"GLOBAL ISSUES, LEADERSHIP CHOICES":

A commission in the UK has found that deaths from infections that were previously curable by antibiotics will surpass cancer and be the leading cause of death worldwide by 2050. Although developed countries, including their agricultural sectors, continue to be heavy users of antibiotics, researchers are finding that urban areas of poorer countries are ground zero in the fight against antibiotic resistance, both because of the widespread availability of cheap generics and the prevalence of untreated human waste.

"Antibiotics, the miracle drugs credited with saving tens of millions of lives, have never been more accessible to the world’s poor, thanks in large part to the mass production of generics in China and India. ... Kibera [a poor neighborhood in Nairobi, Kenya] residents are prodigious consumers of antibiotics. One study found that 90 percent of households in Kibera had used antibiotics in the previous year, compared with about 17 percent for the typical American family. ... [U]rban poverty is a huge and largely unappreciated driver of resistance. And so, the rise of resistant microbes is having a disproportionate impact on poor countries, where squalid and crowded living conditions, lax oversight of antibiotic use and a scarcity of affordable medical care are fueling the spread of infections increasingly unresponsive to drugs. ... Sam Kariuki, a researcher at the Kenya Medical Research Institute who has been studying resistance for two decades, said nearly 70 percent of salmonella infections in Kenya had stopped responding to the most widely available antibiotics, up from 45 percent in the early 2000s. Salmonella kills roughly 45,000 Kenyan children every year, or nearly one in three who fall severely ill with it, he said. In the United States, the mortality rate is close to zero."
www.nytimes.com/2019/04/07/health/antibiotic-resistance-kenya-drugs.html