Antibiotic effectiveness is a common pool resource that can be prematurely depleted through resistance. Some experts warn that we may face a global ecological collapse in antibiotic effectiveness.
University of Pittsburgh Graduate School of Public Health, Center for Public Health Practice
Richard Zimmerman, MD, MPH, MA •
University of Pittsburgh Graduate School of Public Health, Center for Public Health Practice
This study evaluated whether vaccination mandates, either by hospital policy or state law, may increase flu vaccine coverage for healthcare workers. The study finds that vaccination rates were significantly related to mandated vaccination with termination for noncompliance and declination or noncompliance that results in consequences other than termination.
University of Pittsburgh Graduate School of Public Health, Center for Public Health Practice
Overall annual influenza vaccination rate has slowly increased among health care workers but still remains below the national goal of 90 percent. One hundred fifty hospitals required influenza vaccination, 84 with consequences (wear a mask, termination, education, restriction from patient care duties, unpaid leave) and 66 without consequences for noncompliance. Hospitals whose mandates have consequences for noncompliance included a broader range of personnel, were less likely to allow personal belief exemptions, or to require formal declination.
The world faces a worsening public health crisis: A growing number of bacteria are resistant to available antibiotics. Yet there are few new antibiotics in the development pipeline to take the place of these increasingly ineffective drugs. This study reviews a number of proposals intended to bolster drug development, including such financial incentives for pharmaceutical manufacturers as extending the effective patent life for new antibiotics.
This paper explores associations between awareness of New Jersey’s HIV exposure law and the HIV-related attitudes, beliefs, and sexual and seropositive status disclosure behaviors of HIV-positive persons. The study finds 51 percent of participants knew about the HIV exposure law. This awareness was not associated with increased sexual abstinence, condom use with most recent partner, or seropositive status disclosure. Contrary to hypotheses, persons who were unaware of the law experienced greater stigma and were less comfortable with positive serostatus disclosure.
Parental involvement (PI) laws require that physicians notify or obtain consent from a parent(s) of a minor seeking an abortion before performing the procedure. This study shows that prior evidence based on gonorrhea rates overlooked the frequent under-reporting of gonorrhea by race and ethnicity, and presents new evidence on the effects of PI laws using more current data on the prevalence of gonorrhea and data that are novel to this literature (i.e., chlamydia rates and data disaggregated by year of age).
This letter to the editor of Clinical Infectious Diseases explores the "10 x ′20 initiative" — a global commitment to develop 10 new antimicrobials by 2020. The authors question the development costs, the current clinical trial system, and the neglection of current antimicrobials. They also examine issue of quality versus quantity and conclude that "... we need to set priorities to achieve a balance between antibiotic conservation and new drug development, focusing on policies that will best serve public health.
The world faces a worsening public health crisis: A growing number of bacteria are resistant to available antibiotics. Yet there are few new antibiotics in the development pipeline to take the place of these increasingly ineffective drugs. This paper reviews a number of proposals intended to bolster drug development, including such financial incentives for pharmaceutical manufacturers as extending the effective patent life for new antibiotics.
Sanford School of Public Policy; Duke Global Health Institute
Neha Gupta •
Sanford School of Public Policy; Duke Global Health Institute
Samir K. Brahmachari, PhD •
Open Source Drug Discovery; Council of Scientific and Industrial Research, New Delhi, India
Ian Chopra, PhD •
Institute of Molecular and Cellular Biology, University of Leeds
Bernard H. Munos, MS •
InnoThink
Carl F. Nathan, MD •
Weill Cornell Medical College, Department of Microbiology and Immunology
Kevin Outterson, LLM, JD •
Boston University School of Law
Jean Pierre Paccaud, PhD •
Drugs for Neglected Diseases Initiative (DNDi)
David J. Payne, PhD •
GlaxoSmithKline, Infectious Diseases Therapeutic Area Unit
Rosanna Peeling, PhD •
London School of Hygiene & Tropical Medicine
Melvin K. Spigelman, MD •
Global Alliance for TB Drug Development, New York
Johan Weigelt •
Karolinska Institutet Department of Medicine
In the face of a growing global burden of resistance to existing antibiotics, a combination of scientific and economic challenges has posed significant barriers to the development of novel antibacterials over the past few decades. Yet the bottlenecks at each stage of the pharmaceutical value chain—from discovery to post-marketing—present opportunities to reengineer an innovation pipeline that has fallen short.
Concerns about a dearth of antibiotic innovation have spurred calls for incentives to speed the development of new antibiotics. The data from this study suggest that policymakers should be focused on the clinical quality of the new drugs, not just the raw number of new drugs introduced to the market each year. In other words, quality over quantity should be the focus.
