Bill Gates: world faces decade at risk from antibiotic-resistant bugs

People across the world, particularly those in developing countries, face a decade at risk from pandemics spread by antibiotic-resistant bugs, the billionaire Bill Gates has warned.

Gates, who made his fortune with the Microsoft Windows operating system before becoming a philanthropist, said the success of antibiotics had created complacency that was now being exposed by the rise of microbial resistance to the drugs.

“I cross my fingers all the time that some epidemic like a big flu doesn’t come along in the next 10 years,” Gates told a special edition of Radio 4’s Today programme guest-edited by Dame Sally Davies, the chief medical officer for England.

“I do think we will have much better medical tools, much better response, but we are a bit vulnerable right now if something spread very quickly like a flu that was quite fatal – that would be a tragedy and new approaches should allow us to reduce that risk a lot.”

Gates said it was crucial for wealthier countries to step in to help the developing world fight disease, both for humanitarian reasons and for their own health security.

Although mistakes were made, criticism of the World Health Organisation (WHO) during the Ebola crisis in west Africa was unfair, he said, because it was not funded or staffed to do all the things that observers wanted it to do.

International cooperation had led to the eradication of smallpox, and was on the verge of eradicating polio, he added.

“The cooperation that we have seen, I think, needs to intensify,” Gates said. “It’s the only way that global problems like epidemics will get solved and so [for] all the people who are negative on WHO, the message to take away from that is not that that kind of multilateral cooperative effort is doomed and the money is not well spent, rather that we actually need to broaden their capacity. We actually need to dedicate ourselves to this global cooperation.”

In September the UN secretary general, Ban Ki-moon, warned that antimicrobial resistance was a “fundamental threat” to global health that risked making high quality universal healthcare impossible.

It is estimated that more than 700,000 people die each year from drug-resistant infections, though it could be much higher because there is no global system to monitor the figures. There has also been difficulties in tracking death tolls even in places where they are monitored, such as the US, where tens of thousands of deaths have not been attributed to superbugs, according to a Reuters investigation.

The European Centre for Disease Prevention and Control reported in November that illnesses resistant to so-called last-line antibiotics – drugs kept in reserve for use against pathogens that have proved resistant to all other antibiotics – were on the rise in the continent.

Without them, some infectious diseases could become untreatable and some forms of major surgery would again become perilous.

Davies said Britain’s health service was well placed to handle a flu pandemic, although it would still take as long as six months to “produce enough vaccine to start putting it into people”. She was less optimistic about how resilient the rest of British society would be to an outbreak.

“It’s not just the NHS,” she said. “It’s how would our social care system cope with people who aren’t ill enough to be in hospital but need extra support? It’s how would our economy cope if a large proportion are too ill to work? When we have a just-in-time ordering policy for delivery of food, petrol, whatever.

“And if you think about the issues that could happen here if we had a recurrence of the 1918 type flu, then what would it be like in middle- and low-income countries where they don’t have the health systems to look after the patients?”

Bill Gates: world faces decade at risk from antibiotic-resistant bugs

A decade of deadlock over Alzheimer"s treatment may be drawing to a close

When Terry Pratchett was diagnosed with Alzheimer’s he recalled his wife’s relief that he hadn’t got a brain tumour. “All I could think then was, ‘I know three people who have got better after having a brain tumour. I haven’t heard of anyone who’s got better from Alzheimer’s,’” the late author wrote in 2008.

Nearly a decade on, not much has changed for people facing a new diagnosis of Alzheimer’s. Unlike patients with heart disease, cancer or diabetes, there is no well-trodden medical track to follow and no treatments that can slow the disease’s devastating progress.

Between 2002 and 2012, 99.6% of drugs studies aimed at preventing, curing or improving Alzheimer’s symptoms were either halted or discontinued. The consistent failure of trials, at vast financial cost to drugs companies, caused many to shut down dementia programmes as a result.

The latest trial results from Merck, together with other drugs in the final stage of development, provide hope that the years of deadlock may be drawing to a close.

The Merck trial may be preliminary, in the clinical sense, but it represents an entire career’s work for some of the scientists involved. “We’re 16 years into the program,” said Matt Kennedy, the neuroscience director at Merck who led the research. “It’s a good example of how long it takes.”

How BACE1 blocking drug could reduce toxic proteins in Alzheimer’s patients.

The first challenge scientists faced was creating a compound that would get through the blood-brain barrier, without also causing toxic side-effects or damaging healthy structures in the brain. Simply optimising the structure of the compound to do this took a decade, Kennedy said.

The latest results appear to show that the scientists got this bit right – the drug appeared to have few side-effects and it substantially lowered levels of toxic amyloid compounds.

The real question, which the next phase of the trial should answer, is whether the formation of plaques are a root cause of the disease or simply a visible symptom. Previous drugs aimed at clearing abnormal tangles of proteins from the brain have not been successful, and some argue that by the time the plaques are present irreparable brain damage may have already occurred.

It is possible that previous drugs based on the so-called amyloid hypothesis, were given to patients whose disease was too far advanced for them to benefit. Merck hopes that its drug, which acts at an earlier stage in the disease process by shutting down the production of the misshapen proteins rather than clearing them once they appear, will fare better.

There is no guarantee that the drug will ultimately make it to market, but in a field that has seen such scant progress, the fact that a major clinical trial is underway is welcome news.

Professor John Hardy, a neuroscientist at University College London and pioneer in the study of Alzheimer’s disease, said: “Conveying some excitement isn’t the wrong thing to do in this case.”

A decade of deadlock over Alzheimer"s treatment may be drawing to a close

Hospital admissions for drug-related problems reach decade high

More people are ending up in hospital with physical or mental health problems related to drug use than at any time in the past 10 years, despite an overall fall in the number of people using illegal drugs, figures show.

There were 14,279 cases of people admitted to hospital with a primary diagnosis of poisoning by illicit drugs in England in 2014-15, the latest year for which figures are available – a 57% rise since 2004-05 and up 2% year on year.

Drug use in past year

At the same time, 74,801 hospital admissions resulted in a primary or secondary diagnosis of drug-related mental health and behavioural disorders, a 9% rise over 2013-14 and more than double the level of 10 years ago, according to the data from the Health and Social Care Information Centre (HSCIC).

Related: The war on drugs is failing – decriminalisation is the only way forward | Amanda Feilding

The figures will prove uncomfortable for policymakers who say they are keen to minimise the harm caused by drugs in society, particularly with separate data from the crime survey of England and Wales, also published on Thursday, showing a continued decline in drug use. Despite that, deaths from drug poisoning are at an all-time high.

Shirley Cramer, chief executive of the Royal Society for Public Health (RSPH), which last month called for the decriminalisation of drugs, said the contrasting figures showed up UK drugs policy as a “continued failure”.

She said: “Despite falls in use, more people are dying and suffering serious harm to their health from drug misuse than ever before. This is largely a result of a drugs policy that has over-focused on criminal justice at the expense of public health, pushing the most vulnerable users to the margins of society and discouraging them from coming forward for treatment and support.

“Across the globe, many countries have started to turn this situation around by decriminalising drug use and moving towards policies based on public health and harm reduction. Given yet more evidence that harm to the public is increasing, the time is now right for the UK to adopt a new approach to drugs policy.”

Deaths from drugs

The HSCIC data showed that adults between the ages of 16-34 were the most likely to end up up in hospital for drug poisoning, with that age group constituting 45% of cases. Slightly more than half – 54% – of those admitted were men. Blackpool borough council had the highest rate of admissions, with 103 per 100,000 of population.

Drug poisoning rates

Among those admitted to hospital with primary or secondary diagnoses of drug-related mental health and behavioural disorders, most (59%) were aged between 25-44, and 69% were male. Liverpool had the highest rate of admissions, with 444 per 100,000 population. Overall, the north-west had the highest hospital admissions for drug-related problems of any English region.

Mental-health rates

Increases in hospital admissions for drug-related problems mirror a soaring rate of drug deaths which was first reported by the Office for National Statistics last September and was highlighted again in the HSCIC report on Thursday.

Coroners attributed 2,248 deaths to drug misuse in 2014, the latest year for which that data is available, an increase of 15% on 2013. The figure represents a 44% rise from 2004 and the highest number of drug deaths since at least 1993, when comparable records began.

But Paul Hayes, chief executive of Collective Voice, an umbrella group for third-sector substance misuse services, said that merely blaming the increase in deaths on austerity cuts to drug treatment was simplistic. A number of factors including increased availability of strong heroin and an ageing population of drug users was to blame for the increase in deaths, which Hayes said was more a “return to trend” than a dramatic escalation.

“It isn’t use that’s driving it, it’s age and vulnerability,” Hayes said. “Their lung function is shot to pieces, their livers are shot to pieces, their hearts aren’t very good. So [with] the same behaviour in terms of using drugs that they could get away with when they were 25, when they’re 45 they keel over and die.”

Hospital admissions for drug-related problems reach decade high

Prescriptions for Ritalin and other ADHD medication double in a decade

Nearly a million prescriptions for Ritalin and relevant drugs for consideration deficit hyperactivity disorder (ADHD) have been dispensed last yr – more than double the quantity of a decade ago.

The figures have prompted a damning indictment of the method from authorities who declare that the operating down of mental well being companies has led to kids getting misdiagnosed and inappropriately prescribed drugs.

There have been 922,200 prescriptions last yr for methylphenidate hydrochloride, the chemical name for Ritalin, and equivalent merchandise. In 2010, 661,000 were dispensed compared with 359,a hundred in 2004. Tips from the National Institute for Wellness and Care Excellence suggest that the use of these medicines should only be a last resort. There have been repeated warnings from experts that clinicians were as well readily prescribing psychostimulants to youngsters when the evidence recommended there have been no long-term advantages. Animal research have also raised issues over the likely for harm.

Tony Lloyd, chief executive officer of the ADHD Foundation, which provides assistance for kids with the condition, mentioned children had been getting let down by a money-starved technique. NHS paying on children’s mental well being solutions in England has fallen by more than 6% in real terms because 2010.

“The tips are clear that medication need to be dispensed as a final resort. But that is clearly not what is happening,” stated Lloyd. “They are prescribing since kid mental wellness providers are overwhelmed. There are quite handful of services like ours.

“There has been a 41% improve in the number of kids beneath the age of sixteen in just the final 5 years, and so the little spending budget for psychological well being solutions is currently being targeted on that.”

ADHD, which is suffered by effectively-identified figures this kind of as the world champion racing driver Lewis Hamilton and the actor Emma Watson, has signs this kind of as inattentiveness, hyperactivity and impulsiveness more than a sustained period.

The psychostimulants prescribed by medical professionals are believed to stimulate a part of the brain that adjustments mental and behavioural reactions.

Kate Fallon, chief executive of the Association of Educational Psychologists, explained medicines were currently being prescribed by “harassed paediatricians”.

She additional: “These figures present an exponential development.

“We hear stories of teachers who had no notion that a single of their pupils had ADHD till Mum appears with Ritalin. Conversely, we hear of teachers telling dad and mom, ‘We cannot deal with this little one, so you must go to the doctor’.”

ADHD is generally diagnosed between the ages of three and seven. It is believed to impact close to 5% of schoolchildren in the Uk. The surge in prescriptions to treat the issue mirrors the scenario in the US, in which there was an 83% improve in revenue of the drug in between 2006 and 2010.

The use of Ritalin for a yr would be likely decrease a child’s development by three-quarters of an inch. There is also proof that it can precipitate self-harming behaviour.

Prescriptions for Ritalin and other ADHD medication double in a decade

Half of new United kingdom cancer patients "can anticipate to live for another decade"

Chemotherapy bags in a hospital ward. Photograph: Christopher Thomond for the Guardian

Dramatic enhancements in cancer survival suggest that half of people diagnosed right now can count on to reside for at least ten years, according to the UK’s top cancer study charity – even though survival prices in the Uk nevertheless lag behind people of comparable western European countries.

New figures demonstrate excellent progress in the diagnosis and treatment method of cancer in excess of the last four decades, but accelerating in recent many years. In the 1970s, 50% of cancer patients have been surviving for just a single 12 months and just a quarter lived for 10, mentioned Cancer Analysis Uk. By 2005-06, 50% were living for 5 years and 46% for 10.

Nowadays, according to the most latest figures accessible (2010-eleven), 50% are predicted to dwell for at least ten years.

The figures come from the cancer survival group funded by CRUK at the London School of Hygiene and Tropical Medication, led by Professor Michel Coleman. “These outcomes come from in depth analysis of the survival of far more than seven million individuals diagnosed in England and Wales considering that the 1970s,” he said. “They demonstrate just how far we’ve come in enhancing cancer survival, but they also shine a spotlight on areas where considerably much more wants to be carried out.”

CRUK published the figures at the launch of what it described as an ambitious technique to guarantee that, in 20 years’ time, 3-quarters of all those diagnosed survive for at least 10 years.

“We know more about cancer than we ever have ahead of,” stated Harpal Kumar, chief executive of CRUK. “We feel the understanding we have acquired in excess of the last twenty years puts us in a amazing place to accelerate that progress. We want to see things move even quicker from right here on.

“We want 3-quarters of men and women who hear individuals words, ‘you have cancer’ also to hear the phrases, ‘but will not be concerned – you will be fine,’” he stated.

The statistics display that some cancer individuals have far better prospects than other folks. Ladies with breast cancer now have a 78% possibility of surviving for at least a decade – up from forty% in the 1970s.

Testicular cancer individuals have a 98% opportunity of surviving for 10 many years and the probabilities of individuals with malignant melanoma have risen from 46% to 89% because the 1970s.

Others are not so fortunate. Only 1% of men and women diagnosed with pancreatic cancer will survive for ten years and only 5% of lung cancer sufferers. Ten-12 months survival in oesophageal cancer is twelve% and for individuals with brain tumours it is 13%.

People four cancers will be a prime focus of CRUK’s efforts, said Kumar.

It has been identified since the Eurocare examine in 1995, carried out by Coleman’s group, that survival rates in the United kingdom lag behind people of comparable western European nations, and the gap still exists due to the fact, although the Uk has been bettering, so have the other folks.

“There is not a single explanation that accounts for the difference,” stated Coleman. His group did a detailed global benchmarking examine evaluating elements that could affect survival in Australia, Canada, Denmark, Norway and Sweden with the United kingdom, which was published in 2011. All had greater survival than the United kingdom except for Denmark.

“A single [of the concerns] is that cancer sufferers in Britain do have a tendency to get diagnosed at a later on stage than in other nations, but it was not correct for all cancers,” he explained.

Nevertheless, in some cancers, survival in the United kingdom was poorer at every stage, suggesting that investigation and treatment method in the United kingdom was not as very good as elsewhere.

Coleman pointed out that investment in the overall health services and in technologies such as CT and MRI scans has been reduce in the United kingdom in excess of the last 25 many years than in comparable European countries. The distinctions were not about medication, he mentioned. For most of the significant cancers, surgical treatment to eliminate the tumour is the most essential therapy.

CRUK’s new approach consists of making sure all patients are diagnosed at the earliest feasible second, when treatment method is much more probably to be productive. It also desires to velocity up the transition of new surgical techniques as effectively as medication from the lab to the clinic. And it will proceed to operate on avoiding cancer – notably by campaigning towards smoking. In cancer prevention, said Kumar, the single most essential concern was tobacco handle. “Roughly a single fifth of the adult population is smoking in the United kingdom,” he explained. CRUK would like to see a largely tobacco-totally free society, he additional.

CRUK ideas to improve its spending on study by 50% more than the up coming 5 to 10 years to support its ten-12 months method. One of the initiatives it programs to fund is a “grand challenge” scheme for researchers in academia and market in the Uk and overseas to locate answers to the most significant exceptional inquiries in cancer.

It also hopes to harness the UK’s strength in engineering and physical sciences with multidisciplinary awards to scientists in people disciplines investigating new methods to stop, diagnose or deal with cancer.

Half of new United kingdom cancer patients "can anticipate to live for another decade"