When Medicines Fail: Rachel Nugent on Combating Drug Resistance

This week on the Wonkcast, I'm joined by Rachel Nugent, Deputy Director for Global Health here at the Center for Global Development. She is the lead author on a new CGD working group report entitled The Race Against Drug Resistance, which prescribes a global effort to halt and reverse the spread of drug resistant microbes.

In the Wonkcast, Rachel explains that the more people rely on antibiotics and other medicines, the faster disease pathogens adapt and become resistant. In rich countries, a resistant strain of staph now kills thousands per year-- most from hospital-acquired infections. The situation is more dire in the developing world. Rachel tells me that there is only one effective treatment remaining for malaria, and that some strains of tuberculosis are now completely untreatable.

Often the treatments that remain effective are much more expensive, even for relatively simple diseases like bacterial diarrhea. "Antibiotics have been and should be cheap and easily available," says Rachel. "But the cheap, easily available ones no longer work."

Together, Rachel and I discuss the incentives that could nudge the various actors in the drug supply chain-- from manufacturers to patients-- to behave in ways that reduce the risk of drug resistance. The new report which Rachel co-authored suggests four practical recommendations that could form the basis for a coordinated global response to the problem of drug resistance:

1. Collect and share drug resistance information across disease networks.
2. Secure the drug supply chain to ensure quality products and practices.
3. Strengthen national drug regulatory authorities in developing countries.
4. Catalyze research and innovation to speed the development of resistance-fighting technologies.

Listen to the Wonkcast to hear our conversation. For more, read the full working group report, or visit the working group's site. There you'll also find a short documentary film (produced by Rachel's co-author Emma Back) that illustrates the financial and human costs of drug resistance.

Have something to add to our discussion? Ideas for future interviews? Post a comment below, or send me an email. If you use iTunes, you can subscribe to get new episodes delivered straight to your computer every week.

My thanks to Wren Elhai for his very able production assistance on the Wonkcast recording and for a draft version of this blog post.