the the . ringback the resistance to antibiotics controls 10000000 deaths to get from 2050. that's according to the united nations, signed to say climate change is another factor driving the leading crisis. why is that such a risk? and what's being done? the balance that this is inside story, the color, welcome to the product, loves the whole rom and the united nations,

and saw it as world wide. a warning that unless urgent action is taken to deal with resistance, antibiotics across is much bigger than the cobit 19 pandemic. could occur by 2050. do you an estimate. so as many as 10000000 people could die every year from what's known as m p. microtubule resistance. and ma, that's many more that seemed just one. yeah. then the 7000000 lives last joining the pandemic. so why is this happening and what can be done to address it? we'll discuss that in detail with all gashodi. but 1st, let's take a quick look at the problem. recent reports by the you and development program says a major drive is climate change. fueling the rise of global antique micro bill resistance. this happens when bacteria viruses from die or other power sites develop the ability to resist drugs designed to kill them. disease causing bacteria under the microwaves of historically being limited by geography and color temperature. it says prevented diseases from spreading extensively,

but climate change is disrupting these barriers of wilma plan that is bringing in more diseases, floods and drought. so disrupting water systems and sanitation facilities, creating breeding grounds for my craves health experts say, a critical way to stop the soup of bugs is to cub, over use and misuse of antibiotics, measures to help climate change loss of help in the battle against n t. my crew be able resistance well that spring in august for this edition of inside story in geneva mckesson capella and advise the for the world health organization specifically hold onto my credit bill resistance. he's also a professor emeritus of global health and to monetary and assess at the university of manchester in bainbridge and a father and infectious diseases specialist for doctors without borders. and recently cut, wrote a piece of dressing,

the development and spread of antibiotic resistance. bacteria in garza and an oxford in the u. k. i list of all the scientific lead in your socks, the institute for anti microbial research who specializes in but to real resistance will welcome to all of you on the program because you cannot just begin with you do that all 2 ways perhaps of looking at this and what's happening is that we have this scenario in our heads around the, well, that's the pun, demik, the cove it pandemic has had a huge impact on our society. so how is the pulse? debit goody? focus scientists and medical mines in general, about global infections to watch any good reason, but that makes the most a lot to lay up covered. i've shown the world that they can just supply when bugs go out of control their spread across regions and continents. and they're making

millions and billions of people vulnerable, and the new opener, goods, new products of goods are coming up all the time to treat them every year. the have potential for causing brenda makes no resistance is upfront. i mean, it's all right because of the way it impacts it is a public across all continents. the way it could affect everybody, richard ford, north and south. and it's even worse because it is a kind of slow, slow growing. and frank demick and it's on the simplest solutions, that's what i think is likely to brenda meant is appropriate. but unfortunately, it doesn't come with the complexity of the problems we face the present time. now, hopefully we'll have pick a as we go along with this edition of inside story i was to follow, you know, such as, like i said, a slow growing pandemic. would you agree with that?

not? absolutely. i, i agree here that dog. so i'll call out who is the target pandemic, but it's a slow growing one. and if we don't take action appropriately, we type prepared adequately, then the consequences could be less than what bias we've experienced during type it . and then let me just bring you in quickly because obviously you and your colleagues that doctors about board is also name is assess, do work all over the world, not just in conflict size button, climate disaster areas. but obviously, you know, these scenarios occur when the infrastructure of those areas collapses. how is it presenting in general uh, to your colleagues who a noticing this, you might say at the full front to of medical care. so we're noticing it in, in as, as our 1st speaker said, these, these bugs, nose no, no,

no boundaries. and even in places where we were not expecting to see a lot of resistance, we are seeing, it's even there where we were assuming death, not a lot of anti microbial is, would be used. and this changes a bit makes us change the ways we need to treat patients and maybe we need to prepare in another way and all emergencies. so it's very difficult as an already isn't it to uh, you might say conflicts. so at a natural disaster, they have their own issues and they raise that road problems. look ash, i mean, you went into don, i believe as well in the gospel area. we're also seeing events and fold in places like brazil, whether it was heavy flooding recently. we've had the storms in the caribbean, and of course we've got the ongoing conflicting, gaza,

how different to all similar all these areas when it comes to these by crowds and bacteria showing you might say that ugly face. i think all those the corrections of disasters was and those conflicts are different. they have their own specificities . however, the underlying risk and vulnerability has been created. are you really similar? so for example, when you are living in a lot, uh, concert vc now in the sedan or chronic crisis, like in the city of, or an acute caught war. like, you know, no gods and part of your printer. what we're seeing is that health systems are breaking down. oh, we see the basic access to health care is disrupted. what that means is that when the patients need urgent token, they don't necessarily have access to the all the move configuration of pharmaceutical agents required. basically, adult this will make do with whatever is available,

and very often the patients will not get properly treated. instead of having the flu close to find about like somebody to only be able to afford or have access to maybe 3 days. which means that these situations become a hot bed offer his expense because the bugs then get adopted to the conditions in this a regions under. and we have received this report of change as well. um and uh that means that there are organisms like bacteria, viruses, and so on. there's a pretty good foster, thus creating the conditions for uh, the, the, uh, the resistance, the genetic imbedded in the population of organisms dr. scalds is disease and greetings all over. so we see a remarkable commonality despite the diversity around the world. so let's look, let's just bring you in here as well because what we are having is that there was this alarm bell, alarm bells being run across the world. and by very evident segatus, i mean,

if i just mentioned jeannie bizarre i, she's the lady that took over from and add to the, found she after the, the co, 5th 19 scenario, sidney from the american side to the she's now the new head of thought, whole health department across the us, she's told about lives still being over stage and being treated with antibiotics all the time. and it's not very livestock, but humans eat and that's what with them. all right, bodies, we become, you might say, a new to the health care that we would expect if we, with the full ill, i mean the cycle of food generation and, and taking it in how much of a problem does the food chain create for us in this scenario, but i think one thing that's being absolutely clear and is that we all one find that we all oh, connected to my cargo resistance doesn't know any boundaries. i mean national and

have no geographic boundaries. and my client who is a link between and to my credit bill use it and she medicine and culture. something around between 60 and 75 percent on spa tax by mass worldwide. opposite by way, all use in agriculture, in some phone. and some cases this is use to, to treat an infection, but not many cases. it's used preventative, like an apple as provided. so the wide spread spread of an infection across a lot. and now the good was off bad for this can spite out into the environment and that is documented. but what, what is clear is that use of and to mike until politics in agriculture is spending resistance with specific resistance genes that can fire resistance to human drugs. is exhausted by 2 by use macro culture. you're all about doing an agreement. if i

just about to add to, i mean what we are seeing studying complex sciences if we just come to something like gaza, just as $11.00 incident, one story is that when you have the infrastructure of a location destroyed and you have the water supply, disrupted they sold exacerbates the problem of spreading disease and you might say disease and uh to both of you single, changing it into new forms that are very difficult to treat. how, how much of a problem is it to have medical locations destroyed? be in the conflicts the all by natural disaster. i've been trying to rebuild them quickly. so the disease doesn't spread, and the salts of microbes don't become prevalent. so in complex all you have the dis, this destruction of the medical infrastructure meeting that people can seek

healthcare or not able to get the health care or the medication or whatever the. so that's this part you don't get treated in the right way or get the necessary treatment. then there's the 2nd part which is the regular, all around your infrastructure and the water and you don't get to water properly. maybe your house is destroyed. maybe, you know where you live is destroyed, you have to, you have to go somewhere else. you're living conditions change so, so the, the diseases can spread. so things like color i was water or other diseases can spread. these could or could not be resistant, but even if you're sick, you become more prompt to get there. other resistance, you increase the use of anti microbial is if it's available, but also you become more prone to getting disease because of stress because of your food. uh, water you can flush yourselves hygiene, so all these factors play in one research. yeah, this is

a good thing. i was certain that because you're thinking about research within countries such as pockets down south asia, the americas, where you're looking into, are you not and about how these and see microtubules actually affect the loan to scenario. but as i still want 6 hits and gone so i'm up with colleagues with colleagues we, we have series of labels, surveillance programs. i'm looking in pot and contact, signed and often not for disaster. but it's just more generally um that on the big issues is these diagnostics is working out what the bacteria is that a bacteria infection metal. you should use antibiotics and what is what type of bacteria? i'm not certainly don't know what type of resistance james, do they have to get? what are they, what drugs are they resistant to?

and i think you can, you can work out and if you can get cheap uh, cheap and accessible diagnostics and hold wave ready to pay you the ability of the right time to politics. along with good health care and sanitation, then we will be able to tackle problems. i am to my type of assistance alice, today's business connection though not wasting that with climate change. i mean, when did that actually don't on? you might say the scientist older such as a, in your understanding and in this is it's not something that's just being discussed over the last 6 months. is that this is something that's been going yeah. is becoming more prevalent now. the discussions and gaining momentum and but what's clear is that climate climate change is exacerbating extreme weather events. i mean that we're seeing that whether it's

flooding, whether it's hurricanes, that we think at the moment and all these things disrupt the basic health and sanitation. and this leads inevitably to spread off diseases including dice caused by a bacteria. and that's for answer my cardboard assistant spreads. yeah, i know that you are agreeing and in say a result. look, i should like to come to you really a as us to get who's travel the well the for the you and as well. i mean i are you lingle are usually sort of nothing in agreement generally with wireless to said that there is this link now and it's becoming more and more evident that it has to be dealt with at the very high level. a governmental level. yes, i would agree with that, but i would also say that there is unfortunately not a lot go foot urgency about this whole the problem and the police feel free to selection in terms of global mobilization and actual action is a is very poor. i mean, i'm, i'm, i'm

a strategic and by the organization on their own, i do micro being resistance and the spring month back to this problem or how to turn global guidance on good practices and the technologies and science. and we really know what to do with this is true is how you can it's governments around the world, especially those in the developing countries in poor countries who uh don't have a national geographic distribution with this, but not the salt in the, in the re, to what you have to complete to complacency and in the developing world, do you have a lot of a lack of awareness about this and know how to accelerate that action so that we can have a public coke movement. that is to keep this problem before a to implode, sitting on a much bigger scale. then the thing at the moment is really the issue. that's why

the upcoming meeting of the united nations, the high level for a move september on our, to my cool the distance is that some of the event will be much more global engagement and resources. more resources are needed in countries to build the surveillance to build up the bottle crease to build up their reporting capacities and that some kind of global corporations be accelerated. so we can get the grips with this. yeah, i just want to come to that said that you, my general assembly meeting in september to by me, just want to just get back quickly to add a you know, thing ahead your head as well. i'm in agreement with both of our the speakers because i want starsky. yes, it's all very well, isn't it that the government level for, for this to be made aware of it at the end of the day you'll of the grass roots. that's a lot that the coal sites to a certain extent, how do you get your voice heard of? how do you get the voices of your doctors and medics hood when you have these incidents of these bacteria arising all the same, that need to be made aware of to the why to medical surgical. i think this is the

point making the world aware and we're, i would like to go back to the diagnostics part the both of my co speaker has talked about diagnostics. it's key to know that there's a, if we talk about bacteria who need to know that you have a bacteria 1st and then you need to know that it's the resistance. and where we work, i can say that only in, in, in the areas we work. we usually use the diagnostics, we try to use a local diagnostic, a local a lot and only in, in it's less than 40 percent of the places where we work, where we actually can find a lab that has a good quality enough that we can work with so in 60 percent of the time we have to come with our own guilt or microbiology lab and of knowing your problem is where it starts and a lot of places we don't know where the, what the problem is. so we have tools uh that we the so we least try to make

the diagnostics lighter. so we have like the tools that we have to make it easier for people. so there's a front of capacity building. there's a part of us, you know, um i assume those uh there is the infrastructure for it. so we've tried to make it to the, to the, to user. so we have something called a mini lab. we have the empty juggle app and you can use your smart phone to be able to interpret these sensitivities easier. so i would like to make a call for that. yeah, time is your enemy, isn't it really to a certain extent to try and get that voice to get those findings actually outside to those people that kind of make the difference. i list the can i come in here because the book has just mentioned the un general assembly meeting with various reports, for example, who strategic and technical advisory group for entry, antique micro biome issues, place the i need to have the un general assembly,

but we've also got the, the call 29 conference happening and back who and as a by john, which again, links to climate change. how high up the agenda should this be when you know, when you go to the un general assembly, you're, you're on the sidelines. the and then you both for the will be on the sidelines of the, of the call meeting as well later in the, to get your voice heard to get your findings out the, to tell people, this is what's happening. all right, and then no man, no many competing issues and issue competence facing the lot of them. i mean i'm to my current bill resistance is, is a really big growing company. and what we want to do is to prevent the unthinkable being inevitable. this is something that we need to safe, god, 8, and use fancy on to politics, which on the pin martin medicine, a variety of things and they used to treat infections that they also use. but when

patients with all the diseases. so for example, it came most likely you often to ask about takes routine, so treat might no longer be possible if i am all it is a problem. so what we need to do along with all the other issues and climate change is planned for the future. and that's why we're talking um, raising this issue now. lucas, could i just put you in here? i think you want to, i mean, how links all these to conferences now it does of getting the debate going know tony, in september in new york, but later on and also by john as well as having rubbed all my life into your and i wish i could say that all these different conferences were linked together. they're not there all the following. got on tracks, keep tracks and know the route. it's a good things and maybe have some good outcomes, but we're not gonna get into connecting the global global issues. but i want them all to come and one thing, sure. new technologies, new techniques, hun hooked acknowledges, for example, in conflict on so i, but

a black box the on to, for the fact of the matter is that we're constantly looking for new ways to solve problems when we're not doing, doing the basics. so for example, we have the problem of hospital infections. uh, which is a major cause of the spread of m r. we have, for example, the lack of health care universal health coverage is going i've been going down or is not that a little or it's under advancing. and we're looking for some kind of book, a good solution to ask you might cause resistance. but what we need to do is to attend to the basics. there isn't going to be a magic solution or a new physical that is going to this to this uh, seems to solve this problem. we have to deal with the fundamental building block of healthy societies, whether it is a more a peaceful world or the more equitable world or the work where what have are available. ok, this one says, unavailable. they are acting like will be with the says integrated into them. i

think you to go down the road. okay. mark as another sees the be sold alone. so other diseases and health problems being one of many other problems facing the work that i'm afraid, am i read oldest on low down the list of i'm the more integrated temper, etc. but printers, there's been one of the many problems we don't want to partition between my problem is beginning your problem with that question. so conflict is the pickup and mike is austin, but i think we need the smaller kind of unified approach and everyone has the room for the patient or a environment list. yeah, i think i think the other piece because agree i was just beginning. yeah, i mean, how much money is that being pulled into this research to try and find solutions to animals? it is the same amount of money that was bought into and finding solutions for tie red mountain. when governments were forced to act, they did, they put money into it, they subsidized the companies to develop new therapy. we would develop new

n t politics quite quickly. i'm one of the issues as well as that many companies i have withdrawing from the field of development of new anti politics and many types of economic with tons that you typically see what other therapies at carriers. i just know that and say we need more funding from government and organized labor organizations from the private sector and for their nation. so other research partnerships to continue the basic research to find new treatments. so you're basically saying that the big fob is not interested if there's not a big profit margin involved. no, it's more, it's more complicated than that. and but when i was, um, we'll say is that the economic incentives for developing a new drug and you have to box it. um, it just is just not that. so you developing a, a last resort anti biotech that would be used in an extreme cases. you don't want to

use it widely and most on to bile today's what most of the time. and that really cheap, generally cheap, readily available, just in part why they use um, in agriculture and so, and the problem because when these common antibiotics no longer what was that you wanted to come in the yeah, i think i, i think it's a, it's been covered the problem with developing new enter biotech status is a bus missed if you got it printed, do i have to, but i think i can just do kind of start using it then before nobody was blake but assistance to it. because the resistance of the natural phenomena, it's been with us since the funded by 670 years ago. so regardless of the business model, good. uh, this is not going to be funded. but anyway, so we need a public goats approach as opposed to an individual, the companies coming in and developing visual doctor i do want to approve. the

other thing is that they do the easy stuff, different unit in the for once a year and you know, done something good and back to that is really all brought the excessive use of i d micro bills as a result of the last few years. a didn't want to, to use has really gone down and your whole step generated political problems. getting back to a farmer than frost belgium. and many other countries are writing, including leading to the political in upside is as you see in your notice. so it's a politicized nation. m r agenda. we come picketing to see along the side to politicize, the vision of the commentators. and so if you look into that complex, we also see the challenge ahead that we have to face the regardless of the technical solutions of the amount of money which for update on it will come to the end of the program. i'd like to give you the final say being of the full front of looking after people who have this problem. uh, you're facing it and say, what are your colleagues? what would your appeal be to the, the, the,

the move and the shape. because the committee make the decisions as to how to you might say stop a ball is actually the coloring incoming society when they're all conflict zones or climate changes affect to the community. i think we need to go back, go back to basics like like ok said prevention is key and to have accessibility to proper living condition, hygiene, etc. are the basics, are the basics prevention vaccine nation a teen alter. these are prerequisites for, you know, forgetting for preventing micro investments. we need to think of it as an i call resistance lots of vertical thing. it's really needs to be integrated that everything you do a little bit like when you're thinking of climate change. we need to think about it in every gesture we do everyday. yeah, it needs to be the same. well, let's hope it can be in some shape or for both of them, but we have to leave it that we have come to the end of all. probably don't think

all of my guess mckesson capella and the fatherhood alas to folly. and thank you as well for watching. you can see the program again any time by visiting our website. it's all just every adult. come on for further discussion, go to on facebook page. let's facebook dot com forward slash ha, inside store. you can also have join the conversation on exxon handled areas as a inside story for me. so robin and all of a team here. thanks for your time and your company the the

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