One World, One Health

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Infectious diseases are the second leading cause of death worldwide, killing tens of millions of people every year. COVID-19 alone has killed more than 6.8 million people, according to Johns Hopkins University. Drug-resistant superbugs directly kill 1.27 million people a year, according to one recent prominent study.

Surely drug companies are all over this potentially lucrative market, with so many diseases to fight and treat?  However, they aren’t. The US Food and Drug Administration has not approved a new antibiotic since 2019, and only one truly new antibiotic has been approved since 1987.

It’s partly because the money just isn’t there. Companies making cancer drugs raised about $7 billion in funding in 2020, while companies making antibiotics raised a fraction of that – just $160 million. Plus, it’s hard to bring a new drug to market. The National Institutes of Health estimates 90% of experimental drugs never even make it to testing in humans.

In this episode, we are chatting with Kevin Outterson, a professor of law at Boston University and the founding Executive Director and Principal Investigator of Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator or CARB-X, a global nonprofit partnership funded by the U.S., U.K., and German governments; Wellcome; and the Bill & Melinda Gates Foundation.

Professor Outterson argues that antibiotics should be treated as infrastructure, and companies making new drugs to fight antimicrobial-resistant bacteria, viruses, and fungi –often called superbugs – should be treated as vital government contractors and paid upfront for the work they do that could save tens of millions of lives. Listen as he describes the problem, and potential solutions, with One World, One Health host Maggie Fox.

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Lemurs are cute and interesting, and they live in only one place: Madagascar.  As primates, they are related to humans, monkeys, and apes. They are also endangered. 

Dr. Travis Steffens has wanted to help save lemurs since he was a little boy. On the way to living that dream, he found out that he couldn’t save these animals without also helping the people and the environment. His charity, Planet Madagascar,  works to save lemurs and improve the lives of people who live with and near them.

In this episode, host Maggie Fox chats with Dr. Steffens, Assistant Professor in the Department of Sociology & Anthropology at the University of Guelph. Listen as he describes how lemurs are more than just adorable animals.

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Can a picture lie? They can and do – especially when they are used out of context. And photographs and other imagery are regularly abused when it comes to illustrating global health. Available images illustrating disease outbreaks, refugee needs, and even benign public health campaigns routinely show Black and Brown people far more often than they do light-skinned residents of wealthy Western nations. Misery is almost always associated with color.

Dr. Esmita Charani of the University of Liverpool and of the Division of Infectious Diseases and HIV Medicine at the University of Cape Town, tired of seeing this, did something about it. She and colleagues got the hard data about how public health imagery over-represents the global South. Her work got some attention and sparked some action. The Lancet is now changing the way it uses those images.

In this episode of One World, One Health, host Maggie Fox chats with Esmita about how this imbalance happened in the first place, how it’s harmful, and what can be done about it.

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From Ebola outbreaks in Africa to the spread of mpox and, of course, COVID, a disease that emerges in one place can threaten people the world over. Governments, nonprofit organizations, and pharmaceutical companies all get involved in detecting and fighting these outbreaks, but there’s another player that flies under the radar.

The US military has to prepare and protect personnel and their families, and they don’t keep their work to themselves. Just outside of Washington DC, Ft. Detrick houses a series of laboratories where military and civilian scientists and technicians work together to predict what the next outbreak might be – and to help defend against it.

At the US Army Medical Research Institute of Infectious Diseases (USAMRIID), researchers do the basic science of developing vaccines, diagnostic tests, and treatments for dangerous germs. In this episode, we visit the labs and speak with Dr. John Dye, deputy director of the Foundational Sciences Directorate at USAMRIID, who tells host Maggie Fox about the threats facing the world, and why the US military is involved in fighting them.

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Antibiotics can be wonder drugs. Not only do they save lives, but they can also make farm animals fatten up more quickly. But their overuse hurts everyone as the germs they are designed to kill evolve more and more defenses, giving rise to superbugs that infect people and animals alike.

The ROADMAP project aims to find better ways to help farmers and food producers use fewer antibiotics. In this episode of One World, One Health, we’re chatting with Dr. Nicolas Fortané, a senior researcher in sociology at the French Institute for Agricultural Research, part of Paris-Dauphine University.

He’s working to understand the relationships that lead to the continued overuse of antibiotics. It’s one thing to ask farmers and veterinarians to lay off these useful drugs but quite another to expect them to lose their livelihoods if they try.

Listen as Dr. Nicolas Fortané explains what he has learned about what works.

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Can you make a difference for the planet and for your own health if you wait an extra year to update your smartphone or get a new laptop computer?

You can if it means using fewer electronics products that are loaded with toxic metals, says Dr. Dele Ogunseitan, a professor of population health and disease prevention at the University of California Irvine.

In this episode of One World, One Health, Dr. Ogunseitan talks about how even the best-laid plans for recycling electronic products can go awry, and what the consequences can be if TVs, smart appliances, or tablets get into landfills. “Waste should not be endangering your neighbors,” he says.

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Antimicrobial resistance is one of the biggest threats people worldwide are fighting – sometimes without even knowing it’s a threat. But germs that have evolved to resist the effects of the drugs used to fight them directly kill more than a million people a year, and they’re a factor in the deaths of close to a million more.

And women are far more likely to be infected with and then to spread these drug-resistant superbugs.

In this episode of One World, One Health, we’re chatting with Dr. Deepshikha Batheja, an economist and postdoctoral fellow at the One Health Trust. Research has shown that women are 27% more likely than men to be given antibiotics, and Dr. Batheja is researching why that might be – and what can be done about it.

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Disease outbreaks are inevitable. Germs are part of our world, and there’s no way to completely eradicate them.

But epidemics and pandemics are preventable. Vaccines, better treatments, hygiene, improvements in ventilation, and teaching people how diseases spread can all give individuals and communities the tools they need to contain disease outbreaks before they turn into epidemics and pandemics. Trust in public health and in the governments that administer public health measures is key to making them work.

In this episode, Dr. Tom Frieden talks to host Maggie Fox about epidemics that were prevented and how they were stopped. 

Dr. Frieden is the President and CEO of Resolve to Save Lives and a former director of the US Centers for Disease Control and Prevention.

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Imagine catching an infection that could once be cured with a few pills. But the bug causing your infection has evolved, and now that bottle of pills is useless – and even treatment in a hospital, with drugs dripped in through an IV, isn’t helping.  With the emergence of drug-resistant superbugs, this terrifying scene is playing out worldwide, but the greatest burden is faced in low- and middle-income countries.

These bacteria, viruses, and fungal infections cost lives, money, and effort. And sometimes, money – even a lot of money – cannot help. 

In this episode of One World, One Health, Dr. Loice Ombajo, Infectious Disease Specialist and Senior lecturer at the University of Nairobi, tells host Maggie Fox about what she and her colleagues are doing to fight these threats.

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Grandmothers are a source of wisdom, support, and influence in most societies around the world. In much of the West, the emphasis is on youth, and western-based groups trying to help people in other parts of the world forget that most cultures rely on extended families.

Dr. Judi Aubel, Director of the Grandmother Project, noticed early in her career in public health, adult education, and anthropology that key members of communities were being left out of discussions – the grandmothers. Public health organizations were in effect pitting the grandmothers against the younger generation – and then wondering why their efforts to change practices such as genital mutilation were failing. 

In this episode, Dr. Aubel chats with us about what her research has shown about the consequences of ignoring culture in international aid efforts, and how bringing Grandma Power to bear as part of the One Health approach can make a difference.