11 ms·

Typhoid spreads in Pakistan as antibiotics fail

71 points by n1b0m 2y ago

tgv 2y ago
As usual, the measures come too late. It isn't mentioned in the article, but the anti-biotics apparently were not regulated: https://en.dailypakistan.com.pk/04-Aug-2024/antibiotics-in-pakistan-now-require-doctor-s-prescription-under-new-drap-rules https://en.dailypakistan.com.pk/04-Aug-2024/antibiotics-in-p...
skummetmaelk 2y ago
Classic failure to establish a (close to) pareto optimal regulatory structure to avoid ending up in the self-organizing Nash equillibrium which is worse for everyone. The Price of Anarchy strikes again.
- nojvek 2y ago
  What do you mean by Pareto optional regulatory structure? Got links to read further to comprehend meaning of word salad?
  - rramadass 2y ago
    Not the person you asked the question of, but this should clarify; https://en.wikipedia.org/wiki/Pareto_efficiency https://en.wikipedia.org/wiki/Pareto_efficiency https://en.wikipedia.org/wiki/Nash_equilibrium https://en.wikipedia.org/wiki/Nash_equilibrium
Traubenfuchs 2y ago
> Ukasha needed meropenem – a “last-resort” drug reserved for the most serious illnesses. He was given 22 injections, two a day. Meropenem resistant typhi is described since 2022. But don‘t worry, we have IV meropenem + colistin left. Don‘t mind the seizures, neuro- and nephrotoxicity.
- AStonesThrow 2y ago
  It says "for the most serious illnesses", not "to heal/cure the ... illnesses".
flanked-evergl 2y ago
As an outsider looking in, I have to wonder why the rest of the world, and especially the western world sit by silently while countries run themselves into the ground? Pakistan is one of the most poorly governed countries in the world. If the Netherlands or Japan for example was equally poorly governed, the relative human toll would be much higher than it is in Pakistan. Why is every western government not warning Pakistan, and it's population, that if they continue to elect leaders who run the country into the ground that this will have dire consequences for their longevity and wellbeing? I see similar problems coming in South Africa, also, it's quickly approaching crisis, but the population just keeps electing the most corrupt politicians that are not interested in good governance at all. Who wins by letting these countries run themselves into the ground and then create problems for everyone else?
- tim333 2y ago
  The Brits used to run the place until 1947 but we were asked to leave.
- maest 2y ago
  > [..] western government [..] warning Pakistan, and it's population People hate being told what to do/told that what they're doing is wrong. Especially when the advice is unsolicited and coming from people from a different country. I'm not saying whether that is or isn't rational.
- SuperNinKenDo 2y ago
  What exactly would you have the other countries do? What does "warn them" even mean? As if the only problem Pakistan has is that its politics arent sufficiently dictated by the West? I mean, thing would probably be better if that were something the West were actually capable of doing, but Afghanistan shows what that experiment looks like.
  - flanked-evergl 2y ago
    > What does "warn them" even mean? Every western and really non-western government should publicly state that the trajectory of Pakistan, South Africa, Brazil, etc is concerning and that if these countries do not change trajectory the human toll will be catastrophic. Instead we just have silence, and some effective pretence that what is going on in these countries is entirely acceptable merely because the people have voted for their own destruction. I'm not saying the west should invade and replace the governments as they tried in Afghanistan, but the poor governance in Africa, Asia and South America is incredibly costly for the west. If the west has to pick up the tab when it all comes crashing down, it should have some say.
pvaldes 2y ago
Pakistan is a country that launch satellites to the space and spend solid money on building atomic bombs. They are perfectly capable to develop new antibiotics to fix their problem. They may also want to support and teach more people doing microbiology research on the country. That will contribute to the well-being of every children in the world, providing also the state with a lot of political leveraging and allies. The Japanese company that developed the antibiotic currently used on Pakistan will never have the same resources as the state of Pakistan.
- jiggawatts 2y ago
  They do manufacture antibiotics. That’s in some sense the source of the problem: they don’t regulate them enough resulting in excessive usage. This breeds resistant strains.
  - pvaldes 2y ago
    Manufacture and develop are different words. Same as with clone vs create. We all know since decades that the antibiotics are failing. We all know that the misuse of the extant antibiotics cause this damage. We can't just at this state to pretend that weren't warned about that. There are many points here that could improve the problem and don't depend on anything except the will of Pakistan government to do it. A lot of low hanging fruit here. 1. How much could take for the government to regulate better the use of antibiotics? A week? Four hours and a pen? 2. What about building a scientific team to develop new antibiotics? 3. Could be the unreliable water system made more reliable? Maybe just adding a filter made with sand and cheap industrial materials would help. Dunno. 4. What about a campaign to teach your citizens about the correct use of antibiotics?
- adastra22 2y ago
  Pakistan doesn’t have orbital launch capability.
  - pvaldes 2y ago
    > Pakistan doesn’t have orbital launch capability. SUPARCO: https://en.wikipedia.org/wiki/SUPARCO https://en.wikipedia.org/wiki/SUPARCO PAKSAT-1R: https://en.wikipedia.org/wiki/Paksat-1R https://en.wikipedia.org/wiki/Paksat-1R

71 points by n1b0m 2y ago

tgv 2y ago

As usual, the measures come too late. It isn't mentioned in the article, but the anti-biotics apparently were not regulated: https://en.dailypakistan.com.pk/04-Aug-2024/antibiotics-in-pakistan-now-require-doctor-s-prescription-under-new-drap-rules https://en.dailypakistan.com.pk/04-Aug-2024/antibiotics-in-p...

skummetmaelk 2y ago

Classic failure to establish a (close to) pareto optimal regulatory structure to avoid ending up in the self-organizing Nash equillibrium which is worse for everyone. The Price of Anarchy strikes again.

nojvek 2y ago
What do you mean by Pareto optional regulatory structure? Got links to read further to comprehend meaning of word salad?
- rramadass 2y ago
  Not the person you asked the question of, but this should clarify; https://en.wikipedia.org/wiki/Pareto_efficiency https://en.wikipedia.org/wiki/Pareto_efficiency https://en.wikipedia.org/wiki/Nash_equilibrium https://en.wikipedia.org/wiki/Nash_equilibrium

Traubenfuchs 2y ago

> Ukasha needed meropenem – a “last-resort” drug reserved for the most serious illnesses. He was given 22 injections, two a day. Meropenem resistant typhi is described since 2022. But don‘t worry, we have IV meropenem + colistin left. Don‘t mind the seizures, neuro- and nephrotoxicity.

AStonesThrow 2y ago
It says "for the most serious illnesses", not "to heal/cure the ... illnesses".

flanked-evergl 2y ago

As an outsider looking in, I have to wonder why the rest of the world, and especially the western world sit by silently while countries run themselves into the ground? Pakistan is one of the most poorly governed countries in the world. If the Netherlands or Japan for example was equally poorly governed, the relative human toll would be much higher than it is in Pakistan. Why is every western government not warning Pakistan, and it's population, that if they continue to elect leaders who run the country into the ground that this will have dire consequences for their longevity and wellbeing? I see similar problems coming in South Africa, also, it's quickly approaching crisis, but the population just keeps electing the most corrupt politicians that are not interested in good governance at all. Who wins by letting these countries run themselves into the ground and then create problems for everyone else?

tim333 2y ago
The Brits used to run the place until 1947 but we were asked to leave.
maest 2y ago
> [..] western government [..] warning Pakistan, and it's population People hate being told what to do/told that what they're doing is wrong. Especially when the advice is unsolicited and coming from people from a different country. I'm not saying whether that is or isn't rational.
SuperNinKenDo 2y ago
What exactly would you have the other countries do? What does "warn them" even mean? As if the only problem Pakistan has is that its politics arent sufficiently dictated by the West? I mean, thing would probably be better if that were something the West were actually capable of doing, but Afghanistan shows what that experiment looks like.
- flanked-evergl 2y ago
  > What does "warn them" even mean? Every western and really non-western government should publicly state that the trajectory of Pakistan, South Africa, Brazil, etc is concerning and that if these countries do not change trajectory the human toll will be catastrophic. Instead we just have silence, and some effective pretence that what is going on in these countries is entirely acceptable merely because the people have voted for their own destruction. I'm not saying the west should invade and replace the governments as they tried in Afghanistan, but the poor governance in Africa, Asia and South America is incredibly costly for the west. If the west has to pick up the tab when it all comes crashing down, it should have some say.

pvaldes 2y ago

Pakistan is a country that launch satellites to the space and spend solid money on building atomic bombs. They are perfectly capable to develop new antibiotics to fix their problem. They may also want to support and teach more people doing microbiology research on the country. That will contribute to the well-being of every children in the world, providing also the state with a lot of political leveraging and allies. The Japanese company that developed the antibiotic currently used on Pakistan will never have the same resources as the state of Pakistan.

jiggawatts 2y ago
They do manufacture antibiotics. That’s in some sense the source of the problem: they don’t regulate them enough resulting in excessive usage. This breeds resistant strains.
- pvaldes 2y ago
  Manufacture and develop are different words. Same as with clone vs create. We all know since decades that the antibiotics are failing. We all know that the misuse of the extant antibiotics cause this damage. We can't just at this state to pretend that weren't warned about that. There are many points here that could improve the problem and don't depend on anything except the will of Pakistan government to do it. A lot of low hanging fruit here. 1. How much could take for the government to regulate better the use of antibiotics? A week? Four hours and a pen? 2. What about building a scientific team to develop new antibiotics? 3. Could be the unreliable water system made more reliable? Maybe just adding a filter made with sand and cheap industrial materials would help. Dunno. 4. What about a campaign to teach your citizens about the correct use of antibiotics?
adastra22 2y ago
Pakistan doesn’t have orbital launch capability.
- pvaldes 2y ago
  > Pakistan doesn’t have orbital launch capability. SUPARCO: https://en.wikipedia.org/wiki/SUPARCO https://en.wikipedia.org/wiki/SUPARCO PAKSAT-1R: https://en.wikipedia.org/wiki/Paksat-1R https://en.wikipedia.org/wiki/Paksat-1R