Archive for the ‘Incentives’ 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.






Local Stormwater Management: Yes In My Backyard!

A cistern expert once told me that there are some areas of Seattle (home to Knowledge Mosaic Inc!) in which, if you implement certain stormwater management practices, your property is then considered part of Seattle Public Utilities. I haven’t found the documentation to back this up, but the point is this: each individual can contribute substantially to their municipalities’ stormwater management.

Photo by Robert Lawton. Some rights reserved.

What is stormwater? Think about how filthy our city streets are – whether oil leaked from vehicles on the roads or runoff from lawns treated with pesticides. In most places, each time it rains, the rain takes all that grime with it to city drains and into city water systems that eventually empty into surrounding waters. In addition to putting a smelly or dangerous damper on your fishing,  swimming or other recreational water activities, stormwater can degrade ecosystems that salmon and other aquatic organisms call home.

Stormwater is regulated at a national level by the EPA’s National Pollutant Discharge Elimination System (NPDES) Stormwater Program. Most states are then authorized by the EPA to implement the program and issue permits for stormwater sources within the state, such as municipal storm sewer systems. To obtain the permit, municipalities’ stormwater management programs must include certain “minimum control measures” to reduce pollutants discharged into receiving waters. These measures include public outreach, illicit discharge detection, and construction site runoff control.

Seattle currently faces an extra hurdle in managing stormwater. Like more than 700 other cities in the US, Seattle uses a Combined Sewer System (CSS) that hooks up stormwater pipes with sewer pipes. Normally, this combined runoff would go through wastewater treatment plants before rejoining local waterways, but during heavy rains, the pipes reach maximum capacity and we get a Combined Sewer Overflow (CSO), in which some untreated wastewater is discharged directly into nearby streams, rivers or lakes. CSSs are not currently covered by NPDES permits. The EPA has policies for controlling CSOs, but authorities are still working to incorporate CSO conditions into the permits “and other enforceable mechanisms.”

Some of the quickest and most economical ways to prevent CSOs are to modify landscapes to prevent stormwater from entering the sewer systems to begin with. Rain gardens and cisterns are two popular options, both of which are being used extensively in Seattle to curb CSOs. Rain gardens work by diverting stormwater from drains – the water is corralled and filtered of pollutants by specially selected rocks, plants and soils. Cisterns typically collect water runoff from residential roofs – again, diverting water from city drains while providing a source of water that can be saved to water your garden during the drier summer months.

Currently, residents in one Seattle neighborhood susceptible to CSOs are eligible for rebates from the city if they install a rain garden or cistern. This helps the city meet regulatory requirements for reducing CSOs and the applicant gets a cheap cistern or aesthetically pleasing landscape. This kind of incentive is nothing new – has collected links to state and federal financial incentives related to water harvesting from around the world.


You can read about Seattle’s RainWise Residential Rebates program here.

More about broader and larger-scale approaches to  “wet weather management” can be found on the EPA’s Green Infrastructure web page.

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