One World, One Health

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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.

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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.

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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.

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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. 

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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.

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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. 

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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.

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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.

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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. 

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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. 

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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. 

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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.

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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.  

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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. 

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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.

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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.

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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. 

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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.

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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.

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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. 

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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.

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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. 

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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. 

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So many people are working to improve health around the world. But many of these efforts tend to go in one direction – people in wealthy countries traveling to lower-income countries with resources and ideas.

Yet people everywhere have great ideas. It’s a shame not to make use of them. And in making good use of locally generated ideas, efforts to improve health naturally become fairer and more equitable.

In this episode of One World, One Health, we caught up with two people working to promote these good ideas from around the world. Some are hi-tech apps, but some are really low-tech. How about friendship benches, an analog way for older women to reach out and share their experiences and promote mental health in their communities?

Lola Adedokun is the Executive Director of the Aspen Global Innovators Group at the Aspen Institute and co-Chair of the Aspen Institute Forum on Women and Girls.

Blair Palmer is the Senior Director for Foundation Partnerships at UNICEF USA. 

Listen as Blair and Lola talk about some of these great ideas and how to better share them.

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Be prepared. It’s a great credo for parenting, camping, or, perhaps most important, an emergency. 

The world seemed ill-prepared for the COVID-19 pandemic, but in reality, experts had extensive plans in place. They just did not get put into action. 

One of the planners was Dr. Jesse Goodman, an infectious diseases physician who has held leadership positions at the US Food and Drug Administration and who helped advise the White House. Now the director of the Center on Medical Product Access, Safety and Stewardship or COMPASS at Georgetown University, Dr. Goodman helped put together plans for fighting antimicrobial resistance (AMR) – known to many people as drug-resistant superbugs. He’s also helped plan for new influenza pandemics, as well as pandemics of other viruses. 

In this episode of One World, One Health, listen as Dr. Goodman describes the threats that face us, how to successfully plan for them, and what to do when those plans go wrong or fall short. 

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Hindsight is 20-20 – it’s an old saying and never more true than when looking back at an epidemic. But sometimes looking backward can help people think more clearly when planning ahead.

Dr. Sabine Franklin, a post-doctoral researcher at Yale University, is an economist using her training to better understand public health.

She went to west Africa to talk to people about the Ebola epidemic (2014-2016) that killed 11,000 people, most of them in Guinea, Liberia, and Sierra Leone. Franklin wanted to see how communities responded during and after the epidemic, and what might be useful going forward.

In her ongoing research on outbreaks,  she's found that people don't always apply lessons learned to diseases, like what we've seen in the COVID-19 pandemic. Experts are also failing to use what they already know in trying to respond to ever-worsening outbreaks of avian influenza.

Listen to this episode of One World, One Health as Dr. Franklin describes where she sees the world falling short, and how she thinks things could be turned around in time using the One Health approach to help us all better handle the next pandemic.

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When Ebola virus was first spotted in west Africa at the end of 2013, few people were ready. The region had no developed or systematic health system, patients were scattered across remote rural areas, and other infections, such as malaria, were common and mimicked the early symptoms.

But a team in remote Kenema, in Sierra Leone, had been working to fight a different virus – Lassa Fever. They had set up a clinic with diagnostic testing and communications with the outside world. A team of experts had been trained in how to detect and diagnose viral hemorrhagic fevers. They may not have been expecting Ebola, but they had the expertise and some of the equipment and infrastructure needed to help people understand what was happening as the deadly and frightening virus started to spread across borders.

Dr. Robert Garry, who specializes in viruses, had helped set up the team studying Lassa in west Africa. He helped the world understand what was going on with Ebola and quickly understood that his team’s preparations in Kenema had helped in the fight to track and control the virus.

Such preparations also helped when COVID-19 started spreading around the world in 2020.

In this episode of One World, One Health, listen as Dr. Garry explains how he got interested in studying viruses and how preparedness matters in fighting global threats.

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Antibiotics are lifesavers. These 20th-century drugs can save lives within hours, often given as just a handful of pills or an injection. 

But the germs they fight often fight back and evolve quickly. They develop what’s known as antimicrobial resistance, and then the drugs people use to treat infections become worthless. 

This happens naturally, but people and the way we behave often help it develop faster. When people use drugs when they don’t need them, or take the wrong drug, that allows bacteria, viruses, or fungi to evolve new tricks to evade the effects of medicines. 

These drug-resistant superbugs kill millions of people every year, and the problem is getting worse. 

The One Health Trust is working to educate medical professionals about better ways to conserve and care for these precious antibiotics. Policies and practices crafted to ensure that antibiotics, antivirals, and antifungal drugs continue to work are known as antimicrobial stewardship. 

Dr. Azra Hasan, the Head of Academic Programs at OHT, is leading the One Health Trust’s efforts to help physicians, pharmacists, and others learn ways to better preserve antimicrobial drugs. 

In this episode of One World, One Health, Azra explains first what the problem is, and what to do about it.  

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Drug-resistant superbugs are killers, and the problem is getting worse even as people become aware of the need to control how we use antibiotics.

Researchers estimate close to five million people died in 2019 because of antibiotic-resistant bacteria alone. Yet, doctors continue to overprescribe these lifesaving drugs and farmers continue to give them to livestock and fish not only to treat and prevent disease but to help them grow faster.

Now, a team of experts has shown clear links between the use of antibiotics in people and in animals.

Kasim Allel of the London School of Hygiene & Tropical Medicine and University College London and colleagues showed that the more antibiotics were used in people, the higher the rates of antibiotic-resistant bacteria in animals, and vice versa.

But overuse is not the only culprit.

Kasim’s team also found rates of antimicrobial resistance are worse in poorer countries. Sanitation and a lack of health care are both likely factors. Governments will have to do more to control antimicrobial resistance than simply limiting the use of these drugs.

Listen as Kasim explains the many different factors that are feeding the rise of drug-resistant superbugs.

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It was a real mystery. People showing up at hospitals and clinics across the US were infected with a rare and troubling strain of bacteria that was resistant to most of the drugs used to treat it. 

The strain itself had never been seen before. It was Pseudomonas aeruginosa, itself nothing rare. But this one carried a genetic change that allowed it to shake off the effects of even the strongest antibiotics usually used to treat it. Where had it come from? 

It took a good deal of detective work, but the US Centers for Disease Control and Prevention and state health officials finally figured out the common source was eye drops. They tracked down a couple of brands of eye lubricants and contained the outbreak. 

Now they’re working to find out how this particular germ got into eye drops in the first place, and how it acquired the mutations that made it so impervious to treatment. And they’re working to make sure that it’s not still lurking in the bodies of unsuspecting people. 

Dr. Maroya Walters, a CDC epidemiologist and commander in the US Public Health Service, helped lead the investigation. In this episode of One World, One Health, Dr. Walters explains how the team tracked down the source of the unusual outbreak, and how it demonstrates that superbugs know no borders. 

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A walk in the woods can bring serenity and peace of mind. You can bring back souvenirs such as a beautiful leaf, or a pine cone. Sometimes your souvenir is less lovely - a tick. Dogs, cats, and even horses can suffer from tick bites and responsible pet owners regularly check their companions for these unwelcome parasites.

Ticks can carry and transmit bacteria, viruses, and parasites that cause Lyme disease, anaplasmosis, Powassan virus, babesiosis, and erlichiosis.

Climate change is making new regions more tick-friendly, which is bad news for people and animals.

Dr. Katie Clow is an Assistant Professor in One Health in the Department of Population Medicine at the Ontario Veterinary College at Canada’s University of Guelph. She’s working on better ways to track ticks and their spread. She’s also got a website with useful information about ticks for people and pet owners.

In this episode of One World, One Health, listen as Katie explains why people need to keep an eye out for ticks, why simply clearing wildlife such as deer won’t help control ticks, and how climate change is helping ticks thrive in more regions of the world.

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Consumption. The White Plague. Scrofula. Tuberculosis (TB) has been known by so many names over the ages, and those names reflect just how long it’s been around and just how misunderstood it’s been. It’s killed kings and generals, playwrights, and poets.

TB still sickens 10 million people every year and kills 1.5 million – even though it’s easily prevented and can be treated. It’s unusual because it needs to be treated even if the person infected has no symptoms at all.

And even though it’s an ancient disease, TB keeps evolving into new and ever more unpleasant forms. Now, multi-drug-resistant (MDR) TB infects half a million people around the world each year, according to the World Health Organization. A third of these MDR TB infections go undetected, and that means there are tens of millions of people who do not get the treatment they need and who can go on to infect others.

Dr. Jeffrey Tornheim has been studying ways to test people to quickly and easily tell if they’ve got a drug-resistant form of TB infection and need special medications to treat it right away. Quick information can help stop the spread of these dangerous forms of the infection and can ensure that patients and health professionals don’t waste time, money, and medicine with the wrong treatments.

 
In this episode of One World One Health, Dr. Tornheim, Assistant Professor of Medicine and Assistant Professor of Pediatrics at the Johns Hopkins University School of Medicine, as well as at the Johns Hopkins Bloomberg School of Public Health, chats with host Maggie Fox about why TB is so hard to fight and how genomics can make that fight a little easier.

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Antimicrobial resistance – the emergence of new drug-resistant superbugs – is one of the top 10 global health threats, the World Health Organization says.

More than 700,000 people die each year from infections caused by drug-resistant microorganisms – which not only include antibiotic-resistant bacteria but also viruses, fungi, and parasites that can escape the effects of drugs designed to kill them.

Filmmaker Michael Wech illustrates the problem with a series of stories about real people in his documentary “The Silent Pandemic”.

In this episode of One World, One Health, listen as Michael explains why he’s so deeply interested in the danger of antimicrobial resistance and what he has found out about efforts to curb it.

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It was 1994, and a new virus was killing racehorses in Australia. Then it killed a horse trainer who was caring for his charges. The virus, called Hendra after the Brisbane suburb where it first surfaced, is a relative of the measles virus.

Hendra virus has been traced to large, furry bats known as flying foxes. While it doesn’t make the bats sick, they can spread it to animals such as horses, which can become very ill and die.

And there’s an interesting twist. Researchers led by Dr. Raina Plowright, a professor in the department of Public and Ecosystem Health at Cornell University, have found the bats only hang out around the horse farms when they’re hungry. The solution? Blooming trees.

It’s a perfect example of how climate change, animal health, and human health are linked.

In this episode of One World, One Health, listen as Dr. Plowright explains how she and colleagues solved a decades-old mystery and came up with a possible solution.

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Three full years into the COVID-19 pandemic and the world still doesn’t have a firm answer about where the virus came from.

People who have been studying coronaviruses and other viruses for decades say it’s overwhelmingly likely the SARS-CoV-2 virus came from animals, just as the 2002-2004 SARS virus did, the Middle East Respiratory Syndrome or MERS virus did, as Ebola does, and as most influenza viruses do.

But there’s no smoking gun- no animal being sold for food that carries the virus and that could conceivably have been the source of the pandemic. And that makes people suspicious and leads to speculation that a laboratory leak from the Wuhan Institute of Virology in China could have been the source.

Dr. Felicia Goodrum, professor of immunobiology at the University of Arizona and co-editor-in-chief of the Journal of Virology, argues that the tone of the current debate is harmful and undermines trust in science.

“The result has fueled public confusion and, in many instances, ill-informed condemnation of virology. With this article, we seek to promote a return to rational discourse,” she and colleagues wrote in a recent commentary in the Journal of Virology.

“COVID-19 has cast a harsh light on the many cracks, fissures, and disparities in our public health system, and the inability to broadly come together to face a colossal crisis and focus on the needs of the most vulnerable,” they wrote.

Listen as Dr. Goodrum tells One World, One Health host Maggie Fox about what’s at stake.

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Just about everyone has had an unpleasant fungal encounter, usually something as simple as athlete’s foot, ringworm, or dandruff.

But fungal infections can become much more dangerous and even deadly, especially in people whose immune systems are damaged by another infection such as HIV, tuberculosis, or even COVID-19.

Mold species such as aspergillus are in the air all the time and when breathed in by someone whose immune system is damaged, they can cause an infection known as aspergillosis. Another infection, candida auris, spreads in hospitals and can kill. More than 300 million people have such infections and 1.5 million die from them, according to recent estimates.

In this episode, Dr. David Denning, a retired professor of infectious diseases, global health, and medical mycology at Wythenshawe Hospital and the University of Manchester, chats with One World, One Health host Maggie Fox about the threat of fungal diseases, especially as people alter their environments.

Denning is the founding president, executive director, and chief executive of Global Action For Fungal Infections (GAFFI), which focuses on the global impact of fungal disease.

Listen as Dr. Denning describes the need for new, resistance-busting medications to fight fungal infections, better testing to diagnose them, and better awareness of the threat.

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Helping someone less fortunate feels good, right?  But when people from rich countries show up in low- and middle-income countries dispensing goodwill and largesse, their efforts may, at best, be too little and, at worst, could do harm. Dr. Kirk Scirto, a family practice physician in Buffalo, New York, has devoted more than two decades to trying to help others through global health promotion and studying which methods are best for that work. 

What he’s found may surprise many people. In his book, Doing Global Health Work, he describes how he found it’s more important to listen to people than to try to tell them what to do. In some of the poorest parts of the world, he’s witnessed that people are perfectly able to help themselves and they have a better understanding of what they need than outside "do-gooders."

In this episode of One World, One Health, Dr. Scirto tells host Maggie Fox what he’s learned about suitcase medicine and voluntourism and how he’s working to help others make a positive impact without doing harm.

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When salty water seeps into a freshwater swamp, the resident alligators risk getting sick and have to fend off invading sharks. Can a monkey scientist and a pirate cat help solve the conflict?

Dr. Susannah Sandrin, Clinical Professor in Environmental Science & Science Education at Arizona State University helped make sure the science was sound in this episode of the cartoon series The Octonauts: Above & Beyond. It’s aimed at young children, but Sandrin says it’s important to communicate accurate science to everyone if people are ever to come to grips with the inevitable effects of climate change.

Plus, “Everyone responds to goofiness,” Susie says as she chats with One World, One Health host Maggie Fox about her work studying hydrology – the science of water – and studying how best to communicate climate science to kids and adults of all ages.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Lots of factors make rabies the scariest virus known. It kills virtually 100% of its victims, and it’s killing close to 60,000 people a year around the world – many of them young children. Animals can carry and transmit the virus even if they have no symptoms at all, and people can develop a fatal and untreatable infection even if they do not know they’ve been exposed by a bite, scratch, or a drop of saliva. 

Rabies is probably the basis for myths about zombies and vampires, says Dr. Abi Vanak of the Center for Biodiversity and Conservation at the Ashoka Trust for Research in Ecology and the Environment (ATREE) in Bangalore, India. It’s carried and spread by bats, raccoons, foxes, wolves, and, perhaps most important, dogs.

In this episode, Dr. Abi Vanak chats with us about how the One Health approach can help reduce the spread of rabies.

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All humanity relies on forests. Even if you don’t live near one, they produce the air you breathe and are a source of food, clean water, wood, and even medicines.

But people are destroying forests at an unprecedented rate, and it’s hurting not just the forests and the animals and plants in them but also human health. Diseases such as Ebola, hantavirus, Zika, chikungunya, and, yes, Covid, can all be traced to human interaction with animals of the forests.

In this episode of One World, One Health, Dr. Paula Prist, Senior Research Scientist at the EcoHealth Alliance, tells host Maggie Fox about how some of these diseases emerge and how damaging forests can hurt all of us.

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Everyone’s heard the saying about how a butterfly flapping its wings in China can cause a hurricane half a world away. In this episode, we chat with One Health Trust (OHT) Founder and President Dr. Ramanan Laxminarayan about how OHT’s new center in the Nimai Valley outside Bangalore, India, will incorporate this idea into its design and intent. Butterflies are fragile, but vital pollinators, and they can represent how interconnected the world is.

So will the Nimai Valley Center, which will be entirely powered by solar energy, will collect its own water, and produce organic foods onsite to help feed researchers, students, and guests from around the world. The hope is to create a space where people can apply One Health concepts to solving the problems of new and old diseases, poor diet, and climate change. The idea is as ancient as the civilizations of South Asia, China, Africa, and the Americas and as modern as the science showing disrupting the environment can fuel the spread of disease, says Ramanan.

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Two centuries ago, people could die from a simple scratch. It was the pre-antibiotic era when infections killed babies within hours, a cold could turn deadly within days, and people survived injuries through luck alone.

Now a pill can prevent strep throat from turning into scarlet fever and antibiotics keep surgery safe. But because bacteria evolve and mutate so quickly, many drugs are powerless against new strains. The world needs new and better antibiotics.

In this episode of One World, One Health, Anand Anandkumar, co-founder and chief executive officer of Bugworks, explains what his company is doing to help discover and develop new antibiotics. Antibiotics are not big money makers for pharmaceutical companies, so Bugworks is putting together funding from governments, charities, and a new kind of motivated investor.

Listen as Anand Anandkumar tells host Maggie Fox about what his company is trying to do.

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Drug-resistant superbugs are killers. They directly kill more than a million people a year, the World Health Organization says, and contribute to five million deaths a year.

But vaccinated people are much less likely to get infected in the first place, so why not make better use of vaccines to fight these superbugs? In this episode, Dr. David Heymann, a veteran of the war against infectious diseases, tells us how vaccines might be put to better use to prevent antimicrobial-resistant organisms.

Dr. David Heymann spent more than 25 years at the US Centers for Disease Control and Prevention, with more than 20 of those years on secondment to the World Health Organization. He is also a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine.

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In this episode, Dr. Nicholas White of the University of Oxford in the UK and Mahidol University in Thailand tells us how the world is losing ground in the fight against malaria, in no small part because of the emergence of resistance.

Malaria is caused by a parasite transmitted by mosquitoes, and these parasites have repeatedly evolved to escape the effects of drug after drug over the decades. Now, Dr. White argues, there’s a chance to get out ahead of this resistance. How?

Listen as he tells our host Maggie Fox how the parasite manages to evade the effects of drugs and what he thinks needs to be done to stop it from happening yet again.

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In this episode, Thomas Van Boeckel tells us about how aquaculture might be helping drive the rise of drug-resistant superbugs around the world.

Three-quarters of antibiotics sold globally go to farmed animals. Some of these animals are fish and shrimp.

Thomas Van Boeckel studies the rise of antibiotic-resistant bacteria and other drug-resistant microbes at the Department of Environmental Systems Science at the Swiss Federal Institute of Technology-- known as ETH Zurich. He’s also a visiting fellow at the One Health Trust.

People need to pay attention to the use of antibiotics in aquaculture, he says. No one’s even measuring it right now, he tells host Maggie Fox.  And the problem in aquaculture is similar to the problem in intensive farming everywhere. Farmers use antibiotics as insurance. “There are so many fish packed in such a small space that there would be a big loss for the fish farmer is he or she loses production so the use is mostly preventive,” he says. “If you have conditions where animals are packed all together—look at this from the perspective of a pathogen.”

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In this episode, Dr. Hsu Li Yang chats with our host Maggie Fox about how Singapore managed the COVID-19 pandemic.

Singapore is a small country in Southeast Asia, but its experience with the first outbreak of Severe Acute Respiratory Syndrome virus – SARS – in 2003 and 2004 helped prepare leaders there for SARS-CoV-2, which causes COVID-19. Dr. Hsu Li Yang, Vice Dean for Global Health and program leader of infectious diseases at the National University of Singapore’s Saw Swee Hock School of Public Health, lived through the first SARS outbreak and helped fight COVID-19.

While restrictions were tight, Dr. Hsu says they worked – and people saw they worked. “Trust currently has never been higher because people could see the success of how the pandemic was managed,” he tells us. What else worked in Singapore?

Dr. Hsu Li Yang is an infectious diseases physician who is currently Vice Dean of Global Health at Saw Swee Hock School of Public Health, National University of Singapore (NUS). He is also Associate Director of the Singapore Centre for Environmental Life Sciences Engineering, a Research Centre of Excellence on biofilms and microbial communities based jointly at Nanyang Technological University and NUS. Although he has been involved in COVID-19 research and education, his primary academic focus is in the area of antimicrobial resistance. He has worked with famed comic book artist Sonny Liew to publish educational comics on both COVID-19 and antimicrobial resistance.  

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In this episode, our guests, Dr. Joakim Larsson and Dr. Amy Kirby, chat with our host, Maggie Fox, about the use of wastewater to detect known and unknown pathogens.

What have we learned from tracking COVID-19 in wastewater?  How can we use wastewater surveillance for monitoring antimicrobial resistance (AMR)? Could we someday detect and stop the next pandemic by sifting through sewage? Let's find out!

Dr. Joakim Larsson is a Professor in Environmental Pharmacology at the Department of Infectious Diseases, University of Gothenburg, Sweden, and the director of the multidisciplinary Centre for Antibiotic Resistance Research (CARe).

Dr. Amy Kirby is an Environmental Microbiologist in the Waterborne Disease Prevention Branch and the Program Lead for the National Wastewater Surveillance System (NWSS) at the Centers for Disease Control and Prevention (CDC).

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In this episode, our guest, Dr. Bethany Young Holt, chats with our host, Maggie Fox, about products that combine contraceptives with sexually transmitted infection (STI) prevention, Multipurpose Prevention Technologies (MPTs), for women.

Do women get STIs as often as men?  Why do women need MPTs?  Aren't condoms enough?  What do these technologies look like? Let’s find out!

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In this episode, our guest, Dr. Ali Khan, talks to our host, Maggie Fox, about what the World Health Organization has declared a global health emergency, monkeypox. 

Is monkeypox similar to COVID-19?  Why is this disease spreading so quickly now? Is this cause for panic? Let’s find out!

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In this episode, our guest, Dr. Lance Price, discusses the phenomenon often dubbed "the silent pandemic", antimicrobial resistance (AMR), with our host, Maggie Fox.

What causes antibiotics to stop working? What will a world without effective antibiotics look like? How can we fight to stop the present and growing crisis of AMR? Let’s find out!


More about our guest: 

Dr. Lance Price is a Professor at the George Washington University’s Milken Institute School of Public Health and the Founding Director of GW’s Antibiotic Resistance Action Center. Dr. Price works at the interface between science and policy to address the growing crisis of antibiotic resistance. His research, retracing the ecology, evolution, and epidemiology of antibiotic-resistant bacteria, has been published in top peer-reviewed journals and covered in media outlets around the world.

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In the first episode of the One Health Trust's podcast, One World, One Health, our host, Maggie Fox, discusses the importance of rainforests and ways to save these vital ecosystems with our guest, Dr. Kinari Webb.

Who holds the answers to stopping deforestation? What does healthcare access have to do with rainforest destruction? How does the loss of tropical forests affect human health on a global scale? Let's find out!