Avoiding infection has always been expensive. Some human populations escaped tropical infections by migrating into cold climates but then had to procure fuel, warm clothing, durable housing, and crops from a short growing season. Waterborne infections were averted by owning your own well or supporting a community reservoir. Everyone got vaccines in rich countries, while people in others got them later if at all. Antimicrobial agents seemed at first to be an exception. They did not need to be delivered through a cold chain and to everyone, as vaccines did. They had to be given only to infected patients and often then as relatively cheap injectables or pills off a shelf for only a few days to get astonishing cures. Antimicrobials not only were better than most other innovations but also reached more of the world’s people sooner. The problem appeared later. After each new antimicrobial became widely used, genes expressing resistance to it began to emerge and spread through bacterial populations. Patients infected with bacteria expressing such resistance genes then failed treatment and remained infected or died. Growing resistance to antimicrobial agents began to take away more and more of the cures that the agents had brought.

Globalization of the food supply has created conditions favorable for the emergence, reemergence, and spread of food-borne pathogens-compounding the challenge of anticipating, detecting, and effectively responding to food-borne threats to health. In the United States, food-borne agents affect 1 out of 6 individuals and cause approximately 48 million illnesses, 128,000 hospitalizations, and 3,000 deaths each year. This figure likely represents just the tip of the iceberg, because it fails to account for the broad array of food-borne illnesses or for their wide-ranging repercussions for consumers, government, and the food industry-both domestically and internationally. A One Health approach to food safety may hold the promise of harnessing and integrating the expertise and resources from across the spectrum of multiple health domains including the human and veterinary medical and plant pathology communities with those of the wildlife and aquatic health and ecology communities. The IOM's Forum on Microbial Threats hosted a public workshop on December 13 and 14, 2011 that examined issues critical to the protection of the nation's food supply. The workshop explored existing knowledge and unanswered questions on the nature and extent of food-borne threats to health. Participants discussed the globalization of the U.S. food supply and the burden of illness associated with foodborne threats to health; considered the spectrum of food-borne threats as well as illustrative case studies; reviewed existing research, policies, and practices to prevent and mitigate foodborne threats; and, identified opportunities to reduce future threats to the nation's food supply through the use of a "One Health" approach to food safety. Improving Food Safety Through a One Health Approach: Workshop Summary covers the events of the workshop and explains the recommendations for future related workshops.

Summary report published as technical document with reference number: WHO/HSE/PED/AIP/2014.2.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

An accessible overview of the challenges in tackling AMR, and the economic and policy responses of the 'One Health' approach. It will appeal to policy-makers seeking to strengthen national and local polices tackling AMR, as well as students and academics who want an overview of the latest scientific evidence regarding effective AMR policies.

This Open Access volume provides in-depth analysis of the wide range of ethical issues associated with drug-resistant infectious diseases. Antimicrobial resistance (AMR) is widely recognized to be one of the greatest threats to global public health in coming decades; and it has thus become a major topic of discussion among leading bioethicists and scholars from related disciplines including economics, epidemiology, law, and political theory. Topics covered in this volume include responsible use of antimicrobials; control of multi-resistant hospital-acquired infections; privacy and data collection; antibiotic use in childhood and at the end of life; agricultural and veterinary sources of resistance; resistant HIV, tuberculosis, and malaria; mandatory treatment; and trade-offs between current and future generations. As the first book focused on ethical issues associated with drug resistance, it makes a timely contribution to debates regarding practice and policy that are of crucial importance to global public health in the 21st century.

The increasing resistance of bacteria to antibiotics, and pests to pesticides, threatens to undo some of the most remarkable advances made in public health and agriculture during the past century. Though the potential consequences of increased antibiotic and pesticide resistance are far reaching, regulatory efforts to address the problem are at a very early stage. Battling Resistance to Antibiotics and Pesticides moves such discussions forward by presenting cutting edge research and the first comprehensive application of economic tools to analyze how antibiotics and pesticides should be used to maximize their value to society. Laxminarayan and his contributors explore lessons from past experiences with resistance, especially in agriculture. They consider what incentives would be ideal for the individuals who prescribe or apply antibiotics and pesticides, and what would be ideal for the firms engaged in developing and producing these products. The chapters in this groundbreaking book reflect the fact that efforts to combat resistance will require contributions from a broad range of scholars and professionals, representing a broad range of expertise. The analysis demonstrates that, for all these participants, an understanding of economic issues is an essential complement to knowledge of medical or biological factors. The book provides economists with an overview of relevant scientific issues, as well as a variety of analytical approaches to studying the economics of resistance. It offers policymakers detailed analyses of the multiple dimensions of resistance and discusses the future strategies to combat and manage resistance. For professionals in medicine, public health, and agriculture, the book translates the economic approaches into usable guidance for daily practice and decisionmaking.

Humans coexist with millions of harmless microorganisms, but emerging diseases, resistance to antibiotics, and the threat of bioterrorism are forcing scientists to look for new ways to confront the microbes that do pose a danger. This report identifies innovative approaches to the development of antimicrobial drugs and vaccines based on a greater understanding of how the human immune system interacts with both good and bad microbes. The report concludes that the development of a single superdrug to fight all infectious agents is unrealistic.

The National Strategy for Combating Antibiotic Resistant Bacteria, published in 2014, sets out a plan for government work to mitigate the emergence and spread of resistant bacteria. Direction on the implementation of this strategy is provided in five-year national action plans, the first covering 2015 to 2020, and the second covering 2020 to 2025. Combating Antimicrobial Resistance and Protecting the Miracle of Modern Medicine evaluates progress made against the national strategy. This report discusses ways to improve detection of resistant infections and estimate the risk to human health from environmental sources of resistance. In addition, the report considers the effect of agricultural practices on human and animal health and animal welfare and ways these practices could be improved, and advises on key drugs and diseases for which animal-specific test breakpoints are needed.

This open access book explores a special species of trouble afflicting modern societies: creeping crises. These crises evolve over time, reveal themselves in different ways, and resist comprehensive responses despite periodic public attention. As a result, these crises continue to creep in front of our eyes. This book begins by defining the concept of a creeping crisis, showing how existing literature fails to properly define and explore this phenomenon and outlining the challenges such crises pose to practitioners. Drawing on ongoing research, this book presents a diverse set of case studies on: antimicrobial resistance, climate change-induced migration, energy extraction, big data, Covid-19, migration, foreign fighters, and cyberattacks. Each chapter explores how creeping crises come into existence, why they can develop unimpeded, and the consequences they bring in terms of damage and legitimacy loss. The book provides a proof-of-concept to help launch the systematic study of creeping crises. Our analysis helps academics understand a new species of threat and practitioners recognize and prepare for creeping crises.