latin America it is up by two-thirds.
To meet this growing demand, animal husbandry has been intensified, with among other things, an increased reliance on the use of antimicrobials. Farmers use antimicrobials to treat and prevent infections for animals raised in crowded conditions but these drugs are also used to increase weight gain, and thus improve profitability.
This excessive and indiscriminate use of antimicrobials has serious consequences: the proportion of bacteria resistant to antimicrobials is rapidly increasing around the world. Drugs are losing their efficacy, with important consequences for the health of animals but also potentially for humans.
Mapping resistance hotspots
Low- and middle income countries have limited surveillance capacities to track antimicrobial use and resistance on farms. Antimicrobial use is typically less regulated and documented there than in wealthy industrialized countries with established surveillance systems.
The team of researchers led by Thomas Van Boeckel, SNF Assistant Professor of Health Geography and Policy at ETH Zurich, has recently published a map of antimicrobial resistance in animals in low- and middle-income countries in the journal Science.
The team assembled a large literature database and found out where, and in which animals species resistance occurred for the common foodborne bacteria Salmonella, E. coli, Campylobacter and Staphylococcus.
According to this study, the regions associated with high rates of antimicrobial resistance in animals are northeast China, northeast India, southern Brazil, Iran and Turkey. In these countries, the bacteria listed above are now resistant to a large number of drug that are used not only in animals but also in human medicine. An important finding of the study is that so far, few resistance hotspots have emerged in Africa with the exception of Nigeria and the surroundings of Johannesburg.
The highest resistance rates were associated with the antimicrobials most frequently used in animals: tetracyclines, sulphonamides, penicillins and quinolones. In certain regions, these compounds have almost completely lost their efficacy to treat infections.
Alarming trend in multi-drug resistance
The researchers introduced a new index to track the evolution of resistance to multiple drugs: the proportion of drugs tested in each region with resistance rates higher than 50%. Globally, this index has almost tripled for chicken and pigs over the last 20 years. Currently, one third of drugs fail 50% of the time in chicken and one quarter of drug fail in 50% of the time in pigs.
"This alarming trend shows that the drugs used in animal farming are rapidly losing their efficacy," Van Boeckel says. This will affect the sustainability of the animal industry and potentially the health of consumers.
It is of particular concern that antimicrobial resistance is rising in developing and emerging countries because this is where meat consumption is growing the fastest, while access to veterinary antimicrobials remains largely unregulated. "Antimicrobial resistance is a global problem. There is little point in making considerable efforts to reduce it on one side of the world if it is increasing dramatically on the other side," the ETH researcher says.
Input from thousands of studies
For their current study, the team of researchers from ETH, Princeton University and the Free University of Brussels gathered thousands of publications as well as unpublished veterinary reports from around the world. The researchers used this database to produce the maps of antimicrobial resistance.
However, the maps do not cover the entire research area; there are large gaps in particular in South America, which researchers attribute to a lack of publicly available data. "There are hardly any official figures or data from large parts of South America," says co-author and ETH postdoctoral fellow Joao Pires. He said this surprised him, as much more data is available from some African countries , despite resources for conducting surveys being more limited than in South America.
Open-access web platform
The team has created an open-access web platform resistancebank.org to share their findings and gather additional data on resistance in animals. For example, veterinarians and state-authorities can upload data on resistance in their region to the platform and share it with other people who are interested.
Van Boeckel hopes that scientists from countries with more limited resources for whom publishing cost in academic journal can be a barrier will be able to share their findings and get recognition for their work on the platform. "In this way, we can ensure that the data is not just stuffed away in a drawer" he says, "because there are many relevant findings lying dormant, especially in Africa or India, that would complete the global picture of resistance that we try to draw in this first assessment. The platform could also help donors to identify the regions most affected by resistance in order to be able to finance specific interventions.
As meat production continues to rise, the web platform could help target interventions against AMR and assist a transition to more sustainable farming practices in low- and middle-income countries. "The rich countries of the Global North, where antimicrobials have been used since the 1950s, should help make the transition a success," says Van Boeckel.
The research was funded by the Swiss National Science Foundation and the Branco Weiss Fellowship.
Story Source:
Materials provided by ETH Zurich. Original written by Peter Rüegg. Note: Content may be edited for style and length.
Journal Reference:
  1. Thomas P. Van Boeckel, João Pires, Reshma Silvester, Cheng Zhao, Julia Song, Nicola G. Criscuolo, Marius Gilbert, Sebastian Bonhoeffer, Ramanan Laxminarayan. Global trends in antimicrobial resistance in animals in low- and middle-income countries. Science, 2019; 365 (6459): eaaw1944 DOI: 10.1126/science.aaw1944
Cite This Page:
ETH Zurich. "Antimicrobial resistance is drastically rising." ScienceDaily. ScienceDaily, 19 September 2019. <www.sciencedaily.com/releases/2019/09/190919142211.htm>.
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Supreme Court to Decide High-Stakes ‘LGBT’ Cases Amid Partisan Scrutiny
The three cases will ask the justices to decide whether federal law barring discrimination based on ‘sex’ applies to ‘gay’ and ‘transgender’ employees.
Joan Frawley Desmond
WASHINGTON — The U.S. Supreme Court will begin its 2019-2020 term with a thunderclap: a trio of cases that could result in the extension of federal employment protections that now bar discrimination based on “sex” to encompass workers who identify as “gay” or “transgender.”
“When Title VII passed in 1964, there is no question that Congress at that time did not intend to include gender identity or sexual orientation, and most appellate courts have recognized that,” said Eric Kniffin, a Colorado-based attorney who specializes in religious-freedom issues in the workplace.
“But some courts have opened up these cases” to a different statutory interpretation, Kniffin told the Register, and a Supreme Court ruling that sides with the employees’ argument could have far-reaching consequences for religious employers in particular.
On Oct. 8, the justices will first hear consolidated oral arguments for Altitude Express v. Zardaand Bostock v. Clayton County, two cases brought by employees who contend that their sexual orientation led to their dismissal.
They claim that this action violated Title VII of the Civil Rights Act of 1964, though the language of the statute does not specify legal protection for employees fired because of their sexual orientation.
The employers counter that when Congress passed Title VII more than a half-century ago, it never intended that the law prohibit discrimination based on other categories like sexual orientation.
The federal statute, they say, simply asks employers to treat members of one sex no differently than the opposite sex, and if it is time to revisit that law, Congress, not the courts, should do so.

Transgender Rights
On the afternoon of Oct. 8, the court will hear arguments in R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission, which will provide an opportunity for the justices to weigh in on the politically sensitive challenges posed by transgender rights.
In this case, a male funeral home employee who was hired in 2007 was fired in 2013 after revealing plans to live as a woman.
The funeral homeowner, a Christian, testified that he fired the employee because “[he] wanted to dress as a woman.”
The employee filed a complaint with the Equal Employment Opportunity Commission, asserting that discrimination based on gender identity violated Title VII. The commission agreed.
The U.S. Court of Appeals for the Sixth Circuit reversed a lower court decision in favor of the funeral home, and the Supreme Court agreed to rule on the matter.
The justices must now decide whether Title VII bars discrimination against transgender employees “based on 1) their status as transgender or 2) sex stereotyping under Price Waterhouse v. Hopkins, 490 U.S. 228 (1989).”
The Price Waterhouse ruling made it possible for workers to sue their employers for gender stereotyping as a form of sex discrimination.
However, U.S. Solicitor General Noel Francisco argued in a brief that the Equal Employment Opportunity Commission made the wrong call in this case and that the specific language of Title VII must guide the justices’ decision.
“Title VII’s protections apply fully to transgender individuals,” read the brief, “but the fact that a plaintiff is transgender does not change the legal standard or analysis.” Like any plaintiff in a Title VII case, a person who identifies as transgender must show “that an employer treated members of one sex less favorably” than members of the opposite sex in the same position.

Extension of Protection
Meanwhile, the three cases have raised fears that the extension of Title VII protections to these groups would almost certainly threaten the religious freedom of faith-based schools, hospitals and other institutions that adhere to biblical teaching on marriage and sexuality. And recent headlines suggest there is cause for such concern.
Last summer, a male teacher in a same-sex civil union sued the Archdiocese of Indianapolisafter the local archbishop directed a Catholic high school under his jurisdiction not to renew the faculty member’s contract.
In California, a Catholic hospital was sued by a patient “transitioning” to the opposite sex after her hysterectomy was canceled, and a state court sided with the plaintiff in allowing the lawsuit to proceed.
The U.S. Conference of Catholic Bishops, the Southern Baptist Convention and the Anglican Church of North America were among seven religious organization that jointly filed a brief in one of the cases, registering their concerns.
“[C]ompelling a church by law to hire and retain employees who, by speech or conduct, do not espouse or have not integrated its mission and message into their own lives, or who, by their speech or conduct, contradict that message, would invariably bring harm to a church,” read the amicus brief. “It would also undercut the church’s right to decide for itself what its mission and message are.”
The brief tapped into originalist legal arguments that oppose the use of the courts to secure rights that have not been granted by Congress, asserting that U.S. lawmakers have the tools to craft legislation that can address a broad range of concerns and requirements.
Douglas Laycock, a professor at the University of Virginia Law School and a leading authority on religious-freedom issues, agreed that the three cases raise a number of thorny questions for the justices and could result in legal action against religious employers.
“The Title VII cases are a real test for the conservatives” on the high court, most of whom describe themselves as “textualists,” said Laycock, referencing a school of jurisprudence that grounds legal decisions in statutory language.
“The text says no discrimination on the basis of sex.”

Era of ‘Sexual Rights’
That said, Laycock noted that in 1964 U.S. lawmakers could not have foreseen the rise of newly identified “sexual rights.”
“So is it the meaning of the text, or the unstated assumptions of those who drafted the text? Or the social and political predilections of the justices?” he asked, and he suggested that a “5-4 vote on ideological lines” was more than likely.
When asked to consider how a ruling that extended Title VII protections to these employees might affect faith-based institutions, he replied that a religious exemption could be carved out, but questioned whether “LGBT” activists would permit it.
“There could easily enough be gay rights with religious exemptions,” Laycock told the Register. “The threat is political; the gay-rights side is opposed to religious exemptions.”
If the justices rule that Title VII protects these plaintiffs, the “existing Title VII exemptions might protect religious organizations, but the gay-rights side disputes that too,” he noted.
“And the existing exemptions could not protect religiously motivated businesses. They would have to appeal to RFRA [the federal Religious Freedom Restoration Act] or the Free Exercise Clause.”
Luke Goodrich, an attorney with Becket, a public interest group that represented EWTN Global Catholic Network, the Register’s parent company, in its legal challenge to the Health and Human Services’ contraceptive mandate, and the author of the forthcoming Free to Believe: The Battle Over Religious Liberty in America, agreed that a victory for the plaintiffs in these three cases would expose “thousands” of religious employers to liability.
He also suggested there was good reason to wait for U.S. lawmakers in Washington to take up the matter of expanded LGBT protections and pointed to the passage of related legislation at the state level.
”Twenty-two states have already adopted legislation prohibiting discrimination based on gender identity or sexual orientation, and in every single state, they also included a broad religious exemption — even broader than what is now in Title VII,” Goodrich told the Register. “When you handle these issues legislatively, the legislature can grapple with how to protect LGBT individuals and religious freedom.”

Taking a Back Seat
Still, experts predict that religious-liberty concerns will take a back seat in the oral arguments for these cases, leaving the justices to focus on the language of Title VII and the intent of Congress.
But the deliberations also come with a few wild cards.
For starters, the history of these three cases features sharply divided opinions at the appellate level, suggesting that the high court’s proceedings will reflect dueling interpretations of the statutory language.
Likewise, in the wake of the court’s 2015 legalization of same-sex “marriage,” rising acceptance of LGBT rights in U.S. politics, culture and the workplace will exert enormous pressure on the justices to secure additional protections for this group.
This summer, 206 corporations, including Apple, Facebook, Uber, Walt Disney and Coca-Cola, called on the justices to extend Title VII protections to LGBT employees and said that uniform rules governing such matters across the country would provide a welcome “consistency and predictability.”
These fast-moving developments, coupled with the recent revival of attacks on the reputation of the court’s newest member, Justice Brett Kavanaugh, have introduced a measure of uncertainty to the outcome of these three cases.
Kavanaugh replaced the court’s perennial swing vote, Justice Anthony Kennedy, the author of the majority opinion in its 2015 ruling that redefined marriage in the United States and in three other related cases.
Now, the release of a new book, The Education of Brett Kavanaugh: An Investigation, which retraces his years in high school and college, and introduced a “previously unreported” allegation of sexual misconduct against him that has been widely discredited, marks an escalation in the ongoing battle over the high court’s direction on cutting-edge social issues.
The book’s critics have framed the uncorroborated allegation as an attempt to both influence the justice and delegitimize his record, as the court skews more socially conservative and Roe v. Wade hangs in the balance.
“The pending Title VII cases are probably the most significant test so far of what the substitution of Brett Kavanaugh for Anthony Kennedy means for the court,” Gerard Bradley, an expert on the Constitution at the University of Notre Dame Law School, told the Register. “It is practically certain that Kennedy would have sided with the ‘gay’ and ‘transgendered’ plaintiffs.
“Kavanaugh is not the social-conservative justice that Clarence Thomas is or Antonin Scalia was. But there is a sound and somewhat narrow legal argument against these plaintiffs, and Kavanaugh is likely to embrace it,” said Bradley. “If he does not, it will be a catastrophic omen.”
Joan Frawley Desmond is a Register senior editor.

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Ron Paul Asks: "Impeachment... Or CIA Coup?"

You don’t need to be a supporter of President Trump to be concerned about the efforts to remove him from office. Last week House Speaker Nancy Pelosi announced impeachment proceedings against the President over a phone call made to the President of Ukraine. According to the White House record of the call, the President asked his Ukrainian counterpart to look into whether there is any evidence of Ukrainian meddling in the 2016 election and then mentioned that a lot of people were talking about how former US Vice President Joe Biden stopped the prosecution of his son who was under investigation for corruption in Ukraine.
Democrats, who spent more than two years convinced that “Russiagate” would enable them to remove Trump from office only to have their hopes dashed by the Mueller Report, now believe they have their smoking gun in this phone call.
It this about politics? Yes. But there may be more to it than that.
It may appear that the Democratic Party, furious over Hillary Clinton’s 2016 loss, is the driving force behind this ongoing attempt to remove Donald Trump from office, but at every turn we see the fingerprints of the CIA and its allies in the US deep state.
In August 2016, a former acting director of the CIA, Mike Morell, wrote an extraordinary article in the New York Times accusing Donald Trump of being an “agent of the Russian Federation.” Morell was clearly using his intelligence career as a way of bolstering his claim that Trump was a Russian spy – after all, the CIA should know such a thing! But the claim was a lie.
Former CIA director John Brennan accused President Trump of “treason” and of “being in the pocket of Putin” for meeting with the Russian president in Helsinki and accepting his word that Russia did not meddle in the US election. To this day there has yet to be any evidence presented that the Russian government did interfere. Brennan openly called on “patriotic” Republicans to act against this “traitor.”
Brennan and his deep state counterparts James Comey at the FBI and former Director of National Intelligence James Clapper launched an operation, using what we now know is the fake Steele dossier, to spy on the Trump presidential campaign and even attempt to entrap Trump campaign employees.
Notice a pattern here?
Now we hear that the latest trigger for impeachment is a CIA officer assigned to the White House who filed a “whistleblower” complaint against the president over something he heard from someone else that the president said in the Ukraine phone call.
Shockingly, according to multiple press reports the rules for CIA whistleblowing were recently changed, dropping the requirement that the whistleblower have direct, first-hand knowledge of the wrongdoing. Just before this complaint was filed, the rule-change allowed hearsay or second-hand information to be accepted. That seems strange.
As it turns out, the CIA “whistleblower” lurking around the White House got the important things wrong, as there was no quid pro quo discussed and there was no actual request to investigate Biden or his son.
The Democrats have suddenly come out in praise of whistleblowers – well not exactly. Pelosi still wants to prosecute actual whistleblower Ed Snowden. But she’s singing the praises of this fake CIA “whistleblower.”
Senate Minority Leader Chuck Schumer once warned Trump that if “you take on the intelligence community, they have six ways from Sunday at getting back at you.” It’s hard not to ask whether this is a genuine impeachment effort…or a CIA coup!
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