One World, One Health

Send us a text

Children under five years old are fragile. They’re more vulnerable than adults to malaria, pneumonia, diarrhea, and other infections. A growing number of these infections that sicken and kill children are resistant to the drugs developed to treat them – a phenomenon known as antimicrobial resistance, or AMR.

AMR is a big killer. Nearly five million deaths are caused in part by drug-resistant infections each year. While the percentage of children killed by these infections has fallen greatly since 1990, hundreds of thousands still die. 

Vaccines can help.  So can infection control measures as simple as handwashing routines. Patients everywhere also need to be able to get the best antibiotics to treat their infections at the right time. These infections are often more difficult to treat in low- and middle-income countries in part because they have fewer staff to clean and to care for patients, less access to effective antibiotics, and crowded neonatal units, which can worsen the spread of germs.

In a special edition of One World, One Health recorded for AMR Awareness Week, we spoke with Dr. Heather Finlayson, a Pediatric Infectious Diseases Specialist at Stellenbosch University’s Tygerberg Hospital in Cape Town, South Africa.

Listen as she tells us about her struggles fighting drug-resistant superbugs in the youngest of children.

Send us a text

Smallpox may be gone but it’s got a cousin called mpox, and that virus is now spreading fast across parts of Africa.

As of October 2024, this mpox outbreak had infected more than 40,000 people, mostly in the Democratic Republic of Congo, according to the Africa Centres for Disease Control and Prevention. More than 1,000 people have died from the infection. The World Health Organization (WHO) declared mpox in the Democratic Republic of Congo and neighboring countries to be a Public Health Emergency of International Concern in August 2024.

Officials are distributing smallpox vaccines to try to control it. The viruses are closely enough related so researchers believe that modern smallpox vaccines can protect people safely against mpox. But the rollout is slow.  It’s not clear why the virus has started spreading in households, but it’s infecting and killing more and more children.

To make matters worse, people are desperate for medicines to prevent infection and help treat symptoms, which include fevers and a rash. They’re seeking antibiotics, which cannot treat a virus. This inappropriate use of antibiotics can drive drug resistance.

This is the second time mpox has been declared a public health emergency by the WHO since 2022. A slightly different strain of mpox has been spreading since then through close contact, often sexual and often among men who have sex with men. Mpox is even now showing up in new cities and countries in North America and Europe.

Nodar Kipshidze, Senior Research Analyst at the One Health Trust, says the virus spreads easily because people often don’t know they have it. It’s also not clear where it originally came from, although small rodents and other mammals can spread it. In this episode of One World, One Health, Nodar tells us mpox is causing a lot of confusion, and we need to ensure we learn from previous outbreaks and share resources globally to stop the spread and save lives.

Send us a text

Farmers need land to grow their crops, and in many parts of the world, that means clearing forests. That’s especially true in the Amazon region in South America. Crops just won’t grow under the thick forest canopy, so a new banana plantation means clearing trees. This has all sorts of effects on the ecosystem and researchers are seeing a new one.

A virus called Oropouche was identified back in the 1950s, but it was pretty rare. Like so many viruses, it causes headaches, body aches, fever, and other unpleasant symptoms. What’s most unusual about Oropouche is that it’s most often carried by midges – small, biting flies, more difficult to see than mosquitoes. All of a sudden, Oropouche has started spreading and infecting more people than ever before and it has been detected in new countries. The virus has also started to kill people in Brazil and there's some evidence it may affect the fetuses of pregnant women.

So what’s going on? Dr. Daniel Romero-Alvarez has an idea. He’s found Oropouche appears in places where forests have been cleared. The change in land use may be making new and better places for the midges that spread the virus to breed, he says. “Midges loves banana and cocoa plantations,” adds Romero-Alvarez, a medical doctor and epidemiologist at Universidad Internacional SEK in Quito, Ecuador. And the movement of humans and other animals that can carry this virus means that we may be hearing more about Oropouche in the future. Listen as he tells One World, One Health what he’s learned about this once-rare virus.

Send us a text

Most people don’t even think twice when they get an infection. Much of the time, the best treatment is simple: fluids and rest. Bacterial infections can be treated with antibiotics – a quick course of pills, maybe a week or 10 days, and you’re done.

But the rise of drug-resistant pathogens is changing that. These germs (viruses, bacteria, parasites, and fungi) have developed the ability to survive even the strongest of antimicrobial drugs. This phenomenon is known as antimicrobial resistance or AMR.

Drug-resistant infections just from bacteria play a role in close to five million deaths a year. That’s five million people. One of those people was a promising, intelligent young woman named Mallory Smith. An honors student, athlete, and writer, Mallory was just 25 when she died. She had cystic fibrosis, but what killed her was a superbug infection she had caught when she was 12. This happened even after getting a lung transplant.

Now Mallory’s mother, Diane Shader Smith, is telling her daughter’s story to the world. She wants people to know about Mallory and about the threat of antimicrobial resistance. She’s also collecting the stories of other people who have been made victims of this growing threat to humanity because she understands the difference stories make in ensuring people understand the gravity of antimicrobial resistance.

Listen as she tells One World, One Health about her daughter’s struggles and about her own hopes for the future of humanity.

Send us a text

Rosemary Bartel had no idea her life was going to take a turn when she went to a hospital near her home in Chilton, Wisconsin in the United States for standard knee replacement surgery – her second such operation. She was ready to work hard to recover and return to her busy job at her Roman Catholic diocese. But Rosie developed an all-too-common infection known as MRSA—methicillin-resistant Staphylococcus aureus. It’s one of the best-known examples of antimicrobial-resistant microbes, often called superbugs. The United Nations is devoting a high-level meeting to the problem in September 2024 in the hopes of getting nations to do more to fight antimicrobial resistance, also known as  AMR.

Now, 15 years later, Rosie has had her leg and hip amputated because the infection got into her bones. She has suffered numerous other infections, been in comas, experienced sepsis, lost her job, lost her health insurance, and lost most of the life she had loved.

“I will probably be paying hospital bills for the rest of my life,” Rosie tells One World, One Health. Rosie is one of the luckier victims of AMR. She’s still alive. Five million people a year die from complications caused by these drug-resistant germs. Today, Rosie shares her story as widely as she can as part of the Patient Family Partners Network, a group of patient advocates working to improve healthcare in the United States, and the Leapfrog Group, a nonprofit patient safety advocacy organization. She’s also written a book, “Rosie’s Story,” about her experience with this devastating and unending infection. 

Listen as Rosie describes what happened to her and what she hopes to do to help stop it from happening to others.

Send us a text

Dr. Nour Shamas knows about antimicrobial resistance. As a clinical pharmacist, she was trained in how to dispense drugs to treat infections, and her graduate studies in global health policy made her aware of the threat of antimicrobial resistance, or AMR. 

Antimicrobial resistance develops when bacteria, viruses, fungi, or parasites evolve the ability to shake off the effects of drugs developed to fight them. It’s one of the biggest threats to humanity – such a serious threat that the United Nations General Assembly is holding a meeting devoted to the subject. Shamas helps lead the Antimicrobial Stewardship Program at the Ministry of National Guard Health Affairs in Jeddah and Riyadh, Saudi Arabia. She knows about the need to preserve the drugs that still work against the many infections that threaten human life. 

But the issue of AMR got personal for her when her mother developed a urinary tract infection after surgery and a hospital stay. Shamas found herself working with her mother’s doctors, and battling to explain to her mother how she could have developed such an infection in the first place. She also found herself fighting to get the right treatment for her mother, who lives in Lebanon, a country struggling with economic challenges, conflict, and a fragile, underfunded, and overloaded healthcare system. 

Now, as a member of the World Health Organization’s AMR Survivors Task Force, she tells the story of how her mother still fights recurrent infections. Listen as she shares some of her story with One World, One Health. 

Send us a text

Urinary tract infections (UTIs) are common, uncomfortable, and embarrassing. They can also be deadly. These infections of the kidneys, bladder, or urethra affect about 1 in 10 men in their lifetimes and more than half of women. Untreated UTIs can cause a body-wide infection known as sepsis. An estimated 236,000 people globally die every year from UTIs.  

Most UTIs are fairly easy to treat with antibiotics. However, a quarter to a third of urinary tract infections (UTIs) are caused by drug-resistant bacteria. That makes them much more difficult to treat. 

There’s no easy test to tell medical professionals whether an infection will be easy to treat with readily available antibiotics, so they often have to make their best guess. Using the wrong antibiotic to treat any infection can delay recovery and help germs evolve drug resistance. 

Sweden-based Sysmex Astrego developed a test that works in 45 minutes to help determine what type of germ is causing a UTI and which antibiotic should be used to treat it.  

Challenge Works, which awards prizes to encourage solutions to hard problems in global health, climate, technology, and other areas, has awarded Sysmex Astrego the Longitude Prize to help the company develop and commercialize the test. 

“The winning test will be transformational for infection diagnosis and treatment, providing accurate antibiotic susceptibility results in 45 minutes – compared to the 2-3 day wait patients currently face,” Challenge Works says. 

In this episode of One World, One Health, Jasmin Major of Challenge Works explains why diagnostic innovations like this are so important. 

Read more about the One Health Trust’s work on antimicrobial resistance here. 

Send us a text

No one wants to be exposed to air pollution. No one wants to raise their kids breathing in polluted air in their own neighborhoods.

But in Austin, Texas, people of color are disproportionately forced to do both.

Dr. Sarah Chambliss, a research associate in the Department of Population Health at Dell Medical School at the University of Texas at Austin, led a team that ran a study of who is being affected by air pollution in Austin, neighborhood by neighborhood.

They found that while Austin has relatively little of the heavy industry traditionally linked with air pollution, it’s got plenty of polluted air. And the people living in the worst affected neighborhoods were far more likely to be Black or Latino(a) than White, they report in the American Journal of Respiratory and Critical Care Medicine.

It’s not just unpleasant. People living in polluted areas are much more likely to end up in emergency rooms for asthma attacks. That’s expensive for everyone because in the United States hospitals must treat people coming to emergency rooms in distress and those costs are passed along to taxpayers as well as to health insurers – who pass along those expenses to customers.

Aside from hurting people of color more than others, air pollution is costing everyone –in this case, residents of Austin– a lot of money, Chambliss tells One World, One Health host Maggie Fox. Listen as Chambliss explains what else she and her team found, and what can be done to address the problem.

Send us a text

People don’t want to see any more pandemics, notes Nita Madhav, Senior Director of Epidemiology & Modeling at Ginkgo Biosecurity, the biosecurity and public health unit of Ginkgo Bioworks.  

The world is collectively traumatized by the horrors of the COVID-19 pandemic, Madhav says in this episode of One World, One Health. 

But just because we don’t want to see another pandemic doesn’t mean we won’t get one. The world isn’t doing enough to keep an eye out for the next one, says Madhav. 

“Covid was a trial run for something that could be a lot worse. It was really a wakeup call that we need to have better systems in place,” she says.

In any given year, she estimates, there’s a two to three percent chance of a pandemic. But human behavior is raising those odds. More frequent travel is one factor; so is climate change. 

What’s she watching most closely right now? H5N1 bird flu. “The more it spreads within mammals that gives it more chances to mutate. As it mutates, as it changes, there is a greater chance it can infect humans. If it gains the ability to spread efficiently from person to person, then it would be hard to stop.” 

Listen as Madhav tells One World, One Health about how she measures these risks and what the world needs to be doing to watch for and to reduce these risks. 

Send us a text

Drug-resistant bacteria are major killers, playing a role in killing five million people a year. Antibiotics were miracle drugs when they were invented 100 years ago, but they are losing their power against always adapting and evolving bacteria. 

At the same time, the market for new antimicrobial drugs has collapsed. Hardly anyone wants to make new antibiotics, and even fewer companies want to make new diagnostic tests or vaccines for drug-resistant infections. 

While the profit motive works well for most diseases – cancer therapies rake in about $200 billion a year – the market for antibiotics was just $8 billion in 2021. 

“We have to accept that there is no money in antibiotics,” says Dr. Ursula Theuretzbacher, who founded the Center of Anti-Infective Agents in Vienna, Austria. 

Only 12 new antibiotics have been launched since 2017, almost all of them variations of existing drugs. 

“What we really need are completely new approaches,” Theuretzbacher says in this episode of One World, One Health. 

She helped write one of a series of papers in the Lancet medical journal looking at the problem, and aiming to set the tone for a high-level United Nations' meeting on antimicrobial resistance (AMR) in 2024. 

“The increasing number of bacterial infections that are no longer responding to any available antibiotics indicate an urgent need to invest in—and ensure global access to—new antibiotics, vaccines, and diagnostic tests,” Theuretzbacher and her team write. 

Listen as Theuretzbacher tells One World, One Health about some new approaches that may work to bring badly needed new drugs, vaccines, and diagnostic tests to the world. 

Check out our other podcasts about the problem of antimicrobial resistance, or AMR, and the Lancet series, including this one with Dr. Iruka Okeke and this one with Aislinn Cook.