One World, One Health

Send us a textZombie movies may score at the box office and shows about dangerous contagions including “The Last of Us” may be a hit on streaming services, but preparedness for disasters is no winner for American politicians. Every recent U.S. presidential administration has dismantled the pandemic plan put together by the previous one, notes Dr. Asha M. George, Executive Director of the Bipartisan Commission on Biodefense. However, the cuts being made by the new Trump administration to the United States biodefense budget are going deeper than ever before. Global efforts to track diseases including Ebola virus and avian influenza have ended. Among the latest to fall under the axe: the Healthcare Infection Control Practices Advisory Committee (HICPAC), a federal advisory body to the Centers for Disease Control and Prevention (CDC), which had helped shape national infection prevention guidelines meant to keep hospitals safe and contain outbreaks. The loss of the U.S. Agency for International Development, USAID, has already begun devastating not only global health efforts, but also U.S. national security efforts, multiple experts say. And things were not in a good place to begin with, says George. “The biodefense community is in for the fight of its life to get the funding it needs,” she said in her latest report on biodefense. “It was starving before. It is going to be anorexic soon.” Listen as George explains to One World, One Health host Maggie Fox just what's at risk for the world if the United States doesn't start paying attention to biodefense. 

Send us a textThe scene on the beach was horrific. Thousands of mothers and baby elephant seals lay in the sand, taken out by a deadly virus.Dr. Marcela Uhart and her colleagues were shocked by what they found after the H5N1 avian influenza virus swept through a colony of elephant seals on the coast of Argentina's far south Patagonia region. More than 17,000 of the animals had died, their bodies ravaged by the virus.H5N1 bird flu has swept around the world, destroying poultry flocks and wildlife. Like other influenza viruses, it mutates constantly and swaps genetic material in a process called reassortment. It can now infect not just birds, but livestock such as cattle and sheep as well as mink, pet cats, sea lions, and human beings.It has devastated egg production and threatens dairy operations. The biggest fear is that it will acquire both the ability to spread from human to human and maintain its most deadly qualities. An H5N1 pandemic has the potential to be much, much worse than Covid-19 was.People can't be ready for the virus unless the world keeps an eye on it. That's what Uhart, who is Director of the Latin America Program at the Karen C. Drayer Wildlife Health Center at the University of California, Davis, is trying to do. That's why her team studied the bodies of the dead elephant seals and other animals killed by the virus.“Mammal-to-mammal transmission could be a stepping-stone in the evolutionary pathway for these viruses to become capable of human-to-human transmission,” they wrote in their report, published in the journal Nature.“What we can learn from what happens in wildlife is crucial,” Uhart says. “That is where these viruses evolve.”Listen as Uhart chats with One World, One Health host Maggie Fox about what her team discovered in Patagonia and what it might mean for every animal on the planet, including  humans.And listen to our other podcast episodes looking at H5N1 bird flu and how we should be preparing for the next pandemic.

Send us a textPlastic is everywhere. So are drug-resistant microbes.What happens when the two team up?A raft of new studies show that bacteria can grow well on plastics, especially on microplastics. Other studies show just how widespread microplastics are – they are found in every ocean and sea tested so far. The most startling studies show these tiny bits of plastics can also build up in the human body, including in the liver and brain.Science is done piece by piece, study by study, with no single study painting the whole picture. Now a team at Boston University has added one piece to the puzzle, with a study demonstrating that drug-resistant bacteria grow well on microplastics.Neila Gross, a PhD candidate at BU, helped lead the research. Her team confirmed that E. coli bacteria form mats known as biofilms especially well on microplastics. The team found that antibiotic-resistant bacteria grew better when they were grown on microplastics.This raises a specter of billions of tiny pieces of plastic spreading drug-resistant bacteria around the world and being ingested and breathed in by animals from shellfish to marine mammals and, likely, people.Listen as Neila chats with One World, One Health host Maggie Fox about how this happens and what it might mean for the spread of antimicrobial resistance.

Send us a textIt's been a dire year for global health. Almost as soon as he took office as president of the United States, Donald Trump said he would withdraw the country from membership in the World Health Organization (WHO), he fired almost everyone at the U.S. Agency for International Development (USAID), and slashed staffing and budgets at U.S. health agencies such as the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC). The United States government also says it plans to end funding for Gavi, the Vaccine Alliance, and has cut some funding for the United Nations World Food Program's efforts to feed millions of people in 14 countries.Before Trump, the United States was the largest donor to global health in the world, contributing about US$12 billion in funding. That's less than 1 percent of the United States federal budget. But the new administration claimed these efforts were wasteful, did not serve the country's interests, and cost too much. It's not clear who can or will fill the gaps.“I think we are going through a very dark time,” says Dr. Ramanan Laxminarayan, founder and president of the One Health Trust. But Dr. Laxminarayan, an epidemiologist and economist, does see some hope. He doubts the United States will permanently end its robust support of global health and he sees opportunities for organizations such as WHO to streamline and become more efficient.Listen as he chats with One World, One Health host Maggie Fox about the immediate effects of the startling new United States government policies and how he sees things shaking out in the long term.

Send us a textAir pollution is a big killer. Air pollution of all kinds helped kill 4.2 million people globally in 2019, according to the World Health Organization.It can damage nearly every organ in the body, worsening asthma and leading to cancer and heart disease. It especially affects pregnant women and can damage a growing fetus.Air pollution also has more insidious effects.Dr. Álvaro Hofflinger of Arizona State University and colleagues studied school children in a part of Chile where many people still rely on wood-burning stoves. They found the more air pollution children were exposed to, the lower their grades. It's another piece of evidence that can help parents, policymakers, officials, and health experts make decisions about where to focus their efforts in reducing pollution. In this episode of One World, One Health, host Maggie Fox chats with Dr. Hofflinger about what his team found, about the factors that cause this type of pollution, and what people might be able to do about it.They found it's not going to be such an easy problem to solve. Wood is cheap or free for many in parts of Chile, and electricity isn't. Old habits are hard to break. And clean energy is not always an uncomplicated choice for governments.  Give it a listen and check out some of our other episodes on air pollution and health.Learn from Dr. Sarah Chambliss about how people of color and in low resource neighborhoods are disproportionately affected by poor health due to pollution.Find out about the association between air pollution, depression, and pregnancy in our episode with Dr. Jun Wu. 

Send us a textIt's hard to overstate how popular writer John Green is. His most famous book, The Fault in Our Stars – a novel about teenagers with cancer, young love, and fate – has sold tens of millions of copies. The film based on the book brought in more than $300 million and it's still popular to this day.Green has become a YouTube star and leader of online communities of fans including Nerdfighteria, as well as a co-host of an annual fundraiser for Project for Awesome. He's also passionate about public health. Green is a member of the board of trustees for Partners in Health and posts regular videos about it.A trip to Sierra Leone in west Africa got Green interested in tuberculosis. Now he's written a book about that ancient disease: Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection.There are more characters than numbers in the book – from Henry, the charismatic young man John met who appears throughout the story, to the thin and pale women who once made people perceive TB as sexy (really). The book brings a star quality to an often-forgotten infection. Green hopes he can focus the attention of his dedicated audience on this leading global killer. His work to bring attention to TB comes at a dire time, as the incidence of drug-resistant TB grows and the U.S. government slashes funding for global TB care and research.In this episode of One World, One Health, John Green chats with host Maggie Fox about the book, why he wrote it, and what he hopes its publication will accomplish.

Send us a textPeople have always doubted science. In the 17th century, Galileo was sentenced to house arrest by the Catholic Church for reporting his observations that the sun is at the center of the solar system and that the other planets, including Earth, orbit it. In 1925, the U.S. state of Tennessee banned the teaching of evolution and when a high school teacher named John Scopes agreed to challenge the law, the Scopes “monkey” trial resulted. People did not like to think that they descended from monkeys – although that's not quite what the science of evolution shows.Now, the United States and much of the world seems to have regressed into another period when science is denied. This time, much of it centers around vaccines, although there is animosity toward many other public health measures. Climate science is likewise still under attack, decades after the scientific expert community settled the question of whether people's activities are changing the planet's climate.One of the scientists fighting back is Dr. Peter Hotez. Long a champion of fighting neglected tropical diseases such as Chagas disease and leishmaniasis, Hotez has evolved into an advocate for vaccination in general and for inexpensive, freely available vaccines in particular.He wrote a book, Vaccines Did Not Cause Rachel's Autism, that explains the disproven notion that vaccination might cause autism – using his own daughter's case history as an illustration. His latest book, The Deadly Rise of Anti-Science, looks at the history of attacks on science, the political and commercial motives of many of the attacks, and the often fatal results.The attacks have gotten very personal for Hotez, and they've worsened under the new Trump Administration in the United States. Now Hotez, who is Dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston, has become one of the most recognizable public faces in the fight to defend science. In this episode of One World, One Health, Hotez describes how he never expected to be cast as a “cartoon villain” when what he mostly wanted to do was help underprivileged people escape disease.SS

Send us a textMeasles is an extremely infectious virus that can both kill and cripple children. Luckily, there are highly effective vaccines to prevent the disease. The World Health Organization recommends that 95 percent of the population be fully vaccinated against measles because it's so contagious. This helps to ensure that vulnerable children and infants who cannot be vaccinated are protected.Yet vaccination rates are falling globally. The result? A 20 percent increase in measles cases between 2022 and 2023,  according to WHO and the U.S. Centers for Disease Control and Prevention. That adds up to more than 10 million cases. More than 107,000 people died from measles in 2023, mostly children. The problem is worse in some communities, especially where connections to the outside world are limited. One example: the Charedi community in London. Often referred to as ultra-Orthodox Jews, the Charedi often run their own schools and daycare centers and can fall outside the usual public health health system. Vaccination rates have fallen below 70 percent in some of these communities, according to UK health officials.It can be tricky to encourage people in isolated communities to get themselves and their children vaccinated. Sometimes it's simply a matter of logistics, and sometimes it's a matter of overcoming distrust, misinformation, and disinformation.Dr. Ben Kasstan-Dabush has been studying this problem while at the London School of Hygiene and Tropical Medicine. One solution he found: Make use of people from within the community to communicate. “I worked with clinical and community partners to produce a short clinic clip that can be screened in primary care waiting rooms,” he says. “It features the voice of a Charedi Jewish healthcare professional and mum.” Another success: coloring pages for kids that feature vaccination in a positive light and that use common Jewish names. Common-sense solutions include extending clinic hours so parents can attend outside working hours and religious holidays. Now a lecturer of global health policy at the University of Edinburgh, Dr. Kasstan-Dabush is continuing to study how people respond to public health outreach attempts around vaccination. Listen as he chats with One World, One Health about some of the reasons kids might not get vaccinated on time and ways to make it easier.

Send us a textGovernments and corporations are “undermining our future” by supporting fossil fuels in the face of overwhelming evidence that using coal, oil, and gas is killing people, a startling new report finds.The report, from the Lancet Countdown on Health and Climate Change, finds that in 2023 alone, more than double the number of people over 65 died from excessive heat compared to the 1990s. People living in every country around the world are now threatened by the effects of climate change. It's the latest in a series of reports showing the world is marching towards disaster.“We pull our hair out every year,” Dr. Marina Romanello, Executive Director of the Lancet Countdown: Tracking Progress on Health and Climate Change, tells One World, One Health. “One of the findings that shocked us the most was the enormous amount of public funding that gets poured into fossil fuels.”The report shows that oil and gas companies are making record profits and increasing production, driving up the emissions that are making the planet hotter and the weather more extreme and unpredictable.But there is hope, the report finds. More electricity than ever is being generated by clean modern renewables – up to 10.5 percent in 2021, twice as much as in 2016. And clean energy employed 13.7 million people in 2022.Listen as Dr. Romanello tells One World, One Health about the growing problems, how governments and companies are ignoring the warnings, and where hope still lies.

Send us a textChildren 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 textSmallpox 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 textFarmers 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.

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.

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 or 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, 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. Now, 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

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. 

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. 

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.

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. 

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.  

An estimated 7.7 million people die from bacterial infections a year around the world. A growing number of these deaths are caused by bacteria that have developed antibiotic resistance – the ability to thrive in the face of antibiotics. This ability of germs to defy the effects of drugs is called antimicrobial resistance, or AMR. But why wait to treat these infections after they've happened? It's far better to prevent them from happening in the first place. Dr. Joseph Lewnard, an associate professor of Epidemiology at the School of Public Health at the University of California Berkeley, is studying ways to prevent infections. Vaccines, better hygiene and sanitation, clean water, and proper and careful use of antibiotics and antivirals can all play a role. Many governments have done far too little to protect their citizens from infections, Lewnard says. “This has not necessarily been a shining success story,” he says in this episode of One World, One Health. He helped write one of a series of papers in the Lancet medical journal looking at the problem of drug-resistant superbugs. The numbers are significant. “Improving infection prevention and control in healthcare facilities including better hand hygiene and more regular cleaning and sterilization of equipment, could save up to 337,000 lives a year,” they write. They estimated that clean water and sanitation could save another quarter million lives each year.“Access to improved sanitation facilities (defined as toilets that are not shared with other households and are connected to piped sewer systems or septic tanks) reduces diarrhea incidence by 47 percent,” they point out. Listen as Dr. Lewnard explains some of the other findings to One World, One Health host Maggie Fox.  Learn more about the struggle to control drug-resistant bacteria, viruses, and fungi in some of our other episodes. We've spoken with experts about how vaccines can help prevent the spread of drug-resistant germs, about tracking superbugs in sewage, and the surprising rise of drug-resistant fungi. Experts in drug design have talked to us about the search for new and better antibiotics and how these little organisms are winning an arms race against us. Filmmakers have told us about how storytelling can help people understand the threat while global health specialists explained that good stewardship can keep the antibiotics we have working as they should. We've even investigated superbug mysteries, like the case of the killer eyedrops. 

The problem of antimicrobial resistance – AMR for short – is clear. More and more of these germs resistant to existing treatments are emerging everywhere, and there's little disagreement that governments, nonprofits, doctors, patients, and politicians all need to help tackle the problem.But people need to agree on what to do, and they need to agree on how to measure progress.That's where targets come in.Aislinn Cook, a senior research fellow in infectious disease epidemiology on the antimicrobial resistance team in the Centre for Neonatal and Pediatric Infection of St. George's University in London, is helping set some of those targets. Cook, who's also affiliated with the Health Economics Research Centre at the University of Oxford, has helped write a series of papers in the Lancet medical journal bringing attention to the problem of antimicrobial resistance. AMR is a big topic of international discussion in 2024, due in part to it being one of the topics of the United Nations High-Level Meeting, and the Lancet series was put together to help focus that discussion.Cook's paper proposes some clear targets to reach by 2030: a 10 percent reduction in mortality from drug-resistant infections; a 20 percent reduction in inappropriate human antibiotic use; and a 30 percent reduction in inappropriate animal antibiotic use.These goals should be achievable, Cook says. Listen as she tells One World, One Health about some concrete ways the world can work together to control the spread of drug-resistant germs.Learn more about the struggle to control drug-resistant bacteria, viruses, and fungi in some of our other episodes. We've spoken with experts about how vaccines can help prevent the spread of drug-resistant germs, about tracking superbugs in sewage, and the surprising rise of drug-resistant fungi. Experts in drug design have talked to us about the search for new and better antibiotics and how these little organisms are winning an arms race against us. Filmmakers have told us about how storytelling can help people understand the threat while global health specialists explained that good stewardship can keep the antibiotics we have working as they should. We've even investigated superbug mysteries, like the case of the killer eyedrops.

What kills more people than HIV or malaria? What threatens anybody on the planet – and not just people, but animals, too?It's antimicrobial resistance (AMR), the formal name for drug-resistant superbugs. These include bacteria that defy the effects of antibiotics, viruses that thrive in the face of antiviral drugs, and fungi that are immune to antifungal treatments.Each year, an estimated 7.7 million deaths are caused by bacterial infections, and nearly 5 million of these deaths are associated with drug-resistant bacteria. These infections include newborn babies, the elderly, and cancer patients, but also people who were young, fit, and healthy before they got infected.AMR is a major topic of discussion this year (2024) for the World Health Organization and it will take top billing at the United Nations General Assembly. To set the tone for all the discussion, the Lancet has published a series of four papers reviewing the problem and laying out some of the solutions. For the series, the One Health Trust's Dr. Ramanan Laxminarayan brought together experts from around the world to address the issue. Dr. Iruka Okeke of the Department of Pharmaceutical Microbiology at the University of Ibadan in Nigeria helped write the first of these papers. Dr. Okeke, a bacterial geneticist, points out that antimicrobial-resistant infections can happen anywhere – in hospital patients, in people leading their everyday lives, in farm animals, and in nature among wildlife.It's important to use antibiotics and other antimicrobial drugs properly, but also to make sure that people who need them can get the right antibiotics at the right time. It's especially important to keep an eye out for these drug-resistant superbugs, she said. Surveillance helps doctors know whether patients coming in can be treated with everyday antibiotics, or if they need special, usually more expensive, drugs.Skipping surveillance, she says in this episode of One World, One Health, is like playing tennis without keeping score. “If you play tennis and you are not keeping score, you are just practicing.”Listen as Dr. Okeke explains why we all need to do a better job watching out for these killer germs.Read more about the One Health Trust's work on antimicrobial resistance here.

The second wave of the COVID-19 pandemic was especially bad in India. Patients filled hospitals as the Delta variant swept the country in April of 2021. As many as 2,000 people died every day.Many died literally gasping for air. Although India is a major producer of medical oxygen, supplies ran out amid the unprecedented demand. And while some areas of the vast country had access to medical oxygen, there was no good system for transferring them to places with more need.It was a horrifying disaster as people who might otherwise have survived succumbed to COVID-19 or other conditions for lack of medical oxygen.India wasn't the only country with this type of crisis. Oxygen became a black market item in Peru, Supplies were rationed in the UK and patients lined up to fill empty oxygen cylinders in countries around the world, including Brazil, Somalia, and Indonesia. It should never happen again, says Varun Manhas, Associate Director of Public Health Programs for the One Health Trust. Varun is working to build a national oxygen grid for India and then share the blueprints with the world.The National Medical Oxygen Grid isn't what would come to mind for many. It's a cellphone-based app to help hospitals and health officials keep track of where medical oxygen is needed and where supplies are plentiful. The app could be used to make sure no one runs out of oxygen in future crises.You can hear more about the Global need for medical oxygen in this earlier episode of One World, One Health.

Vaccines save lives. There's no doubt about this: childhood vaccination saves four million lives every year, the US Centers for Disease Control and Prevention says. Children worldwide get a long list of vaccines, but what about adults?A study by the Office of Health Economics (OHE), an independent research organization, took a look at the cost-effectiveness of four commonly given adult vaccines: the influenza vaccine, pneumococcal vaccines that protect against a batch of respiratory infections, the herpes zoster vaccine that protects against shingles, and the RSV vaccine that prevents respiratory syncytial virus. To get a good idea of the value across different types of economies and cultures, they looked at 10 countries: Australia, Brazil, France, Germany, Italy, Japan, Poland, South Africa, Thailand, and the United States. On average, the report found, these 4 adult vaccines gave a 19-fold return, meaning that the benefits equaled 19 times the costs of vaccination. On average, it worked out to US$4,637 per person vaccinated. Some of the savings are direct – people didn't rack up hospital costs or miss work if they were vaccinated and evaded serious illness. Some savings were indirect. For instance, “receiving the influenza vaccine reduces the risk of having a stroke and subsequent hospitalization in older adults by 16 percent,” the report reads. “Cancer patients vaccinated with the influenza vaccine also had statistically significantly better survival outcomes, including longer progression-free survival rates and overall survival compared to unvaccinated patients.” One study cited in the report found that Italian adults vaccinated against flu were 13 percent less likely to die of any cause – not just flu, but any cause – over the 2018-2019 winter flu season than unvaccinated adults. In this episode of One World, One Health, Dr. Lotte Steuten, Deputy CEO of OHE and co-author of the report, chats about how her team came up with their findings.

Bird flu – aka avian influenza – is doing what it does best yet again – surprising scientists, public health officials, farmers, and wildlife experts. It's been spreading among dairy cattle in the United States, something that startles even long-term observers of the virus.The H5N1 strain of avian influenza was first noticed in the late 1990s and it immediately worried experts, who saw its potential to cause a pandemic. It infects many wild birds without causing them too much trouble, but they can spread it to domestic poultry, which often die en masse. It has occasionally spread to people – just under 900 since 2003 – according to the World Health Organization. But it's deadly when it does, killing half of these people. It's a perfect One Health issue – a disease that circulates among animals, spreads from one species to another, and then makes the jump to people. Farming practices, climate change, and the environment all play a role. Now it's shown up in Antarctica, and at least one person on a dairy farm has been infected. That surprised Dr. Richard Webby, Director of the World Health Organization Collaborating Centre for Studies on the Ecology of Influenza in Animals and Birds at St. Jude Children's Research Hospital in Memphis, Tennessee. He says H5N1, like so many flu viruses, is constantly changing and evolving. That's why it's so important to keep an eye on it. “If there is one virus I don't want to catch, this is it,” he says. Listen as Dr. Webby tells One World, One Health about what experts are working to find out about H5N1's latest moves.

Coral reefs are literally the foundation for much of the life on Earth. These living cities are made up of animals –coral – which exist in symbiosis with algae.They are home to thousands of species of fish, as well as important to the lives of as many as a billion people who rely on their production of food, their protection of coastal areas, and their attraction for tourists. They're ancient, too, and have survived for millions of years. But now coral reefs are under threat, from pollution, changing temperatures, and disease.  Alizée Zimmermann, executive director of the Turks & Caicos Reef Fund, says she was startled to see one particular disease, stony coral tissue loss disease, kill off 500-year-old corals in the span of a few weeks.Her organization has started to preserve coral species, maintaining them in a lab to save them for when they might safely be returned to the sea. It's a complicated project and they are racing against time to save species before they go extinct. It's too late for some. The United Nations Environment Program estimates that 14 percent of the world's corals died between 2009 and 2018. To stop stony coral tissue disease from killing off selected colonies in the ocean, Alizée's team has even had to apply a specially formulated antibiotic to save these creatures and the ecosystem they comprise. In this episode of One World, One Health, Alizée explains why corals are so important to everyone, and she talks about some of the creative ways she and her colleagues are working to save these animals that are so important to so many.

From the moment people discovered how to use penicillin, the first antibiotic, resistance has been a problem. Bacteria may be small, but they are not simple organisms and they have been fighting for survival for billions of years. Many bacteria have developed the tools they need to evade the effects of antibiotic treatments, and they can trade these weapons with other bacteria as they swap genetic material.Bacterial infections aren't new to humanity, and for more than two decades world health leaders have urgently warned about the threat of antibiotic resistance. Dr. Otto Cars is one of them. He is a senior professor of infectious diseases at Uppsala University in Sweden and the founder and senior adviser to ReAct – Action on Antibiotic Resistance.In this episode of One World, One Health, Dr. Cars says he has hope for turning around the impending dystopia of a world without antibiotics.Listen as Dr. Cars outlines the history of the fight against antibiotic resistance, and what he hopes its future might be.Learn more about the struggle to control drug-resistant bacteria, viruses, and fungi in some of our other episodes. We've spoken with experts about how vaccines can help prevent the spread of drug-resistant germs, about tracking superbugs in sewage, and the surprising rise of drug-resistant fungi. Experts in drug design have talked to us about the search for new and better antibiotics and how these little organisms are winning an arms race against us. Filmmakers have told us about how storytelling can help people understand the threat while global health specialists explained that good stewardship can keep the antibiotics we have working as they should. We've even investigated superbug mysteries, like the case of the killer eyedrops.

It's hotter and wetter than usual in Brazil, and climate conditions are driving an early blast of a killer virus – dengue. The mosquito-borne virus is spreading earlier than ever before and affecting far more parts of the country than usual – and all at once.Dengue's a nasty virus. It causes pain so severe that it's sometimes called breakbone fever. Patients often feel nauseated, develop rashes, and vomit blood. The most severe cases can cause internal bleeding. There's no specific treatment – just fluids and rest, and watching out for signs of shock, which can kill patients within hours.Dengue is unusual because there are four different types, known as serotypes. The first infection is often mild, but people are not immune to the other three serotypes after that first time. The second time someone gets infected, they are more likely to become seriously ill – a phenomenon called antibody-dependent enhancement. Sometimes a vaccine can cause this effect.Brazilian authorities are keeping this in mind as they rush to roll out vaccines to fight this unusually early and widespread epidemic of dengue, says Dr. André Siqueira, principal investigator at the National Institute of Infectious Diseases Evandro Chagas at Fundação Oswaldo Cruz, also known as FioCruz, in Rio de Janeiro.There are nowhere near enough vaccines yet – only six million doses this year, enough to protect just three million people with the two-dose regimen. Brazil's population is more than 200 million.Researchers at Brazil's Butantan Institute are working to develop a new vaccine that should protect people with just one dose and, they hope, will protect against all four serotypes of dengue.Dr. Siqueira is part of the team working on that new vaccine. Listen as he explains to One World, One Health host Maggie Fox why dengue is so bad in Brazil this year and what he and colleagues are doing to control it.

Peggy Lillis wasn't expecting trouble when her dentist prescribed antibiotics after she had a root canal in 2010. It was a standard, just-in-case treatment to prevent infections after the procedure.She also wasn't worried when she developed diarrhea soon afterward. The kindergarten teacher assumed she'd caught a bug from one of her young students.But within just a few days, the previously healthy 56-year-old was dead – a victim of Clostridioides difficile or C. diff. These bacteria are common but can grow out of control when antibiotics or other factors deplete the healthy microbes living in the intestines – the microbiome.Patients can suffer severe diarrhea, a distortion of the colon known as megacolon, and sepsis as the infection spreads to the bloodstream. It's painful and can be hard to treat.About one out of every six patients who get C. diff will get it again in the following two months, the U.S. Centers for Disease Control and Prevention says. Such infections kill 1 out of 11 people over the age of 65 who develop a C. diff infection in the hospital.It's a One Health problem, as the bacteria spread globally.Antibiotics are not always effective in treating C. diff. because these bacteria thrive when the natural population of microbes is killed off. Instead, many doctors are turning to treatments that can replace the healthy microbiome. These can include fecal microbiota transplants (FMTs), also known as poop transplants, or therapies that more directly replace the “good” microbes.Peggy Lillis' sons, Christian and Liam, didn't want her death to have been in vain, so they founded the Peggy Lillis Foundation to advocate for awareness of C. diff, public policy to fight it, and for better treatments.Christian Lillis says he will never get over losing his mother to C. diff.  “It remains the worst thing that has ever happened to me,” he tells One World, One Health host Maggie Fox. In this episode, Lillis tells us about this dangerous repercussion of the misuse and overuse of antibiotics, the need for new treatments, and what survivors and family members can do to take action against C. diff.

There's a virus that infects just about every adult. It's passed by skin-to-skin contact – most often during sexual intercourse. It's the human papillomavirus (HPV for short). It often doesn't show any symptoms, and at times the infection resolves on its own.  It can cause warts, but more ominously, HPV is the single biggest cause of cervical cancer. It's also a factor in common cancers of the head and neck, as well as cancers of the anus and penis. It's the main reason most adult women must undergo regular Pap smears, which work well to catch the changes that can lead to cancer while still treatable. But there's no Pap smear for the mouth and throat, and none for the anus or penis either.  So the invention of a vaccine that prevents cancers caused by HPV should have people running to get it. It has been proven very safe and effective. According to the US Centers for Disease Control and Prevention, infections with the strains of HPV that cause cancers and genital warts have dropped 88 percent in vaccinated teen girls, and 81 percent among vaccinated young women.While vaccination has focused on girls, boys and men suffer from and spread this infection. A study in the Lancet Global Health found nearly a third of men and boys over the age of 15 are infected with at least one genital strain of HPV and one in five have a cancer-causing type.Studies show that the earlier teens get the vaccine against HPV, the better it protects them. But people are resisting it. Dr. Grace Ryan, assistant professor of population & quantitative health sciences at the University of Massachusetts Chan Medical School, is looking at why people are hesitant to use this life-saving vaccine, and at how to get people to better understand its benefits.In this episode of One World, One Health, Dr. Ryan chats with host Maggie Fox about what she's found about HPV vaccine hesitancy.

The world acted as if the COVID-19 pandemic was a big surprise. However, just months before, the Global Preparedness Monitoring Board (GPMB) had warned that the world was vulnerable to a pandemic of respiratory illness and needed to act quickly.  Kolinda Grabar-Kitarović, the former president of Croatia, says she felt frustrated and helpless when the pandemic took hold in early 2020. She had just left office and felt powerless as she watched global failure after global failure from lockdown.Now Grabar-Kitarović is co-chair of the GPMB and is urging world leaders and institutions to act on what's been learned from COVID-19 failures. “Today, we find that despite some improvement, preparedness remains perilously fragile,” the GPMB says in its latest report. “We know in theory how to stop a pandemic in its tracks, but in practice, the gaps in preparedness leave us dangerously exposed to a future threat.”What's needed is much better planning, preparation, and, above all, trust, Grabar-Kitarović tells us in this episode of One World, One Health.  And the first step to growing trust is to build equity.Listen as Grabar-Kitarović explains how short attention spans work against us, and what the Three Little Pigs can teach everyone about preparing for the next pandemic.

Drug-resistant infections are a problem for everyone, but especially for newborns. They don't have fully developed immune systems, and their bodies are less equipped to fight infections.The risk is highest for infants born sick or prematurely.  Bloodborne infections – sepsis – are one major threat to newborns. Sepsis can move quickly, overpowering the body and causing severe illness and even death within hours. Doctors don't have time to test babies to see what's infecting them and have to treat them based on what Dr. Mike Sharland calls a best guess. These infections are often resistant to the drugs that are available to treat them, too. National and international guidelines can help doctors make difficult and life-altering decisions about treatment, but there's not much guidance for health professionals treating newborns. That's in part because there is so little research on which antibiotics work in newborns. Sharland, a pediatric infectious disease specialist at St George's University of London, is helping lead a group running the clinical trials needed to form the basis of guidelines.In this episode, Dr. Sharland tells us about the terrifying growth of drug-resistant infections in newborns and the need for better antibiotics for these vulnerable babies. 

Air pollution is a big killer, a culprit in 6.7 million deaths a year. It's also depressing to live in a polluted area, and not simply for aesthetic reasons. Many people don't even know they are being exposed to some types of invisible air pollution.A team of researchers in California recently linked air pollution to depression during and after pregnancy. That's dangerous to both mothers and their babies, explains Dr. Jun Wu, the team's principal investigator and a Professor of Environmental and Occupational Health at the University of California Irvine.Mothers with postpartum depression have a higher risk of suicide and of harming their babies. Babies of mothers with postpartum depression themselves risk emotional and cognitive damage.The UC Irvine team found that air pollution shows up in some surprising places as well. Listen as Dr. Wu chats with One World, One Health host Maggie Fox about what her team found and what it means for our health.

While innovative and effective ideas to help solve major global health problems are hard to come by, finding and attaining funding to put them into action can be even more difficult. The research grant review process takes time and can be bogged down in red tape. Decisions on who and what kind of research gets funded can pass over novel ideas in favor of familiar project plans.The Trinity Challenge aims to shake things up a bit by rewarding creative and practical ideas that take research down to the community level. While the first round was dedicated to addressing COVID-19, the latest prize will go to ideas to fight the emergence and spread of drug-resistant infections, otherwise known as antimicrobial resistance (AMR). In this episode of One World, One Health, Dr. Marc Mendelson, Professor of Infectious Diseases and Head of the Division of Infectious Diseases & HIV Medicine at Groote Schuur Hospital at the University of Cape Town and director of the Trinity Challenge tells us how the Trinity Challenge aims to support researchers with ideas to fight the present and growing problem of drug resistance in new and inclusive ways. 

In Gaza, thousands have been killed, tens of thousands injured, and hundreds of thousands more are without shelter, clean water, or medical care.“You have these horrible, horrible scenes playing out in many places,” says Avril Benoit, executive director of Medecins Sans Frontieres-USA, also known as MSF or Doctors Without Borders in English.Humanitarian groups such as Doctors Without Borders have called for an immediate ceasefire between Israel and Hamas so they can help innocent and helpless civilians caught in the conflict in Gaza.People in Gaza are suffering horrific injuries, and without antibiotics and even the most basic of medical supplies, they are likely to develop deadly infections. The filthy and crowded conditions are helping the spread of diarrhea and respiratory disease. People are also developing skin infections such as scabies, and they've had to abandon treatment for day-to-day conditions from diabetes and high blood pressure to cancer chemotherapy.MSF is struggling to help the people of Gaza, Benoit tells One World, One Health host Maggie Fox in this episode. While Gaza is, understandably, grabbing the headlines, more than six million Sudanese people are displaced and fighting malaria and malnutrition, while avoiding violence and slaughter. Rohingya refugees from Myanmar are living in unbearable conditions in the world's largest refugee camp in Bangladesh. Refugees are fleeing conflict in Ukraine and Syria as well. “We are really stretched very thin,” Benoit says. “Syria has fallen off our radar.”Listen as Benoit talks about the horrors that conflict rain on populations, and the enduring effects that persist long after the bombs and shooting stop.

It's heartbreaking when a drought or flood causes crops in a region to fail, and children to go hungry. Kids can starve to death or endure social, economic, and health problems well into adulthood due to malnutrition. But what if there was a way to predict when these weather disasters are likely to happen, so governments, aid organizations, and residents could prepare? A team at the University of Chicago says people could already do this, using one of the best-known weather patterns: the El Niño Southern Oscillation or ENSO. “ENSO has destabilizing effects on agriculture, economic production, and social stability throughout areas of the global tropics that are teleconnected to it. It has been linked to human health outcomes directly through its effects on vector- and water-borne infectious diseases, as well as indirectly by decreasing agricultural yields and increasing food insecurity and the likelihood of conflict,” they write in a Nature Communications article. It's possible to predict this Pacific Ocean-based pattern, says Dr. Amir Jina, an Assistant Professor at the University of Chicago's Harris School of Public Policy and a Senior Fellow at the Energy Policy Institute of Chicago. In this episode of One World, One Health, listen as Dr. Jina explains how people could use predictions about El Niño years to get ahead of some of the forces that make children go hungry.

Who reminds an HIV-positive pregnant woman to take her vitamins and the drugs that will protect her baby from infection? Who explains to fearful parents that COVID-19 vaccines will protect them and their children from the disease? Who shows people how to wash their hands properly so they don't spread germs to themselves and others? In many countries across the globe it's community health workers like Margaret Odera of Nairobi, Kenya. Margaret, herself an HIV-positive mother who has managed to ensure her husband and children remain uninfected, works day and night to keep her community safe, too. Yet she feels undervalued and underpaid. She's become an advocate for community health workers like herself – most of whom are women, and many untrained and either underpaid or unpaid.Listen as Margaret tells One World, One Health host Maggie Fox what she does in her work for the community, and how training and better pay are needed for her and others in her trade to promote health both locally and globally. 

Vaccines are lifesavers. Childhood vaccines save 4 million lives every year, according to the US Centers for Disease Control and Prevention. And it turns out vaccines don't just save lives by directly preventing disease. They can save lives by reducing the rise of drug-resistant pathogens (mostly bacteria and viruses). This is because people who are vaccinated are less likely to get sick and to get treated either appropriately or inappropriately with antibiotics and antiviral drugs. And less use of these valuable drugs means less opportunity for germs to develop resistance to them. The One Health Trust set out to quantify just how well vaccination could reduce the emergence and spread of antimicrobial resistance or drug-defying germs.   The latest report from the One Health Trust pulls together a variety of studies showing the impact of vaccines not only on drug resistance but also on economies, especially in low- and middle-income countries.   Some highlights:  A typhoid vaccination campaign for infants could prevent more than 53 million cases of drug-resistant typhoid in low- and middle-income countries over 10 years. A successful rotavirus vaccination program in Africa and Asia could prevent more than 13 million cases of diarrhea that otherwise would be treated with antibiotics – reducing opportunities for bacteria to evolve resistance to those drugs. In Indonesia alone, vaccinating 50% of eligible people with pneumococcal vaccine over five years could save more than US$2 million in costs related to treatment failure.   One Health Trust Fellow and Director of Partnerships, Dr. Erta Kalanxhi, led the team that put together the report. Listen as she chats with One World, One Health host Maggie Fox about how vaccines can prevent the rise of drug-resistant bacteria and viruses. 

Air – it's our most basic need. It's far more vital than water, food, or medicine. People can survive just minutes without its most important component: oxygen. But in much of the world, people struggling to breathe lack access to medical oxygen, a treatment that makes the difference between life and death. The COVID-19 pandemic highlighted the problem and made it exponentially worse. “I will never forget the images,” Leith Greenslade, coordinator of the Every Breath Counts coalition, tells us on the One World, One Health podcast. “Patients suffocating to death as hospitals ran out of oxygen.” A team at the University of Washington estimates that 25 million people die every year of both acute and chronic conditions that need treatment with medical oxygen. “It's unclear exactly how many of the estimated seven million COVID-19 deaths could have been prevented with adequate supplies of medical oxygen, but a study of COVID-19 deaths in African intensive care units found that half of patients died without ever receiving it,” Greenslade and the One Health Trust's Ramanan Laxminarayan wrote in a recent article. “Shamefully, world leaders have turned a blind eye to the lack of access to medical oxygen.” Listen as Leith explains the scope of the problem and the possible solutions in this episode of One World, One Health. 

Bird flu is terrifying. Although avian influenza only rarely infects people, when it does, it kills half or more of them. For the past 25 years, the number one avian influenza threat has been highly pathogenic H5N1 avian influenza. Like other influenza A viruses, it gets its name from the two important components of the virus – the hemagglutinin, or H designation, and the neuraminidase, or N. Less important than the name is what the virus has been doing. Tens of millions of birds around the world have been infected, from poultry to wild migrating birds, and H5N1 is making friends with other viruses. These virus "friendships" help the germs evolve. And the new versions of H5N1 are popping up in unexpected places. It was recently detected in Antarctica. It's also infecting new animals, including sea lions, foxes, and otters. Dr. Vijaykrishna Dhanasekaran, Associate Professor in the School of Public Health at Hong Kong University and head of the university's Pathogen Evolution Lab, has been studying the startling changes in H5N1. In this episode of One World, One Health, he chats with host Maggie Fox about his team's most recent findings and what they mean for global efforts to control H5N1 bird flu.

Drug-defying superbugs can be found in manure, soil, the ocean, and especially in sewers.  These places are sources of infection, but they also provide a way to keep an eye on which drug-resistant germs are where – and how much they are changing. The World Health Organization encourages mapping all of the places drug-resistant organisms are popping up, and what kind of organisms there are. “If no action is taken, AMR (antimicrobial resistance) could cost the world's economy US$ 100 trillion by 2050,” WHO says. Windi Muziasari, PhD, became passionate about tracking these deadly germs while doing postdoctoral research at the University of Helsinki in Finland. The Indonesian-born scientist founded her own company to do this mapping for governments, communities, and companies. As Founder and CEO of ResistoMap, Muziasari has looked for drug-resistant microbes in agricultural runoff, in hospitals, under city streets, among wildlife, and elsewhere in dozens of countries. The hope is to act as an early warning system so that companies, governments, and others can do something about the problem. “Almost everywhere is polluted,” she tells us on the One World, One Health podcast. Listen as Windi Muziasari tells host Maggie Fox about how and why she got started and what she's learned since launching ResistoMap.  

Sexually transmitted infections (STIs) are very, very common. One million people get infected with an STI every day, according to the World Health Organization. Many are easy to treat with antibiotics, or should be. These include gonorrhea, syphilis, and chlamydia. Like nearly all bacterial infections, they can and have begun to evolve resistance to antibiotics. The threat: these infections may again become untreatable, as they were in the days before antibiotics.Sex workers have a very high risk of catching these infections.So if sex workers have a higher risk of sexually transmitted infections, shouldn't they get specialized treatment? It sounds like a good idea, says Salome Manyau, PhD, a researcher in the Department of Global Health and Development and the Faculty of Public Health and Policy at the London School of Hygiene and Tropical Medicine.But things haven't always worked out the way global health nonprofits and medical experts thought they would. Dr. Manyau spent months living among sex workers in Harare, Zimbabwe, and what she discovered may surprise many. It's not so easy to just tell people to practice safe sex, and focusing treatments on one particular group of people can cause unexpected problems.Listen as she tells One World, One Health host Maggie Fox what she found out in her research on antibiotic use among some of the most stigmatized people in the world. 

Malaria is an ancient killer and it's one that keeps outwitting humanity at every turn. It took centuries for people to figure out it was spread by mosquitoes. It evolved resistance to the drugs used to treat it and we developed new ones. It's made comebacks thanks to climate change in places that got rid of the disease before by cleaning out mosquitoes. And now, the parasites that cause malaria have evolved resistance to the newest treatments – drugs based on artemisinin. Worse, that resistance is spreading and has emerged in Africa, the continent with the most malaria cases. COVID created a double whammy, not only killing people directly but also raising the death rate from malaria, as people got the symptoms mixed up or simply avoided going to clinics for treatment, says Karen Barnes, a professor of pharmacology and Founding Director of the Collaborating Centre for Optimising Antimalarial Therapy at the University of Cape Town in South Africa.  Professor Barnes has been working for 20 years to coordinate better treatments for malaria as Director of the Pharmacology Scientific Group for the World Wide Antimalarial Resistance Network (WWARN) and Co-chair of the South African Malaria Elimination Committee. She's also the coordinator of an EU-funded consortium to help countries in eastern and southern Africa tackle malaria drug resistance called MARC SE-Africa (Mitigating Antimalarial Resistance Consortium for South-East Africa). She says it's vital to improve treatments by combining drugs more effectively to catch the parasite at various stages of its life cycle in the body. And, of course, new and better drugs are needed to fight malaria. Listen as Professor Barnes explains the problem and possible solutions to One World, One Health host Maggie Fox.   You can hear more about malaria from One World, One Health here.

When the so-called Spanish Influenza started spreading in 1918, people locked themselves in their homes or even into small towns and tried to ride it out. It seemed to make sense – travelers could bring the virus with them, so wouldn't keeping them out keep the deadly germ out, too?It did not work, of course. No one could stay isolated for years on end while the virus and its descendants made its way through the population. People are still getting infected today by a distant descendant of that virus.Humans are far too interconnected to be able to think that keeping others out will protect them from disease. Yet that attitude remains. So does the stigmatization and exclusion of migrants.Dr. Alena Kamenshchikova, an assistant professor in the Care and Public Health Research Institute (CAPHRI) at Maastricht University in the Netherlands has been studying this very complicated intersection of language, migration, and disease spread – especially the spread of antimicrobial-resistant organisms, often called superbugs.She says that all stigma does is force people to try to hide it when they are sick. Or, worse, they may take antibiotics inappropriately to try to treat themselves when they cannot get the proper healthcare they need. This inappropriate use of antibiotics can drive the rise of drug-resistant bacteria.Listen as Dr. Kamenshchikova tells some startling stories about how keeping migrants of all kinds on the margins can endanger everyone around them.

Meat is never cheap – not in terms of the cost of raising animals for meat, or in terms of the impact on the environment. And now science has clearly shown that the way people use antibiotics in their flocks and herds can feed the rise of antimicrobial resistance. But antibiotics are so very useful, and in many countries, they are just “part of the furniture,” says Clare Chandler, PhD, a medical anthropologist who leads the Anthropology of Antimicrobial Resistance research group at the London School of Hygiene and Tropical Medicine. It's impossible to figure out how to help people stop overusing antibiotics without first understanding all the reasons they are doing it, Chandler says. In this episode of One World, One Health, Chandler describes how some people who were never traditionally farmers are raising meat small scale as a business venture. This economic drive to raise livestock is entangled with the idea that eating meat demonstrates wealth and status. Listen as Chandler tells host Maggie Fox how experts can't simply tell people to stop feeding antibiotics to their livestock. 

Dr. Henry Skinner thought he had a winning new antibiotic – perhaps even more than one – when he was CEO of a small biotech company called SelectX Pharmaceuticals. But like so many other companies working to develop new antimicrobial drugs, it went bust.Skinner learned a fair bit from that experience. Many people working in antibiotics become “gun-shy,” he says, or simply get burned out. But he's taken those hard lessons and is using them as CEO of the AMR Action Fund. AMR stands for antimicrobial resistance – the inevitable ability of viruses, bacteria, fungi, and parasites to acquire resistance to antibiotics, antivirals, antifungals, and antiparasitic drugs. AMR Action Fund has one billion US dollars to invest in labs willing to take the gamble and develop new antibiotics.The organization has also collaborated with the BBC on a documentary, “Race Against Resistance,” to tell the story of antimicrobial resistance and its effects on people.Listen as Dr. Skinner chats with One World, One Health host Maggie Fox about lessons learned and the value of telling the story of antimicrobial resistance.

Humans developed antibiotics in the 20th century.  These wonder drugs defeat killer microbes and have revolutionized medicine, making surgeries and treatments like chemotherapy much safer. Unfortunately, people are overusing and misusing antibiotics, helping bacteria learn how to defend themselves against these lifesaving drugs.Antimicrobial resistance is one of the top 10 global health threats. Drug-resistant microbes directly killed nearly 1.3 million people in 2019 – more than breast cancer, for example. The World Health Organization predicts they'll kill as many as 10 million people a year by 2050 if humanity doesn't act.Can we take action to control the drug resistance these germs continuously build up,  and can we develop new and better drugs for our arsenal against these killer bacteria?Dr. Manica Balasegaram hopes so. As Executive Director of The Global Antibiotic Research & Development Partnership, he's working to encourage the development of better antibiotics that target the infections that affect people the most – and then to get them to the people who most need them.Listen as Manica chats with One World, One Health host Maggie Fox about the ways he hopes to help solve this life-or-death problem.

Drug-resistant germs are big killers. The World Health Organization estimates that infections caused by drug-resistant microbes help kill close to five million people a year, a number that's expected to grow. The world needs new antibiotics, but bacteria are outwitting scientists and drug developers at every turn.  Microbes can produce complex molecules, such as antibiotics, to protect themselves from other organisms. And they naturally develop survival mechanisms to fight these molecules, including swapping genetic material among themselves. On top of that, continuous exposure from our own use of antibiotics contributes to the inevitable rise of bacteria that can survive even the newest antibiotics. Among the biggest killers are Gram-negative bacteria, which are also harder to fight because of their extra layers of protection – or armor, as Dr. Skyler Cochrane, a research scholar at Duke University, calls it.Gram-negative bacteria cause plague, cholera, whooping cough, salmonella, typhoid fever, and urinary tract infections, and are the root of many pneumonia and bloodstream infections. Cochrane is working in a lab that is looking for chinks in the armor of Gram-negative bacteria. In this episode of One World, One Health, listen as she talks about a promising new compound that might just offer the first new weapon against these bacteria in decades. 

When COVID-19 started spreading around the world, many groups of indigenous people knew just what to do. They retreated into the forests they knew so well, an isolation practice that had helped their forebears survive countless other outbreaks, epidemics, and pandemics.But their survival skills didn't stop there. Away from modern methods of food production, they turned to their knowledge of local, traditional foods to stay comfortable and healthy.Dr. Carol Zavaleta-Cortijo, a public health researcher at the Universidad Peruana Cayetano Heredia, studies indigenous groups such as the Shawi people in the Amazonian region of Peru and the Irula and Kurumba communities in Tamil Nadu, India. During the pandemic, she found that these groups made good use of their skills and knowledge that had been passed down orally over generations to get through the pandemic. She says these skills will help them survive the effects of climate change and other disasters as well.Many indigenous communities applied the One Health approach – acknowledging the interconnectedness of the health of the environment, animals, and humans – in their way of life before the term was coined. In this episode of One World, One Health, Dr. Zavaleta-Cortijo chats with host Maggie Fox about what she's learned from these indigenous groups, and what all of us can learn from them about resilience and protecting our planet. 

Few diseases are as fast-moving and as horrific as cholera. Fiction may focus on the internal bleeding caused by Ebola, while movie scripts about zombie apocalypses pull from what's known about rabies.But cholera can infect someone in the morning and kill them by the evening. It can carry off a child before a parent can even register the little one is suffering from more than a run-of-the-mill tummy bug. Worse still, the diarrhea and vomiting caused by the infection carry the killer germs right back into the water supply that is its source.Cholera never really goes away, but a recent upsurge has hit countries across the African continent from Malawi, Mozambique, and Zambia up to Ethiopia, Somalia, and Kenya. It's infecting people in Pakistan, Lebanon, and Syria and is making a comeback in Haiti. A billion people are at risk, the World Health Organization says. Climate disasters and a weakening of public health resources are to blame.Most measures used to strengthen public health, in general, can help fight cholera, says Amanda McClelland, senior vice president at Resolve to Save Lives.In this episode of One World, One Health, listen as McClelland tells us about the gravity of the current multi-country outbreak of cholera. She explains that measures like clean water, good sanitation, vaccination, and access to basic healthcare can all help prevent cholera and stop ongoing outbreaks. 

Fungi can be our friends. They're responsible, after all, for some of our favorite foods and drinks, including beer, bread, wine, and cheese. Penicillin, the parent of all antibiotics, comes from the fungal family as well.But fungi can also cause disease in humans, animals, and plants. In this episode of One World, One Health, Dr. Ana Alastruey-Izquierdo,  a research scientist at the Mycology Reference Laboratory of Spain head of the mold unit, explains how fungal diseases affect people, how they evolve to evade treatment, and what people are doing that helps make these fungal infections even more dangerous. Climate change and the imprudent use of antifungal treatments on crops are both working to toughen up fungal pathogens, she says. The World Health Organization even released a list of the world's most preoccupying fungal pathogens in 2022. Listen as Dr. Alastruey-Izquierdo tells us why we need more awareness of fungal infections and what we can do to fight them.