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Including use in urban poverty: https://www.nytimes.com/2019/04/07/health/antibiotic-resista...

Where antibiotics are handed out without prescription and people live in squalid conditions.

"70 percent of salmonella infections in Kenya had stopped responding to the most widely available antibiotics, up from 45 percent in the early 2000s."

"Even when the drugs are authentic, many poor Kenyans try to save money by buying just a few tablets instead of the full course — not enough to vanquish an infection but enough to allow bacteria to mutate and gain resistance."

The current population of Kenya is 50m, forecast to increase to 95m by 2050, and 156m by 2100.

Kenya also currently has the scientific output of Serbia, a country 14% the size. Its likely that Kenya will continue to import drugs developed in advanced nations, and internally produce only antibiotic resistance.

https://www.natureindex.com/country-outputs/generate/All/glo...




SO I do a little work in Kenya, and it's really hard there. Because you do have rampant resistance, but you also have lack of drug availability - especially in rural parts of Kenya.

We've got some data suggesting there that stewardship is, relatively speaking, less impactful there than decreases in transmission. Because the environment is heavily contaminated, which is itself conducive to the spread of resistance.




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