Archive for the ‘Department of Health and Human Services’ Category

The Thousand Natural Shocks That Flesh Is Heir To

via Wikipedia

via Wikipedia

I don’t know about you, but I don’t like reading the words “bacteria” and “apocalyptic” in the same sentence – especially in the lead paragraph of a World Health Organization Report. The report, released last month, tells us in no uncertain terms that we are now entering the post-antibiotic world. Almost a century after the discovery of penicillin, humanity is once again vulnerable to simple infections we thought we had confined to the dustbin of medical history.

All the ills that flesh is heir to, the countless ailments and fevers that have plagued humanity for millennia, were seemingly in retreat with the flurry of antibiotics that followed on penicillin’s heels. Ten years ago, a simple urinary tract infection or a scrape from a rose bush would pass without incident – a simple course of antibiotics saw to that. Now, increasingly, even the most minor infections can take an ominous turn, thanks to the relentless evolution of the microbes antibiotics are designed to destroy. The prospect of expiring from simple infections is growing daily, in every corner of the globe.

The WHO report is a hypochondriac’s nightmare. According to the Organization, resistance to common bacteria has reached alarming levels around the world. The post-antibiotic era, far from being an apocalyptic fantasy, is a very real possibility for the 21st century. Antimicrobial resistance, it says, threatens the effective prevention and treatment of an ever-increasing range of infections. Resistance to common bacteria, parasites, viruses and fungi has reached alarming levels in many parts of the world. In some settings, there are few, if any, effective treatment options. One of the greatest achievements of modern medicine is teetering on the verge of collapse. And it isn’t simply preventing or treating hitherto minor infections which is problematic. Many pillars of modern medicine rest on defeating microbes: without antibiotics routine surgery, transplants, and chemotherapy would be impossible.

In an ironic twist, it was in hospitals themselves where resistant bacteria first appeared, and they have spread steadily outward. In 2005, approximately 100,000 Americans had severe anti-biotic resistant infections, of whom nearly 20,000 died. That’s a higher fatality rate than HIV and tuberculosis combined. In the words of Katherine Xue, writing in Harvard Magazine, this state of infectious affairs is the new normal. The relentless spread of antibiotic resistant super bugs raises the grim specter of a return to the medicine of a century ago.

Dr Jennifer Cohn, medical director of Medecins sans Frontier, says the WHO report “should be a wake-up call to governments to introduce incentives for industry to develop new, affordable antibiotics.”

Developing antibiotics is extraordinarily expensive and time consuming. Encouraging innovation in the field will likely require close coordination on a global scale and significant government intervention and support. Given that Britain’s chief medical officer has compared the rise in drug-resistant infections to the threat of global warming, we’ll have to cross our well-scrubbed fingers and hope the nations of the world can pull together on this. An ounce of prevention, as they say, is worth a pound of cure.






President Obama’s cuts to low income energy program stir controversy

Photo by Flickr user matsuyuki

As part of the federal budget proposal he submitted on Tuesday, President Obama offered significant cuts to LIHEAP (Low Income Home Energy Assistance Program) as a way to reduce funding in the realm of energy services and lower the national deficit. The program currently calls for $5.1 billion in funding as it stands, and Obama’s proposal would cut nearly half of that figure, removing $2.5 billion from its operating budget. Roughly 8.3 million people made use of the program last year, many in impoverished areas, in order to heat their homes.

Obama defended his choice by arguing that LIHEAP had been a more essential program in the infancy of his presidency when energy prices were spiking, but that now that those prices have leveled out, these forced cuts could also be an opportunity to promote sustainable living wherever possible. Other supporters of the program in government and private agencies have been more skeptical about how these cuts would affect its beneficiaries.

As highlighted by an article in the Wall Street Journal, the formula used to determine distribution of funding amongst the 50 states may be using outdated population data, a flaw that may have wrongfully provided budget protection for some states while others equally in need would be shut out. Senator John Kerry echoed similar concerns in a letter drafted to President Obama last Wednesday, stipulating that “over 3 million families that qualify for heating assistance would not receive it if the funding levels are not maintained.” White House budget director Jacob Lew addressed these concerns and acknowledged the program’s value in a press conference held on Monday, stating that it was a hard cut to make but that “balancing our fiscal challenges and the funding change from 2008 until now, we made the tough decision.”

Public Water Fluoridation or: How I Learned to Stop Worrying and Love the Mass Medication

Early last week, the EPA announced a joint effort with the US Department of Health and Human Services (HHS) to update guidelines and standards for fluoride in drinking water.

Photo by petit hiboux. Some rights reserved.

HHS is proposing to lower the recommended level of fluoride in drinking water to 0.7 milligrams of fluoride per liter of water (the low end of their current recommended range of 0.7 to 1.2 milligrams), while the EPA is looking into lowering the maximum enforceable amount of fluoride allowed in drinking water. These changes were prompted by the EPA’s own updated risk assessment of fluoride, which was itself prompted by a report from the National Academies of Science (NAS) recommending the EPA re-evaluate their “health and exposure assessments.” These assessments will help the EPA determine whether current maximum fluoride amounts are appropriate.

Fluoridation of water (the controlled addition of sodium fluoride, fluorosilicic acid, or sodium fluorosilicate to a public water system) became widely used in the US in the 1960s as a means of widespread tooth decay prevention. It was cited – along with “healthier foods” – by the CDC as one of Ten Great Public Health Achievements of the 20th century.

While there is no federal regulation mandating fluoridation, many states or cities voluntarily fluoridate their water systems based on the recommendations from organizations such as HSS, WHO, or CDC. However, under the Safe Drinking Water Act, the EPA is required to set national standards regarding the maximum allowable levels of fluoride in drinking water in order to prevent such crippling conditions as skeletal fluorosis, which is caused by excessive amounts of fluoride.

The current enforceable drinking water standard for fluoride is 4.0 mg/L. Of course, recommended fluoridation levels can change as the public becomes exposed to more sources of fluoride (today’s toothpastes and mouthwashes are often awash with fluoride), which is one reason the EPA and HSS are taking action.

But this wouldn’t be a topic of environmental regulation if it didn’t have its share of controversy. If you type “water fluoridation” into Google, the second suggested search is “water fluoridation conspiracy.” The Wikipedia article dedicated solely to the debate describes fluoridation of public water systems, in the eyes of a theorist, as “a form of compulsory mass medication,” and “a violation of ethical or legal rules that prohibit medical treatment without medical supervision or informed consent.”

Is someone administering you fluoride without your consent? Find the fluoridation status of your water system with CDC’s “My Water’s Fluoride” tool or browse Consumer Confidence Reports from select community water systems.

%d bloggers like this: