Thursday, May 1, 2014 A3
LEADING THE NEWS HK at No 4 in survey of global spending
HEALTH
SUPERBUGS ‘A GLOBAL EMERGENCY’ Rising resistance to antibiotics in China and elsewhere means that common infections could once again become killers, warns WHO
Cause and effect
................................................
Name of bacterium/ resistance
Examples of typical diseases caused
Escherichia coli
Urinary tract infections, bloodstream infections
Klebsiella pneumoniae
Pneumonia, bloodstream infections, urinary tract infections
Staphylococcus aureus
Wound infections, bloodstream infections
Jeanette Wang jeanette.wang@scmp.com Long-treatable everyday medical conditions such as urinary tract and bloodstream infections could once again become killers if antibiotic resistance continues at its current rate, the World Health Organisation has warned. The unprecedented WHO study, published yesterday and compiled using data from 114 countries – including China – described the problem of antibiotic resistance as a “global emergency”. In China, treatment for Escherichia coli – the most frequent cause of bloodstream and urinary tract infections – using antibiotics is now ineffective in as many as 70 per cent of patients, the 256-page report by the global health watchdog said. Already, methicillin, the drug used to combat Staphylococcus
aureus – a common cause of skin infections, respiratory disease and food poisoning – does not work in more than one-third of Chinese patients. More than half of patients in China have resistance to the common antibacterial medication for treatment of Klebsiella pneumoniae, a common cause of hospital-acquired urinary tract, bloodstream and respiratory tract infections. Resistance to the treatment of last resort for these infections – carbapenem antibiotics – already stands at 8 per cent on the mainland. The hard-hitting report presents in stark detail the magnitude of the threat. “Without urgent, co-ordinated action by many stakeholders, the world is headed for a postantibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill,” warned Keiji Fukuda, the WHO’S
assistant director general for health security, adding that implications of the resistance trend would be “devastating”. Though the exact health burden of resistance to antibacterial drugs is not known, another WHO report released last December estimated that hospitalacquired infections with multiresistant bacteria cause about 80,000 deaths annually in China, at least 25,000 across the European Union and at least 23,000 in the United States. Mortality aside, health care costs could rise due to more expensive drugs, extended rounds of medication and longer hospital stays. Patients could experience more side effects due to more toxic drugs required. “The problem is perhaps more serious than many people realise,” says Dr Vivian Lin, director of the division of health sector development for the WHO’s Western Pacific Region, which
Resistance rates in China of some bacterial pathogens to common antibiotics
Source: WHO
Highest reported resistance rate (%)
70 52.5 41.1
* Data collected in 2012, published in 2013
includes 37 countries including China. “We are looking at resistance to treatment of last resort for some life-threatening infections having spread to all regions in the world.” The other key finding of the report is the significant gaps in surveillance among countries and regions and a lack of standards for methodology, data sharing and co-ordination, says Dr Seto Wing-hong, a Hong Kong-based member of the WHO’s Global Strategic and Technical Advisory Group on
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antimicrobial resistance. Some countries had incomplete data; many others had none at all. “If you have no good data, you’re groping in the dark – and that’s pointless,” said Seto. The report kick-starts a global effort led by the WHO to address drug resistance, which will involve the development of tools and standards and improved collaboration worldwide to track drug resistance, measure its health and economic impacts and design targeted solutions. Overall, the prevalence of
Flower power
China in push for Asia-Pacific trade deal
Indian front runner for prime minister Narendra Modi takes a selfie of his inked finger and flashes his party’s symbol of the lotus flower to crowds as he voted yesterday in his home state of Gujarat in the latest stage of the country’s elections. The Hindu nationalist hardliner predicted defeat for the Gandhi political dynasty, saying “nothing can save the mother-son government ... a strong government will come to power”. Voters queued across nine states and territories in the latest stage of the world’s biggest election. The Congress party, headed by Sonia Gandhi and her son Rahul, is widely expected to lose to Modi’s Bharatiya Janata Party after a decade in power. Photo: Reuters
> CONTINUED FROM A1
Wang’s comments on the possible regional trade agreement came just a day after US President Barack Obama concluded a four-nation Asia tour without securing an important bilateral trade accord with Japan. Without such a deal, the fate of the 12-nation Trans-Pacific Partnership (TPP) free-trade agreement remains uncertain. The TPP is seen as the centrepiece of Obama’s efforts to boost US influence in Asia in the face of China’s rising clout. The pact does not include China and is seen by some analysts as an effort to economically contain Beijing. But Chinese officials have since last year expressed interest – both publicly and privately – in joining the transpacific deal. “This came on the heels of Obama’s not so successful trip to Asia … one could not help but wonder if China is taking advantage of the lost TPP momentum and trying to push for a regionwide alternative free-trade agreement,” said Oh Ei Sun, a senior fellow at the S. Rajaratnam School of International Studies in Singapore. But He Maochun, director of the Research Centre for Economic Diplomacy Studies at Tsinghua University, said China’s initiative to kick-start the FTAAP was part of Beijing’s drive to promote regional integration. “This [FTAAP] is not a rival to TPP. The FTAAP could potentially benefit from TPP,” He said. Both Oh and He said the FTAAP could attract more support from regional countries if its thresholds were not as strenuous as the TPP. Negotiations for the TPP have run into an impasse as countries refuse to make concessions on issues such as intellectual property rights and market access. Chinese Foreign Minister Wang Yi has stated economic diplomacy is one of the five major focuses for Beijing’s foreign policy this year. Wang has also targeted wrapping up negotiations for a free-trade zone with Japan and South Korea.
antimicrobial resistance on the mainland was relatively high compared to other countries, said Seto. A key reason for this, he said, had been the high usage of antibiotics. An important cause of “irrational use of antibiotics” on the mainland is the financial compensation provided to health care institutions for drug sales, according to Zhejiang University researchers in their study published in the journal PLOS Medicine in November last year. With less than 20 per cent of a hospital’s expenditure coming from government contributions, the institutions sell their services and drugs to finance their budgets. Drug sales constitute about half of institutional income and most of the profit, with more than 25 per cent being sales of antimicrobial agents. Meanwhile, in the sectors of animal husbandry and farming, the overuse of antimicrobial agents has contributed to the occurrence and spread of antibiotic-resistant microbes in the environment.
World Bank study also shows China closing in on US as the world’s largest economy ................................................ Denise Tsang denise.tsang@scmp.com Hongkongers are perched comfortably near the top of a global ranking of material well-being, a new World Bank study shows. China, meanwhile, has made a huge leap towards overtaking the United States as the world’s largest economy, the agency’s International Comparison Programme found, based on 2011 data. The study used purchasing power parity (PPP) calculations, which adjust for price levels and exchange rates to allow comparison of disparate economies. Hong Kong ranked fourth in actual individual consumption per capita among 199 economies on a PPP basis. Actual individual consumption refers to consumer spending by households and spending on goods and services for individuals, such as on health care and education, by government and non-profit institutions. The figure for the city was 87 per cent of that in the US, which ranked second. Bermuda topped the list with 101 per cent, and the Cayman Islands ranked third with 91 per cent. Rounding out the top 10 were Luxembourg, Norway, Switzerland, the United Arab Emirates, Germany and Austria. Bank of East Asia economist Paul Tang Sai-on said Hong Kong’s heavy consumption was
Big spenders Top 10, ranked by consumption per capita in 2011 1
Bermuda
2
US
3
Cayman Islands
4
Hong Kong
5
Luxembourg
6
Norway
7
Switzerland
8
United Arab Emirates
9
Germany
10 Austria Source: World Bank
POLITICS
Civic Party insists on group session with Zhang All six lawmakers will hold talks with liaison office chief after Ronny Tong drops demand ................................................ Tanna Chong tanna.chong@scmp.com The Civic Party will insist on meeting Beijing’s liaison office chief as a group to discuss electoral reform, despite differences with one of its six lawmakers over public nomination. The decision was made at a party meeting yesterday after Dennis Kwok confirmed he had been the second Civic Party lawmaker after Dr Kwok Ka-ki to
receive an individual invitation from the central government’s liaison office for talks. It came after Ronny Tong Ka-wah – who has put forward his own proposal for the 2017 chief executive election that omits the public’s right to nominate candidates – dropped an earlier demand to meet office director Zhang Xiaoming alone or with pan-democrats who support his plan. Tong said yesterday he had changed his mind after the meet-
ing. “I would meet Zhang with other Civic Party lawmakers. I was assured there would be sufficient time for me to discuss my proposal,” he said. He added the party would like to meet Zhang at a venue other than the liaison office’s premises in Western. “We would prefer Legco or even the government offices as the venue,” he said. Zhang is expected to invite pan-democrats shortly, following a trip to Shanghai by legislators to discuss political reform. Education-sector lawmaker Ip Kin-yuen also confirmed that he had received an invitation on Monday, but he “has to discuss
details with the sector before making a decision”. While he had stated a preference to meet Zhang with Charles Mok and Kenneth Leung of Professional Commons, who support his proposal, Tong said yesterday: “I would not tag along … with Leung and Mok. It is unnecessary.” Tong’s plan, unveiled in October, focused on making the nominating committee for chief executive candidates more representative while leaving out the contentious element of allowing all voters to nominate candidates. Fellow moderate pan-demo-
crats, including those from his own party, opposed his idea. The public consultation on methods for electing the chief executive in 2017 and the Legislative Council in 2016 is due to end on Saturday. The Democratic Party and Labour Party said they had not been contacted by the liaison office, but “were likely to only accept a party-based meeting”. League of Social Democrats lawmaker “Long Hair” Leung Kwok-hung said he would meet Zhang “as long as the meeting was open and recorded”. > MORE REPORTS C1, C3
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closely related to a sharp jump in retail property rents. Rents for retail spaces had risen 55 per cent in the five years to February, he said. “Retail-space supply lags behind demand, which creates more pressure on the Hong Kong government to offer more land to shopping malls at the border or develop underground shopping arcades in busy districts,” he said. China’s gross domestic product on a PPP basis doubled to 86.9 per cent of US GDP from 43.1 per cent in 2005, the last time the study was done. India also nearly doubled its ratio, to 37.1 per cent from 18.9 per cent, to emerge as the world’s third-largest economy, overtaking Japan, whose GDP fell to 28.2 per cent of that in the US, from 31.3 per cent. Britain, which ranked ninth, was the only other economy in the top 10 that shrank relative to the US, to 14.2 from 15.4 per cent. The report cautioned that the latest findings were not strictly comparable with those from 2005, as there had been changes in methodology and the number of economies compared had increased from 146 to 199.
TRANSPORT
Another MTR manager quits amid delay woes ................................................ Ada Lee and Samuel Chan A second top manager involved in the construction of the delayed high-speed railway will leave his job before the project finishes. The MTR Corp confirmed yesterday that Alan Myers, general manager of construction at the cross-border link’s West Kowloon terminus, will not renew his contract when it ends in two weeks. The confirmation – two days after media reports about Myers’ departure surfaced – followed news that the corporation’s projects director, Chew Tai-chong, would leave in October, more than a year before the end of his contract. It came as research by the
Ground investigation sites
Sorrento Tower
South China Morning Post found that only a small part of the troubled section of the terminus area had been surveyed Alan for underground Myers conditions. The MTR found rock formations at a higher level than expected and quoted it as one reason for the two-year delay in completion, until 2017. Myers, who joined the company in May 2010, was responsible for overseeing construction at the terminus. He was previously involved in construction of the English Channel Tunnel, the Heathrow Express and a highspeed railway in Britain. An MTR spokesman said yes-
terday that Myers had decided not to renew his contract at the end of last year for family reasons. A Post study of Civil Engineering and Development Department documents found that boreholes to survey underground conditions had been drilled only in a thin strip on the western side of a former 20,000 square metre golf range on the terminus site. In contrast, hundreds of boreholes were found in other areas of the terminus site. Dr Greg Wong Chak-yan, a former president of the Institution of Engineers, said that because of the size of the range, surveying only the rim posed the risk of misjudging conditions. “The MTR lacks some luck in
this,” he said, adding that the question now was whether it had done its best to get access to the golf range for its surveys. The MTR said it would not comment as it was preparing reports for a Legislative Council meeting on the issue on Monday.
They have to come clean on the issue at the subcommittee’s meeting on May 5 SUBCOMMITTEE HEAD MICHAEL TIEN
Lawmakers who visited the terminus this week were told there had probably been no survey of the golf-range area as the MTR was “not granted access”. The MTR is also under pressure to say when it became aware of the engineering obstacle posed by the granite formation. Referring to reports about consultancy documents from 2009 and 2010, indicating that the MTR might have known about the problem long ago, lawmaker Michael Tien Puk-sun said the timing was crucial and could point to a cover-up. “They have to come clean on the issue at the subcommittee’s meeting on May 5,” he said, referring to Legco’s rail subcommittee, which he chairs.
Elements
The Waterfront
Old driving range Express Rail Link West Kowloon Terminus
Jord an R oad
Austin Station
i Wu
oad gR n u Che
Austin Road West
50m SCMP