Ungcoliseko lwemizi-mveliso olusuka kwiinkampani zamayeza e-India ezenza amayeza phantse kuzo zonke iinkampani zamachiza ehlabathi ziphembelela ukudalwa kweencukuthu ezibulalayo, lucebisa uphando olutsha. Abasemagunyeni kwezempilo behlabathi abanayo imimiselo ekhoyo yokunqanda oku ukuba kwenzeke.
A isifundo esikhulu epapashwe namhlanje kwijenali yenzululwazi edumileyo Sulelo kufunyenwe amanqanaba โaphezulu ngokugqithisileyoโ amayeza okubulala iintsholongwane kunye nentsalela yeyeza elilwa nokungunda kwimithombo yamanzi nakwindawo ejikeleze indawo enkulu yokuvelisa amachiza kwisixeko saseIndiya iHyderabad, kunye namazinga aphezulu ebhaktiriya kunye nomngundo onganyangekiyo kuloo machiza. Oosonzululwazi baxelele i-Bureau ukuba ubungakanani obufunyenweyo buthetha ukuba bakholelwa ukuba iintsalela zamachiza kufuneka ukuba zisuka kwimizi-mveliso yamayeza.
Ubukho beentsalela zamachiza kwindawo yendalo kuvumela iintsholongwane ezihlala apho ukuba zakhe ukuxhathisa kwizithako ezikumayeza ebekumele ukuba ziyawabulala, ziwaguqulele ekubeni sibize ii-superbugs. Iintsholongwane ezixhathisayo zihamba ngokulula kwaye zande ngamanani amakhulu kwihlabathi liphela, zidala imeko engxamisekileyo yezempilo yoluntu ekucingelwa ukuba ibulala amakhulu amawaka abantu ngonyaka.
Xa amachiza e-antimicrobial eyeka ukusebenza usulelo oluqhelekileyo lunokubulala, kwaye izazinzulu kunye neenkokheli zempilo yoluntu zithi ingxaki eyandayo yokumelana ne-antibiotic (ekwaziwa ngokuba yi-AMR) inokuguqula isiqingatha senkulungwane yenkqubela phambili yezonyango ukuba ihlabathi alisebenzi ngokukhawuleza. Nangona kusenziwa imigaqo-nkqubo ukulwa nokusetyenziswa ngokugqithisileyo nokusetyenziswa kakubi kwamachiza okubangele ingxaki, abalawuli bamazwe ngamazwe bavumela iindlela zokuvelisa amachiza amdaka ukuba ziqhubeke zingaqwalaselwa.
Amagunya ehlabathi afana noLawulo lokuTya kunye neChiza kunye ne-Arhente yaMayeza yaseYurophu ilawula ngokungqongqo ikhonkco lokubonelela ngamachiza ngokokhuseleko lwamachiza - kodwa imigangatho yokusingqongileyo ayibonakali kwincwadi yabo yomthetho. Abavelisi bamachiza kufuneka babambelele Izikhokelo ze-Good Production Practices (GMP). โ kodwa ezo zikhokelo aziluquki ungcoliseko.
Nditsho noMbutho wezeMpilo weHlabathi (i-WHO) - iqumrhu lezempilo likawonke-wonke eliye labiza ngokuphindaphindiweyo ukuba lithathelwe amanyathelo adibeneyo ngamazwe ngamazwe ukulwa nesoyikiso esiyingozi sokumelana ne-antibiotics - uthenga i-antibiotics kwiinkampani ezinezithako zamachiza ezenziwe e-Hyderabad ngaphandle kokuhlola indalo.
Imibutho yamazwe ngamazwe ithi oorhulumente bamazwe enziwa kuwo amachiza ngabo abanoxanduva lokunqanda ungcoliseko โ kodwa umthetho wasekhaya awunafuthe elitheni emhlabeni, bathi ababhali bophononongo. Ukunqongophala komgaqo wamazwe ngamazwe kufuneka kujongwane, bayaxoxa, beqaqambisa isoyikiso sezempilo sikawonke-wonke esijongene nokuxhathisa amayeza okubulala iintsholongwane kunye nokusasazeka kwehlabathi jikelele kwee-superbugs ezivela eIndiya, esele yaba ngundoqo wale ngxaki.
โUkungcoliseka okungazange kubonwe ngamachiza alwa neentsholongwaneโ
Iqela lezazinzulu ezisekelwe kwiYunivesithi yaseLeipzig zisebenze kunye neentatheli zaseJamani ukujonga nzulu kungcoliseko lwamayeza e-Hyderabad, apho i-50% yokuthunyelwa kweziyobisi eIndiya ziveliswa. Isihlanu samachiza ehlabathi aveliswa e-India, kunye nemizi-mveliso eseHyderabad ibonelela iBig Pharma kunye nabasemagunyeni kwezempilo yoluntu njengoMbutho wezeMpilo weHlabathi ngezigidi zeetoni zamayeza okubulala iintsholongwane kunye namayeza okulwa nokungunda nyaka ngamnye.
Abaphandi bavavanye iisampulu zamanzi ezingama-28 ngaphakathi nakwindawo ejikeleze iPatancheru-Bollaram Industrial zone ngaphandle kwesixeko, apho zingaphezulu kwama-30 iinkampani ezivelisa amachiza ezibonelela phantse zonke iinkampani zamachiza eziphambili zehlabathi. Eli phephandaba lithi amawaka eetoni zenkunkuma ephuma kumayeza enziwa yimizi-mveliso suku ngalunye.
Phantse zonke iisampulu ziqulethe iibhaktheriya kunye nomngundo onganyangekiyo kumachiza amaninzi (ezaziwa ngokuba zii-MDR pathogens, igama lobuchwephesha lee-superbugs). Abaphandi emva koko bavavanya i-16 yeesampulu zeentsalela zamachiza kwaye bafumanisa ukuba i-13 kubo yayingcoliswe ngamayeza okubulala iintsholongwane kunye ne-antifungals. Uphononongo lwangaphambili lubonise indlela ukuvezwa kwi-antibiotics kunye ne-antifungals kwindawo ebangela ukuba ibhaktheriya kunye nomngundo ziphuhlise ukunganyangeki kuloo machiza.
Ungcoliseko lokusingqongileyo kunye nolawulo olulambathayo lwamanzi amdaka eHyderabad lubangela โukungcoliseka okungazange kubonwe ngamayeza e-antimicrobialโ kwimithombo yamanzi ejikelezileyo, baqukumbela abaphandi-ungcoliseko olubonakala ngathi luqhuba indalo kunye nokusasazeka kwee-superbugs eziye zasasazeka kwihlabathi liphela. Idityaniswe nokusetyenziswa gwenxa kwamayeza okubulala iintsholongwane kunye nogutyulo olulambathayo, ii-superbugs sele zineziphumo ezibi eIndiya - kuqikelelwa ukuba iintsana ezisanda kuzalwa ezingama-56,000 zibulawa zizifo ezinganyangekiyo apho unyaka nonyaka.
Umsasazi waseJamani i-NDR, ethe yanegalelo kuphononongo, ichonge iinkampani ezili-19 ezisebenza ngaphakathi kwindawo evavanyiwe njengababoneleli bamayeza okubulala iintsholongwane kwimarike yaseYurophu. Kwezo zili-19, i-Bureau ichonge ubuncinci iinkampani ezine ezibonelela nge-UK kunye nezintlanu ezibonelela nge-US.
Iinkampani ekuthethwa ngazo ziyakukhanyela ngamandla ukuba iifektri zabo zingcolisa indalo esingqongileyo, kwaye inani elikhulu leefektri ezisebenza eHyderabad lithetha ukuba akunakwenzeka ukuchonga ngokuthe ngqo ukuba zeziphi iinkampani ezinoxanduva lokungcoliseka okufunyenwe kwiisampulu ezivavanyiweyo.
Okucacileyo sesinye sezona ndawo zikhulu zemveliso yamachiza ehlabathini zivelisa amanqanaba anobungozi ongcoliseko lwamayeza, kwaye amaqumrhu ezizwe ngezizwe anikwe uxanduva lokuqinisekisa ukhuseleko lwamachiza awenzi nto ingako ukuyilungisa.
Abalawuli bezempilo kufuneka bathathe inyathelo, utshilo uNjingalwazi uRamanan Laxminarayan, umlawuli weZiko leSifo seDynamics, uQoqosho kunye noMgaqo-nkqubo kunye nelizwi eliphambili lokuchasa amayeza okubulala iintsholongwane. โKufuneka sikuthathele phezulu ukungcoliseka kwendalo kumaziko okuvelisa isambuku kwaye siwuphelise kwangoko lo mkhuba,โ utshilo. "Oku kufanele kube yinxalenye ye-GMP ngaphandle kombuzo kwaye iinkampani zamayeza kwihlabathi liphela kufuneka ziphantsi kophicotho-zincwadi ukuqinisekisa ukuba ziyahambelana noko kuthenjiswe ngumzi-mveliso."
Undoqo wentlekele yehlabathi
Isixeko esinabemi abaninzi kwaye siya sikhula eHyderabad kumazantsi eIndiya sakha saliziko lokurhweba ledayimani kunye neeperile. Namhlanje, liziko eliphambili lamazwe ngamazwe kumashishini axuba amayeza kunye ne-biotech, evelisa izigidi zeetoni zamayeza, amachiza kunye nezitshabalalisi minyaka le.
Malunga neenkampani ze-170 ukwenza amachiza amaninzi afana namayeza okubulala iintsholongwane asebenza ngaphakathi nakufutshane ne-Hyderabad, uninzi ludityaniswe kwiindawo ezinemizi-mveliso ethe kratya ecaleni komlambo uMusi. Iinkampani zaseYurophu nase-US, kunye nabasemagunyeni kwezempilo njenge-WHO kunye ne-UK's NHS baxhomekeke kumachiza avelisiweyo kwezi fektri.
Le ndawo kudala igxekwa ngongcoliseko lwayo, oluye lwaqhubeka lungathintelwanga nangona amashumi eminyaka ekhankasela ii-NGOs zaseIndiya, bathi ababhali bengxelo. Ngo-2009 indawo yasePatancheru-Bollaram yachazwa njenge "ingcoliseke kakhulu" kwisalathiso songcoliseko selizwe laseIndiya kwaye ulwakhiwo kwindawo yavalwa. Kodwa urhulumente wayihlaziya imithetho ngo-2014 kwaye ukwakha kwavunyelwa ukuba kuqale kwakhona.
Kunyaka ophelileyo iNkundla ePhakamileyo yaseIndiya iyalele iinkampani zamayeza zeli lizwe ukuba zisebenzise umgaqo-nkqubo wokulahlwa kwenkunkuma, kodwa โkwaphulwa umthetho omkhuluโ kuxelwe ukuba kwenzeke, utshilo Sulelo ingxelo.
Njengoko imveliso yemveliso yeziyobisi eIndiya ikhulile, kukwanjalo nokuxhaphaka kwee-superbugs-ingxaki yelizwe iye yaqina ngokusetyenziswa ngokugqithisileyo kunye nokusetyenziswa kakubi kwamayeza okubulala iintsholongwane, athengwa ngokulula kwikhawuntara, kunye nogutyulo olulambathayo ecaleni kokudalwa kwee-superbugs, imfuza kunye ne-enzymes. iphuhlisiwe enokuthi idlule phakathi kweentlobo ezininzi zeebhaktheriya, izenze zixhathise kumachiza.
I-Indiya iye yaba ngoyena ndoqo wengxaki yehlabathi yokuxhathisa kumachiza, kukho iintsana ezingama-56,000 ezisanda kuzalwa zaseIndiya eziqikelelwa ukuba zisweleke minyaka le ngenxa yosulelo lwegazi olunganyangekiyo ngamachiza, kunye ne-70 ukuya kwi-90% yabantu abahamba besiya eIndiya bebuyela ekhaya beneebhaktheriya ezinganyangekiyo ngamachiza. amathumbu abo, ngokutsho kophononongo.
Iibhaktheriya zinokuhlala emathunjini ngaphandle kokubangela iingxaki, kodwa ukuba zihamba ukusuka apho ukuya kwigazi lomguli okanye umgudu womchamo zinokubangela usulelo olubi. Banokudlulisela ukuchasana nezinye iibhaktheriya emathunjini- ke ukuba isigulana sifumana ityhefu yokutya ibhaktheriya ebangele ukuba ifumane ukuxhathisa kwaye kube nzima ukuyinyanga.
Iphupha elibi le-AMR: Ibali likaDavid Ricci
Ukubuyela eSeattle inxeba lakhe losuleleka. Oogqirha bampompoza ngezibulala-zintsholongwane ngaphandle kwempembelelo encinane de ekugqibeleni banyanzeleka ukuba benze utyando olungakumbi ukuze banqumle iinxalenye zesikhondo sakhe esosulelekileyo. Ekugqibeleni, waxelelwa ukuba ubambe iincukuthu ezimbini ezinkulu, ekwakunzima kakhulu ukuzinyanga oogqirha. Wayenethamsanqa ukuba iincukuthu zivalelwe enxebeni, batsho oogqirha. Ukuba babengene egazini lakhe ngewayefile.
Iincukuthu zazingakhuselekanga kumayeza okubulala iintsholongwane ngoko ke ogqirha kuye kwafuneka bajike kumachiza anamandla asetyenziswa kancinci kumayeza anamhlanje kuba aneziphumo ebezingalindelekanga ezibi. UDavid wayetyiswe i-colistin, iyeza lokubulala iintsholongwane elinetyhefu ebekelwe ixesha likaxakeka, kodwa kwafuneka akhutshwe emva kweveki kuba amalungu akhe aqala ukuvalwa. Emva koko wanikwa i<em>tigecycline, iyeza lokubulala iintsholongwane elitsha elenzelwe izifo ezixhathisayo. Kwanyanzeleka ukuba alitofe iyeza kangangeenyanga ezintandathu, idosi yanyuka ngalo lonke ixesha usulelo lubuya. Yayimenza azive enesicaphucaphu kangangokuba wayengakwazi nokubukela umabonwakude okanye enze ikomityi yekofu; kwafuneka achithe iintsuku zakhe elele entlungwini, enethemba lokuba le khosi ekugqibeleni yayiza kuzibulala iintsholongwane. โKwakungathi ndinyangwa umhlazaโ, watsho. Ndandiye ndivuke ndicinga ukuba 'Nceda undisuse, ndicela uyiyeke le nto.'
UDavid wayechole izinambuzane ezahlukahlukeneyo eIndiya ezazinemfuza eyaziwa ngokuba yi-NDM-1, ebizwa ngegama laseNew Delhi apho yafunyanwa okokuqala ngo-2008. zisetyenziselwa ukunyanga izifo eziye zakwazi ukumelana namanye amayeza. Iintsholongwane ezikwaziyo ukuxhathisa i<em>carbapenems ziye zabizwa ngokuba ziibhaktheriya โeziyingoziโ liZiko laseUnited States loLawulo noThintelo lweZifo ngenxa yokuba isiqingatha sabo bonke abantu abasulelwa sisifo segazi kubo siyafa.
I-NDM-1 isasazeke kwihlabathi liphela ukusukela oko yabhaqwayo. Ubuncinci abantu abayi-175 e-US banyangelwe usulelo lwe-NDM-1 ukusukela ngo-2009, nangona kunokwenzeka ukuba kubekho iimeko ezininzi ngakumbi njengoko izibhedlele zingafuneki ukuba zixele. Ngelixa iimeko ezininzi zivela phesheya, usulelo kwizigulana ezingakhange zimke e-US luyaxelwa ngoku.
I-NDM-1 nayo iyaqala ukubonakala e-UK. Kuye kwakho iingxelo ezili-1,129 zale ntsholongwane eNgilani ukususela ngowama-2003, yaye oku kucingelwa ukuba lilonke.
Ekugqibeleni uDavid wachacha, kodwa ukunganyangeki ngamayeza okubulala iintsholongwane kuye kwabuguqula ubomi bakhe. usebenza nemibutho ekhankaselayo kwaye uthetha namalungu enkongolo ngalo mba, kwaye ufuna ukusebenza kwezamayeza kwixesha elizayo.
โNdiziva ngathi ndinenjongo,โ watsho. โOnke la mava andenze ndaziva ndinethamsanqa ngokuphila.โ
Amachiza okulwa neentsholongwane afunyenwe kumanqanaba ngamawaka amaxesha aphezulu kunomda okhuselekileyo
abaninzi kwizifundo zangaphambili baye baqaqambisa ungcoliseko lwamayeza eIndiya naseTshayina โ abathi xa bebonke bavelisa uninzi lwamayeza okubulala iintsholongwane ehlabathini โ kwaye babonise indlela ungcoliseko olunjalo olubangela ukwanda kwezinambuzane ezinkulu kwihlabathi jikelele. Ababhali bophononongo olutsha lwe-Infection olubekwe ukubonelela ngomfanekiso ocacileyo wamanqanaba kunye neentlobo zongcoliseko e-Hyderabad kunye namakhonkco ayo ekuxhathiseni amachiza.
Abaphandi bathathe iisampulu zamanzi emilanjeni, kumachibi, kumanzi aphantsi komhlaba, amanzi okusela kunye namanzi angaphezulu ukusuka emaphandleni nasezidolophini kwindawo ekufutshane nemizi-mveliso, kunye namachibi akufuphi neefektri kunye nemithombo yamanzi angcoliswe zizixhobo zokucocwa kogutyulo. Ezine zathathwa kwiimpompo, enye kumngxuma wokutsala amanzi, kwaye ezingama-23 ezishiyekileyo zafakwa kuluhlu lweesampulu zokusingqongileyo.
Iisampulu zavavanyelwa iintsholongwane ezikwaziyo ukumelana namachiza amaninzi (ezaziwa ngokuba zii-MDR pathogens, igama lobuchwephesha lee-superbugs). Abaphandi baye bavavanya i-16 yeesampulu ze-antibiotics kunye ne-antifungals esetyenziselwa ukunyanga usulelo.
Zonke iisampulu ngaphandle kwenye ethatyathwe kumanzi etephu kwihotele yeenkwenkwezi ezine zifunyenwe zinentsholongwane enganyangekiyo ngamachiza. Zonke iisampulu zokusingqongileyo ezingama-23 zinebhaktiriya evelisa i-carbapenemase-iqela leebhugi ezibizwa "ibhaktheriya yasebusuku" ngenxa yokuba phantse azinyangeki kwaye zibulala ama-40-50% abantu abanegazi labo elosulelwa zizo.
Kwiisampulu ezili-16 emva koko zavavanyelwa intsalela yeziyobisi, i-13 yafunyaniswa ukuba ingcolisekile ngamayeza okubulala iintsholongwane kunye ne-antifungal, ezinye zikwinqanaba eliphezulu ngendlela ephazamisayo. Abaphandi bathelekisa amanqanaba okushiyeka kwimida ecetyiswa ngabaphambili be-microbiologists; xa amanqanaba edlula loo mida kunokwenzeka ukuba ii-superbugs ziyakukhula.
Isampulu ethatyathwe kumjelo omnye ohambisa amanzi amdaka iqulathe ugxininiso lwechiza le-antifungal i-fluconazole - ichiza elisetyenziswa kwizithambiso zosulelo lomngundo olufana nethrush kunye nonyawo lomdlali okanye linikezelwe emithanjeni ngenxa yosulelo olubi kakhulu - kumanqanaba angama-950,000 aphezulu kunomda ocetyiswayo okhuselekileyo. Abaphandi bahlalutya ngokuphindaphindiweyo oku kufunyanisiweyo ukuze baqinisekise ukuba ichanekile. โNgokolwazi lwethu, olu lolona xinzelelo luphezulu lwalo naliphi na iyeza elakha lalinganiswa kwindawo esingqongileyo,โ babhala babhala ababhali.
Iisampulu ezisuka kumjelo ophantsi komhlaba ohambisa amanzi amdaka kwindawo yoshishino zikwafunyaniswa "zinogxininiso oluphezulu kakhulu" lwamayeza alithoba awohlukeneyo. Amanqanaba e-moxifloxacin - esetyenziselwa ukunyanga izifo zemiphunga, ulusu kunye ne-sinus kunye nesifo sephepha - ayenyuka ukuya kumaxesha angama-5,500 aphezulu kunomda ocetyiswayo, ngelixa esinye isithinteli-ntsholongwane esiqhelekileyo i-ciprofloxacin sifunyenwe kumanqanaba ukuya kumaxesha angama-700 ngaphezu koko kucetyiswayo. Ugxininiso lwe-antibiotics i-clarithromycin kunye ne-ampicillin zifunyenwe kumanqanaba angaphezu kwamaxesha e-100 aphezulu kunomda okhuselekileyo.
Amanani ee-antimicrobials afunyenwe kuvavanyo olutsha "ayephezulu kakhulu," utshilo uGqr Mark Holmes, isazi ngezinto eziphilayo kwiYunivesithi yaseCambridge. โUbungakanani obubandakanyekayo buthetha ukuba isixa emanzini siphantse safana nethamo lonyango,โ utshilo, ecela abasemagunyeni baseIndiya ukuba baphande ngokukhawuleza ngokuvavanya ukungcola kumzi-mveliso ngamnye. โOko ayikokususa nje iipilisi ezimbalwa kwindlu yangasese.โ
Ungcoliseko lwamayeza ayikuphela kwendlela apho amayeza okubulala iintsholongwane angena kwindawo yaseIndiya - ilindle eliphuma ebantwini nakwizilwanyana kunye nenkunkuma evela ezibhedlele nakwiifama nayo iqulethe iintsalela zamachiza. Kodwa amanye amanqanaba afunyenwe kuvavanyo lwamva nje athetha ukuba iintsalela zinokuvela kuphela kwimveliso eninzi, ngokutsho kwezazinzulu.
Unjingalwazi uJoakim Larsson, weYunivesithi yaseGothenburg ukholelwa ukuba amanqanaba e-antimicrobials afunyenweyo akanakuchazwa ngenye into ngaphandle kokukhutshwa kwimizi-mveliso. โKe isixelela ukuba ingxaki isekhona, kufuneka isombululwe,โ uxelele iintatheli zaseJamani ebezisebenza kule ngxelo.
Umzi mveliso wamayeza eHyderabad uvelisa โinkunkuma eninziโ suku ngalunye, utsho Sulelo ingxelo. Amanzi amdaka ahanjiswa ngeelori ukuya kwindawo enye yokucocwa kwenkunkuma, ithi, apho icocwa khona phambi kokuba ithunyelwe kumzi-mveliso omkhulu wamanzi amdaka. Apho, ixutywe nelindle kwaye iphinde iphathwe emva koko ikhutshelwe kumlambo okufuphi waseMusi.
Ukubambelela kumgaqo-nkqubo wenkunkuma yolwelo onguziro oyalelwe yiNkundla ePhakamileyo kufuna ubuchwepheshe obubiza imali eninzi, kwaye enye inkunkuma isathunyelwa ngokufihlakeleyo kwindawo yokucocwa kwenkunkuma okanye ilahlwe ngqo kwindawo engqongileyo, ngokwengxelo.
Amakhonkco kwiimarike zase-US nase-UK
Phantse zonke iinkampani zamachiza ezinkulu zehlabathi zibonelelwa ngamaziko emveliso eHyderabad. Iinkampani ezahlukeneyo ezinemizi-mveliso ekufutshane okanye kufutshane neendawo apho iisampulu zamanzi zathathwa khona zibonelela ngeemarike zase-US nase-UK, nangona izixa ezikhulu kangaka zamayeza okubulala iintsholongwane akhoyo kuyo yonke imo yaseIndiya akunakwenzeka ukudibanisa ngokuthe ngqo iifektri ezithile kwiziphumo ezithile zovavanyo.
Ukusebenzisa i-Bulk Drug Manufacturing Industry's 2015 manual, edwelisa bonke abenzi beziyobisi baseIndiya, iindawo zabo kunye neemveliso zabo, iintatheli kwi-NDR ziye zakwazi ukuchonga iinkampani ze-19 ezisebenza kwindawo ye-Patancheru-Bollaram evelisa amachiza e-antimicrobial afunyenwe kwiisampuli zamanzi. (Kusenokubakho abanye abavelisi abangachazwanga ngamagama abasebenza kwindawo okanye iinkampani ezingabhengezi ukuba zeziphi na ii-antimicrobials ezizivelisayo.)
I-Bureau idibanise inani lezi nkampani kwiimarike zase-US nase-UK. I-MSN Pharmachem yenye yabenzi bamachiza abakhula ngokukhawuleza eIndiya. Yenza isithako ekrwada sesibulali-zintsholongwane i-moxifloxacin egameni leenkampani zamachiza zamazwe ngamazwe i-Macleods kunye ne-Sun Pharmaceuticals, ezithi ke ziyijike ibe yimveliso egqityiweyo enikezelwe kuMbutho wezeMpilo weHlabathi.
Ezinye iinkampani ezinkulu ezisebenza kummandla obonelela ngeemarike zase-US nase-UK ziquka i-Aurobindo, umvelisi ophambili waseIndiya othumela kumazwe angaphezulu kwe-150 kwihlabathi liphela, kunye ne-Mylan, inkampani ebanga ukuba iimveliso zayo zizalisa enye kwimiyalelo eli-13 ekhutshwayo. eMelika. UMylan ukwabonelela ngemakethi yeManyano yaseYurophu, kwaye uthi ngoyena mthengisi mkhulu wesine wamachiza enziwe afana nalawo aveliswe ngumenzi (angenalo uphawu) e-UK.
Iinkampani zizikhaba ngamandla iingcebiso zokuba imizi-mveliso yazo inoxanduva longcoliseko.
I-MSN Pharmachem ithe ihambelana neyona migangatho iphezulu yoshishino, imithetho esebenzayo kunye nemimiselo, kwaye yasebenzisa umgaqo-nkqubo wokukhupha iqanda kwiifektri zayo.
โIindawo zethu zihlala zijongwa ngaphakathi kwaye zihlolwa ngaphandle,โ satsho isithethi. "Sizibophelele kwindawo ecocekileyo, impilo yabo bonke abasebenzi bethu, abamelwane, amaqabane kunye nabathengi."
U-Aurobindo uthe akunakwenzeka ukuba naluphi na ungcoliseko lunokuba luvela kwiifektri zalo njengoko liphinde lasebenzisa umgaqo-nkqubo wenkunkuma engamanzi - yonke inkunkuma iphathwa kwaye iphinda isetyenziswe ngaphakathi kwezityalo. Ikwathe ubume bendawo kunye nokuhamba kwamanzi kwiindawo ezifanelekileyo kuthetha ukuba akukho namanzi emvula okanye amanzi aphuma embhoxweni aya kukwazi ukuhamba ukusuka kwimizi-mveliso yawo ukuya kwiindawo zokuqokelelwa kweisampulu.
UMylan ukwathe umzi-mveliso wawo awunakuba negalelo kwiintsalela ezichongwe ngabaphandi, njengoko zonke iiplanti zabo zinomgaqo-nkqubo wenkunkuma yolwelo ongunothi apho onke amanzi amdaka agaywa ngokutsha aphinde asetyenziswe kwindawo. Inezixokelelwano zayo zokucocwa kwamanzi amdaka kuzo zonke izityalo zayo zaseHyderabad, satsho isithethi, esisebenzisa ubuchwephesha obuphezulu ukuphelisa inkunkuma eyingozi. "Ezi zityalo zisebenza iiyure ezingama-24 ngosuku, iintsuku ezisixhenxe ngeveki ngabantu abafanelekileyo," yatsho ingxelo.
I-Macleods kunye ne-Sun Pharmaceuticals ayizange iphendule kwizicelo zokunika izimvo.
Isithethi se-WHO sathi umbutho awuzange uthenge izithako zamachiza, amayeza nje okugqibela, kwaye awukhange udibane nabavelisi bezithako. "Iindawo zokuvelisa zihlolwe ngokuqhelekileyo kwi-Good Manufacturing Practice (GMP) egxile ekuqinisekiseni umgangatho ohambelanayo wemveliso echaphazelekayo kwimbono yomngcipheko wempilo yabantu," satsho isitatimende. "I-GMP ayijongani nolawulo lwenkunkuma kunye nemilinganiselo yolawulo lwendalo esingqongileyo ngokujonga ukukhutshwa kwenkunkuma kunye nolawulo longcoliseko - njengoko kuya kusebenza imimiselo yemo engqongileyo yasekhaya kunye neyeshishini."
Ityhefu ekutyeni yajika yaba ngamava aphantse afa
U-Andrew, oneminyaka engama-57, kunye nenkosikazi yakhe uSally bagula zizisu ezibuhlungu nje emva kokufika eNew Delhi ukuze bathathe umsebenzi omtsha.
Ngoxa umfazi wakhe wachacha ngokukhawuleza, uAndrew wathabatha iiveki ukuba achache. Waba nesinye isifo esibuhlungu kunye norhudo kwiinyanga ezimbalwa kamva, kwaye waqhubeka egula manqaphanqapha unyaka wonke.
โInto esasingayazi ngelo xesha kukuba wayesulelwe yintsholongwane eyingozi ngoku eyayiphila emzimbeni wakhe,โ watsho uSally. โUbuntu bakhe batshintsha. Waba nexhala kakhulu, wayengakwazi ukuphumla, eziva egula kwaye ephazamisekile. Ndandikhathazeke kakhulu, ubomi bethu babusiba mbi ngokwenene kuzo zonke iinkalo.โ
Imeko yakhe yaba mandundu ngokuhamba kwexesha, waza u-Andrew walaliswa esibhedlele apho waxelelwa ukuba unosulelo kumchamo.
Isibhedlele samisela amayeza okubulala iintsholongwane anamandla, awayebonakala esebenza ekuqaleni, kodwa kwiiveki ezimbalwa kamva wavuka enomkhuhlane. Wabuyiselwa esibhedlele, apho oogqirha bathi ugula ngokuyingozi nge-sepsis - amalungu akhe ayevaliwe.
Wachacha ngokwaneleyo ukuba abuyele e-UK, apho ogqirha kwiSikolo saseLondon seHigiene & Tropical Medicine bathi usulelo lwakhe lune-NDM-1. Uvavanyo lubonise ukuba ayinyangeki kuzo zonke izibulala-ntsholongwane ngaphandle kwe-fosfomycin. UAndrew noSally balungisa imicimbi yabo, besoyikela ukuba uya kufa ukuba usulelo lubuyile.
Abahlobo baqala ukumphepha bekholelwa ukuba banokubamba iibhaktheriya. Ngoku sele ethathe umhlala-phantsi kwaye ephantsi kokhathalelo lweengcali, yena nenkosikazi yakhe banexhala lokuba i-NDM-1 ixhaphake kakhulu eIndiya yinto nje yexesha ngaphambi kokuba ibe yinto eqhelekileyo e-UK.
Ngaphandle kokuba iinkampani zibizelwe ukuhambisa inkunkuma, de urhulumente waseIndiya aqalise ukufundisa ucoceko lwezandla ezibhedlele nakwindawo zokutyela ezinje ngeehotele kunye neeresityu, amathuba okuba olu sulelo lusasazeke kwihlabathi liphela, utshilo uSally. โKuyinto eqhelekileyo ukuthi โAndifuni abantu badlule kwinto esadlula kuyoโ kodwa yinyani. Ibutshintshile ubomi bethu.โ
Amagama atshintshiwe ukukhusela izazisi
Akukho kukhankanywa kongcoliseko kwimimiselo yehlabathi
Kukho imimiselo yemigaqo kunye nemimiselo ekufuneka abavelisi babambelele kuyo ukuze bathumele iimveliso zabo e-US naseYurophu - eyaziwa ngokuba yi-Good Manufacturing Practices (GMP) isakhelo. Ezi zijolise ekuqinisekiseni ukuba amachiza akhuselekile, amsulwa, kwaye ayasebenza.
Ukuhlolwa okungqongqo yi-FDA, WHO kunye nabasemagunyeni baseYurophu bajonga ukuba le mithetho iyalandelwa.
Nangona kunjalo le migaqo ayijongani neenkxalabo zokusingqongileyo. Abahloli abanagunya lokunika i-factory isohlwayo ngokungcolisa, ukusilela ukunyanga inkunkuma yayo okanye ezinye iingxaki zokusingqongileyo - oku kuwela kuxanduva loorhulumente basekhaya.
Ngaphakathi eIndiya, kukho imigaqo yokusingqongileyo ebandakanya ukuba zeziphi izithako iifektri ezivumelekileyo ukuba zivelise, indlela ezisebenzisa ngayo amanzi kunye nendlela ezilahla ngayo inkunkuma yazo. EHyderabad, iTelangana State Pollution Board (TSPCB) ihlola iifektri ezisekelwe kwezi.
Nangona kunjalo olu hlolo luye lwenziwa ibhalwe ukuba ayinamazinyo ngamaqela ephulo asekhaya nawamazwe ngamazwe. NgoNovemba 2015, i uhlalutyo lweengxelo zokuhlolwa kwe-TSPCB yiZiko leNzululwazi kunye nokusiNgqongileyo eDelhi bafumanisa ukuba abenzi beziyobisi be-15 besambuku ngaphakathi kwendawo yoshishino yasePatancheru Bollaram babevelisa izithako ababengenayo imvume, besebenzisa amanzi angaphezu komda ovunyelweyo, kunye nokulahla amanzi amdaka kunye nenkunkuma eyingozi kunokuba kuvunyelwe.
Zininzi izithembiso ezenziweyo. Ngaphezu kwe-100 yeenkampani zamachiza (kubandakanywa neMylan) zatyikitya isibhengezo kwiForam yezoQoqosho yeHlabathi eDavos ekuqaleni konyaka ophelileyo zithembisa ukucoca imveliso; izibophelelo eziye zaphindwa kuluhlu lwendlela yoshishino olukhutshwe ngabavelisi abaphambili abali-13 kwintlanganiso yokuqala ekwinqanaba eliphezulu leZizwe eziManyeneyo malunga nokuchasana nokulwa namagciwane ngoSeptemba ophelileyo.
Kwiveki ephelileyo iKhomishini yaseYurophu nayo ipapashe imephu yendlela ukuvuma ukukhutshwa kwezithako ezilwa neentsholongwane kwindawo esingqongileyo ngexesha lokwenziwa kwayo โkusenokubangela ingozi.โ Ithembisile ukuba iza kuphonononga indlela yokuhlangabezana nomngeni ngo-2018, kodwa yasilela ekuzibopheleleni kumgaqo-nkqubo wokwenene.
Urhulumente wase-UK uthembise ngokuthatha inyathelo malunga nongcoliseko kumakhonkco obonelelo e-NHS alandelayo Ingxelo yeBureau yangaphambili ngo-Oktobha ophelileyo, kodwa akakwazanga ukuphawula malunga nokuba oku kulandelwe ngenxa yemithetho ye-purdah evimbela naziphi na izibhengezo zomgaqo-nkqubo ngexesha lonyulo.
Kwaye i-WHO, kunye neearhente ze-UN, utyikitye โiNgxelo yeNjongoโ kuDisemba odluleyo ejolise โekuhambiseleni phambili ukuthengwa kwemeko-bume nenkathalo ngokwentlaloโ yeemveliso zabo zempilo. Kule veki nje, umlawuli-jikelele we-WHO uMargaret Chan ulumkise umhlaba ukuba usiya โkwixesha lasemva kokubulala amayezaโ kwaye kwakhona kubizwe intshukumo emanyeneyo yehlabathi. Udwelise izenzo ebezifuneka ngokungxamisekileyo, kuqukwa ukusika imimiselo yamayeza okubulala iintsholongwane, ukuphuhlisa amachiza amatsha, kunye nemigaqo-nkqubo elungelelanisiweyo karhulumente kwihlabathi jikelele. Akazange athethe ngongcoliseko lwamayeza.
I-European Public Health Alliance, i-ambrella yemibutho engaphezu kwe-90 engenzi nzuzo, yagxeka ukungaphumeleli kwabalawuli bamazwe ngamazwe ukwenza nantoni na malunga nongcoliseko "oluxhaphakileyo" "oluyimbangela ecacileyo" ye-AMR.
"Oku kushiyiwa kufuneka kulungiswe ngokubandakanya imigangatho yokusingqongileyo ebophelelayo ngokusemthethweni kwiiprothokholi ze-GMP, ngakumbi malunga nokungcoliseka kwezinto ezilwa ne-antimicrobial - njengemeko yokugunyaziswa kunye nokungeniswa kweziyobisi," satsho isithethi. "Izivumelwano zokuzithandela azanele ukumisa ugqatso ukuya ezantsi, apho iinkampani zamachiza zisebenzisa amakhonkco abuthathaka kumakhonkco obonelelo lwehlabathi, kwiindawo apho kuncinci okanye kungabikho ukunyanzeliswa kwemigangatho ebalulekileyo yokusingqongileyo."
Imimiselo eqinile malunga nongcoliseko kufuneka ingeniswe, utshilo uGqr Yohei Doi, uNjingalwazi wezoNyango kwiYunivesithi yasePittsburgh School of Medicine, kwaye bekuya kubathengi bamazwe ngamazwe beziyobisi ezifana ne-FDA ukwenza oku kwenzeke. โNgabathengi base-US abahlawulela ezi zinto,โ utshilo. Logama nje abantu bewathenga la machiza, iinkampani ziyakuhlala ziwenza ngolu hlobo.
I-documentary ka-NDR, i-WDR kunye ne-SZ ebizwa ngokuthi "Utshaba olungabonakaliyo - i-Deadly Superbugs evela kwiiFactory zasePharmaโ, izakudlala ngomhla we-8 kuCanzibe ngo-10:45 ebusuku kwisitishi i-ARD. IsiNgesi inguqulelo iya kuvela kwifidi yejelo likaYouTube.
Landela uhlaziyo lwe-Bureau lwe-antibiotic resistance kuTwitter: @TBIJAntibiotics
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