The Global Story: Antibiotics - A casualty of war?

Summary

Global News Podcast Summary
Episode: The Global Story: Antibiotics - A casualty of war?
Release Date: February 16, 2025
Host/Author: BBC World Service
Duration: Approximately 28 minutes

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Introduction

In this episode of the Global News Podcast by the BBC World Service, host Oliver Conway introduces a deep dive into the precarious state of antimicrobial resistance (AMR) and how contemporary conflicts are exacerbating this global health crisis. The episode, titled "Antibiotics - A casualty of war?", explores the historical significance of antibiotics, the rise of drug-resistant bacteria, and the profound impact of war on these developments.

The Evolution and Importance of Antimicrobials

Dominic Hughes, the program's global health correspondent, sets the stage by highlighting the transformative role of antimicrobial drugs in modern medicine. He emphasizes their critical importance both in civilian healthcare and on the battlefield.

Dominic Hughes:
"Antimicrobial drugs have transformed the health of humanity. Some of the greatest advances in those drugs' development have been forged in wartime."
(01:04)

Jonny Diamond, a contributor, elaborates on the history of antimicrobials, tracing their origins back to ancient civilizations and detailing key milestones in their development.

Jonny Diamond:
"Before antimicrobials were really discovered, life was essentially precarious. Even a relatively minor infection could prove fatal."
(02:24)

He further explains the discovery of penicillin by Alexander Fleming in 1928, noting its revolutionary impact during the Second World War and the subsequent “golden age” of antibiotic discovery up until the 1970s.

The Rise of Antimicrobial Resistance (AMR)

The conversation shifts to the alarming increase in AMR, a situation where bacteria evolve to resist the effects of antibiotics, rendering these life-saving drugs ineffective.

Dominic Hughes:
"Antimicrobials, antibiotics are becoming less effective. Instead, we're seeing the emergence of what are called superbugs."
(10:02)

Jonny Diamond explains the mechanisms behind AMR, emphasizing both natural evolutionary processes and the misuse or overuse of antibiotics as primary drivers.

Jonny Diamond:
"Antibiotics are used to treat or prevent a really big range of bacterial infections... global antibiotic consumption rates since they were introduced have just gone through the roof."
(08:23)

He highlights the stagnation in new antibiotic development since the late 1980s, a trend that has significantly contributed to the current AMR crisis.

War as an Accelerant for AMR: The Case of Ukraine

The episode delves into how ongoing conflicts, particularly the Russian invasion of Ukraine, are intensifying the AMR problem. Abdul Jalil Abdul Rasulov reports firsthand from Ukrainian hospitals overwhelmed by war casualties.

Abdul Jalil Abdul Rasulov:
"Private Bezverni had resistance to antibiotics... when they arrive at hospital, they get some sort of antibiotics and then the treatment procedure gets disrupted."
(16:50)

Patients like Private Osanda Biswerkni suffer severe injuries compounded by multi-resistant infections, largely due to disrupted treatment protocols and overcrowded, understaffed hospitals unable to maintain sterile environments.

Jonny Diamond:
"It's estimated that penicillin reduced the mortality rate from bacterial infections among wounded soldiers by 15%... a new dark age of drug resistance looms."
(12:11)

The report underscores the dire situation where the battlefield's massive antibiotic use is breeding superbugs, undermining decades of medical progress.

War's Impact on AMR in Gaza

Expanding the scope, the podcast examines similar patterns in Gaza, where conflicts have led to soaring rates of antibiotic-resistant infections.

Abdul Jalil Abdul Rasulov:
"MSF treated almost twice the number of patients it had the previous year in Gaza, reaching around 8,000 people."
(20:05)

He details how fragile health systems, environmental contamination, and the intermingling of civilians with combatants exacerbate the spread of AMR. Hospitals often become sites of infection rather than healing, with over 80% of admitted patients in Kyiv facing multi-resistant infections.

Jonny Diamond:
"In conflict-affected regions, you've got this sort of pretty fragile health system to start with... it's highly likely that AMR rates have gone up."
(20:34)

Global Implications and Responses

The discussion broadens to the global ramifications of AMR, emphasizing that it is not confined to war zones but is a universal threat requiring coordinated international action.

Jonny Diamond:
"It's a properly global problem. It affects high, medium, low-income countries across the world... One country just can't take it on alone."
(25:50)

The World Health Organization's initiatives to combat AMR are mentioned, including boosting research into new antibiotics and reducing global death rates from AMR by 10% by 2030 against the 2019 baseline.

Jonny Diamond:
"There has been this acknowledgement of the significant gaps in addressing AMR in what it calls humanitarian and low-resource settings."
(27:10)

However, challenges remain in translating these commitments into tangible actions, especially in resource-strapped and conflict-ridden regions.

Conclusion

The episode wraps up by reaffirming the critical nature of AMR as a global health emergency, exacerbated by the chaos of war. With projections estimating up to 10 million deaths annually by 2050 due to AMR, the need for sustained, global efforts to mitigate this threat has never been more urgent.

Dominic Hughes:
"These antimicrobial medicines, they're the cornerstone of modern medicine. Drug-resistant bacteria threaten to undermine all of that."
(13:52)

The podcast concludes with a call to action for responsible antibiotic use, adherence to international humanitarian laws in conflict zones, and the necessity of global cooperation to address the AMR crisis effectively.

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Notable Quotes:

• Dominic Hughes
  "A new dark age of drug resistance looms as antimicrobial drugs are prescribed in massive quantities on the battlefield and to civilian casualties."
  (01:36)

• Jonny Diamond
  "Antimicrobial medicines, they're the cornerstone of modern medicine. Drug-resistant bacteria threatens to undermine all of that."
  (13:52)

• Abdul Jalil Abdul Rasulov
  "Private Bezverny had resistance to antibiotics... he had sepsis five times and doctors operated on him more than 100 times."
  (19:16)

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This episode of the Global News Podcast provides a comprehensive exploration of the intertwined issues of antimicrobial resistance and global conflict, highlighting the urgent need for coordinated efforts to safeguard humanity's medical advancements.

Transcript

[Jonny Diamond]

This BBC podcast is supported by ads outside the uk.

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[Oliver Conway]

Hello, this is the Global News podcast from the BBC World Service. I'm Oliver Conway with your weekly bonus from the Global Story, which brings you a single story with depth and insight from the BBC's best journalists. There's a new episode every weekday. Just search for the global story wherever you get your podcasts and be sure to subscribe so you don't miss a single episode. Here's my colleague, Johnny Diamond.

[Dominic Hughes]

They have saved countless lives and improved tens, maybe hundreds of millions more. Antimicrobial drugs have transformed the health of humanity. Some of the greatest advances in those drugs development have been forged in wartime. But now those same wars threaten the progress that's been made.

[Abdul Jalil Abdul Rasulov]

But the Russian invasion of Ukraine has.

[Jonny Diamond]

Led to the emergence of bacteria that are severely resistant to multiple antibiotics.

[Dominic Hughes]

A new dark age of drug resistance looms as antimicrobial drugs are prescribed in massive quantities on the battlefield and to civilian casualties. Today, the story of humanity's triumph over disease and how that is threatened by the wars we fight. With me today is Dominic Hughes, our global health correspondent.

[Jonny Diamond]

Hello, Jonny. How are you?

[Dominic Hughes]

It's just lovely to have you on the show. Thank you very much indeed. We are talking, of course, about antimicrobial resistance. Can we start with where we were before we had drugs like these? Where we were, I guess, for civilians, but also where we were in wartime.

[Jonny Diamond]

Yeah. So before antimicrobials were really discovered, life was essentially precarious. Even a relatively minor infection could prove fatal. So people say a paper cut could have killed you. Anything that could lead to an infection. So any kind of surgery giving birth, deaths of mothers and babies were really commonplace. And treatments were pretty medieval. Bloodletting was a treatment for pneumonia. Fresh air was the main treatment for tuberculosis. And for hundreds of years, mercury compounds were used to treat syphilis. But also that came along with terrible side effects. And of course, on the field of battle, any little cut could be really dangerous because battlefields are full of dirt, other people's bloods, bits of hot metal flying around. There were a lot of serious injuries. And from that, deadly infections.

[Dominic Hughes]

Okay, so then along come antimicrobials. Now, I think a fair number of people Will probably be thinking, hang on, antimicrobial antibiotics, are they one and the same thing?

[Jonny Diamond]

They're slightly different. So an antimicrobial is an agent that kills microorganisms or it stops them from growing in the first place. So antimicrobial medicines can be grouped according to the different microorganisms they act against. So, for example, antibiotics, as you mentioned, are used against bacteria. Antifungals are used against fungal infections. And they can include things like, you know, disinfectants which are used on surfaces, or antiseptics which are used on living tissue, for example, during surgery. And then, of course, yeah, antibiotics, which destroy microorganisms in the body.

[Dominic Hughes]

So antibiotics are a subset.

[Jonny Diamond]

Yeah, exactly.

[Dominic Hughes]

A broader group of antimicrobials.

[Jonny Diamond]

Exactly that, yeah.

[Dominic Hughes]

What about the discovery of antimicrobials and the people that made these, I guess, revolutionary discoveries?

[Jonny Diamond]

Yeah. So look, there's a really ancient history to the use of antimicrobials. The ancient Egyptians and the Greeks, they used molds to treat infection, you know, more than 2,000 years ago. But in the 19th century, Louis Pasteur and Jean Francois Joubert noticed what they described as antagonism between bacteria. In other words, one type of bacteria stop the action or the effect of another. Joseph Lister then used their work and he developed this into the sterilization of surgical tools and treating wounds, which of course had a massive impact on survival rates during surgery. But then the crucial breakthrough was in 1928, Alexander Fleming.

[Dominic Hughes]

I was studying the appearance of staphylococcal common. The staphylococcus is the microbe that gives us boils and carbuncles.

[Jonny Diamond]

He came back from a holiday to his lab at St. Mary's Hospital in London and he found mold that was growing on a petri dish that seemed to be preventing the bacteria that was around it from growing.

[Dominic Hughes]

They extracted it and purified it. We injected it into animals and human beings.

[Jonny Diamond]

This mold produced pretty much a self defense chemical that could kill the bacteria. And he named that substance penicillin.

[Dominic Hughes]

Penicillin, which is probably what most people, if they think about antibiotics, they think about penicillin as the sort of great father of antibiotics. Yeah, you said that happens between the first and the Second World War. Presumably it's the second World War. That means you have a massive take up in particular on the battlefield.

[Jonny Diamond]

Yeah. It took actually almost 20 years to develop Fleming's discovery into a useful drug. It's an extremely tricky process to get penicillin made on an industrial scale. And in fact, it wasn't until about 1942, in the middle of the Second World War, that production of penicillin really took off. And that happened in the United States, industrial monument to the miracle drugs mass production penicillin plant at Terre Haute, Indiana. But very quickly, by 1943, the US had sufficient penicillin stocks to satisfy the demands of both its own armed forces and their allies for battle casualties with pneumonia, meningitis, gas, gang green and other wound infections. It's estimated, right, that penicillin reduced the mortality rate from bacterial infections among wounded soldiers by 15%. And it completely transformed the landscape. It prevented, for example, many amputations, it sped up recovery times. And then after the war, in 1946, penicillin became available for the first time in the U.K. for example, for public use. And then there was just this huge growth in discoveries of new types of antibiotics that lasted right up until the 1970s. And people often refer to that as the golden age of discovery.

[Dominic Hughes]

How much have we relied on antimicrobials since then?

[Jonny Diamond]

Well, antibiotics are used to treat or prevent a really big range of bacterial infections. So it's things as varied as acne, the sexually transmitted infection, chlamydia, kidney infections, pneumonia. But also they're sometimes given as a precaution to prevent rather than treat an infection. So if you're having an operation or you have a bite or a wound that could get infected, or if you have a health problem, that means you're at a higher risk of infection. Something like having your spleen removed or you're having chemotherapy treatment for cancer. All of those will involve the administration of some kind of antibiotic.

[Dominic Hughes]

It sounds like they are very common both in civilian life and in military life.

[Jonny Diamond]

Yeah, they really are. I mean, to give you an idea of the sort of sense of scale, global antibiotic consumption rates since they were introduced have just gone through the roof. One study in 2021 found that use had increased by nearly 50% in the last two decades. It's a bit tricky this, but consumption is measured in what's called defined daily doses per 100,000 population per day. So in other words, it's the proportion of people who are getting antibiotics on any single day on each single day in that year in any given country. So between 2000 and 2018, that figure has gone from 9.8 to 14.3.

[Dominic Hughes]

Wow.

[Jonny Diamond]

And most of that, yeah, really significant increase. Most of that increase, interestingly, has been driven by a huge uptake in use in low and middle income countries. But high income countries have remained also extremely High but stable. So you can see the growth now has just really spread right around the globe.

[Dominic Hughes]

Dom, since I was a kid there has been talk of, in particular antibiotic resistance, of all of us becoming resistant, or the threat of resistance, of no longer being touched properly by antibiotics. Can you just explain how the resistance builds and how we understand the pattern of it?

[Jonny Diamond]

Scientists refer to this as antimicrobial resistance, it's known as amr. And that develops when the microbes that cause an infection, they basically evolve ways to protect themselves from that effect that Fleming noticed in his petri dish back in 1928. So that mould that Fleming noticed no longer stops the bacteria from growing. It's basically driven by a couple of things, but the main one is evolution. The bacteria just evolves ways round the obstacles that are placed in their way, but also by the misuse and overuse of antibiotics in recent years. And that's meant that these antimicrobials, antibiotics are becoming less effective. And instead we're seeing the emergence of what are called superbugs, things like mrsa, Clostridium difficile, known as C. Diff, and the bacteria that cause multi drug resistant tuberculosis. So really serious infections and the range of drugs then that are available to treat them are becoming fewer.

[Dominic Hughes]

So why don't we just discover some new antimicrobials to get round the resistance that's trying to get around the ones we've got already?

[Jonny Diamond]

So this is interesting. Since the 1970s, the production of new antibiotics, antimicrobials has really slowed. I think the last antibiotic was discovered in the late 1980s and there's lots of reasons for that. Particularly it's extremely difficult to produce these new drugs, it's extremely expensive and, and it takes a very long time. And because of all those reasons, the big pharmaceutical companies have shied away from producing them. And in doing so, they've kind of lost some of the expertise and the knowledge that was available in order to produce these drugs in the first place. So a lot of different factors have come together to mean that the production of new antimicrobials, antibiotics, has really, really ground to a halt.

[Dominic Hughes]

We've been talking about resistance to antimicrobials as if it's just a sort of one thing. Is it? Or do you have different kinds of resistance?

[Jonny Diamond]

No, you're right, there are different scales of resistance. So they talk about multiple drug resistance and that's when bacteria developed the ability to kind of resist multiple antibiotics. But since 2011, and this gives us a clue as to how serious this is, since 2011, scientists have also referred to different degrees of resistance. So we have the terms extensively drug resistant and pan drug resistant. So pan drug resistance is when a microorganism, like a bacteria, becomes resistant to all known antimicrobial agents. Basically that means all approved drugs that are useful for a treatment just stop working and there is no backup as such. There are no readily available alternatives. And the reason for that is there have been this dearth of new antibiotics since the 1980s. And in the same way that we call the period up to the 1970s the Golden Age of discovery, they're now calling that age after the 1980s the discovery void. So that all means that there are, for some infections in some parts of the world, there are very, very limited treatment options.

[Dominic Hughes]

Dom, can I just ask you a personal question? I mean, you're our global health correspondent. You've been sort of wallow in all this stuff for a fair old time. I mean, does it alarm you? I mean, does it make you think, gosh, yeah, sound the alarm. This is a really, really worrying situation.

[Jonny Diamond]

It is really worrying. I mean, the World Health Organization estimated that in 2019, around 1.3 million people died as a direct result of antimicrobial resistance. And AMR contributed to another nearly 5 million deaths. So I was thinking about exactly what you mentioned on the way into the office as I walked in this morning and I was thinking, thank goodness I am healthy, fit, ish, and not in a part of the world where I'm likely to get one of these sort of pan drug resistant infections. AMR is now described as one of the top global public health and development threats that we face. By 2050, it's projected that deaths both direct and associated with AMR will hit 10 million a year. And that's going to make it a bigger cause of death than cancer. So, you know, these antimicrobial medicines, they're the cornerstone of modern medicine. Drug resistant bacteria threatens to undermine all of that.

[Dominic Hughes]

So we've looked at the revolutionary development of antimicrobials, their massive importance to modern medicine and the threat of developing a resistance to them. Next we're going to hear how antimicrobial resistance is being driven by global conflict. From Ukraine to Gaza.

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[Dominic Hughes]

This is the global. We bring you one big international story in detail five days a week. Follow or subscribe, wherever you listen. Earlier on, we told you about the near miraculous difference that antimicrobials made to the treatment of battlefield infections when they were first mass produced more than 80 years ago. But on the front lines in Ukraine, war is rapidly undermining the power of these treatments. The BBC's Abdul Jalil Abdul Rasulov has been speaking to some soldiers and hospital staff to see how antimicrobial resistance is affecting the ability to treat casualties. This is what he found.

[Abdul Jalil Abdul Rasulov]

I recently went to a hospital in Kyiv that treats casualties from the front line and I met a soldier there, Private Osanda Biswerkni, who had really serious injuries. His legs were amputated, shrapnel ripped through his buttocks and abdomen, and as a result, doctors had to remove part of his intestines. But also doctors discovered that Private Bezverni had resistance to antibiotics. The thing is that most casualties go through several stages of evacuation. That means they get treated at several different clinics. When they arrive at hospital, they get some sort of antibiotics and then the treatment procedure gets disrupted. Then they transfer to another facility where there might be other bacteria around in those hospitals that can infect those patients. And then they get these multi resistant infections that cannot be treated with commonly used antibiotics. All medical facilities across the country must deal with the biggest influx of patients that they have had since World War II. And many hospitals, as a result, they are overcrowded and understaffed at the same time. So of course, in such conditions, it's much more difficult to keep the facility sterile and to maintain all the procedures to prevent infections from spreading. The hospital in Kyiv where Private Biswerkny is being treated now, they say that more than 80% of patients they admit have multi resistant infections or pathogens that can cause them. And this is exactly what happened to Private Bezverkny. He nearly died. He had sepsis five times and doctors operated on him more than 100 times. The problem is that hospitals usually treat these multi resistant infections with special antibiotics from what they call a reserved list. But the more often they prescribe them, the quicker those bacteria will adapt to those new special antibiotics and become resistant to those drugs as well. And as a result, doctors face a dilemma. And I spoke to deputy chief physician at the hospital in Theophania who explained me the challenges they face when they treat patients with such resistance.

[Jonny Diamond]

We have to balance our scales. On the one hand, we must save a patient, on the other, we mustn't breed new microorganisms that will have antimicrobial resistance. We have to save lives. But we also need to restrict the use of certain antibiotics in order to be able to treat our patients in the future.

[Abdul Jalil Abdul Rasulov]

Private Bezverny, after spending several months at ICU unit, was finally transferred to a separate ward. And doctors said that this should be a normal practice, that all patients who have such infections, they must be isolated. But because the hospitals are so overcrowded, they simply have no space to do that. And they keep all these patients together and then they contaminate each other as a result of that.

[Dominic Hughes]

Well, that was the BBC's Abdul Jalil, Abdul Rasulov talking about what he found in Ukraine. An extraordinary illustration there of the role of war building up antimicrobial resistance. Listening to that, and still with me is the BBC's global health correspondent, Dominic Hughes. Dom, is the situation that Abdul Jalil just described, is that mirrored, as far as we understand, in other conflicts? And I'm thinking, particularly, of course, of Gaza.

[Jonny Diamond]

Yeah, I think it very much is. I mean, so far there's no hard data on the most recent conflict in Gaza. That's not surprising. But it's highly likely that AMR rates have gone up. We can look at what happened, for example, after what were called the Great March of return protests in 2018 demanding the end of an Israeli blockade and the right of return for refugees. Medecin Sans Frontiere, the humanitarian organization, they reported a 300% increase in antibiotic resistance in bone and tissue cultures. And in 2018, MSF says it treated almost twice the number of patients it had the previous year in Gaza, reaching around 8,000 people. Now, if you think about the casualty numbers seen in Gaza this time, around maybe 100,000, it's really hard to get an accurate recent figure. But this most recent conflict has touched the lives of so many people. That tells you that, yes, it's highly likely, I think, that AMR rates will again have just gone through the roof.

[Dominic Hughes]

And of course, what's particularly noticeable in Gaza is the intermingling of civilians throughout the conflict and that presumably ups the risk of increased resistance.

[Jonny Diamond]

Yeah, I think, as we heard from Abdul Jalil, lots of different factors come together to drive up the risk of AMR developing in the first place. So MSF says that in conflict affected regions, you've got this sort of pretty fragile health system to start with. Then you have barriers to accessing Proper healthcare and then environmental contamination. You know, the sort of thing about not being able to change your rubber gloves between treating patients. So in Gaza, first, hospitals have been used as shelters during the conflict, and that puts the civilians themselves much closer to centers of disease. Then some of these hospitals have in turn been targeted. And you combine that with the scale of the injuries, just lack of medical supplies, sick and injured people being regularly released back into the population to make space for the incoming casualties before they have even fully recovered, then infections are out there in the general population. It's not a good scenario. So it's likely that, you know, AMR is going to impact public health in Gaza for years after this conflict ends.

[Dominic Hughes]

Dom, it's absolutely fascinating what you say, because I have to say I hadn't thought for a moment about, you know, war as an accelerant for antimicrobial resistance. And yet what Abdul Jalil said, what you just say about Gaza, it's clearly happening. Is there anything that can be done to slow the rate or the increase in the rate of AMR in war zones?

[Jonny Diamond]

Yeah, I think to start with some of those problems that have been identified by organizations like MSF in conflict zones like we've seen in Gaza, they could be addressed through observing the principles of international humanitarian law, things like proportionality, distinguishing between civilians and combatants, not bombing hospitals. That all limits the chances of infection entering the general population to start with. Then there are these issues around supplies of medicines, access to good quality microbiology, so you can see what's going on in these patients, all those sort of things. But, you know, it's really, really challenging in a war zone, and really, really.

[Dominic Hughes]

Challenging when the war zone is sort of spread throughout society rather than being a battlefield or a. What about in civilian medicine, leaving the war zones for the moment to one side, how can sort of best practice help limit antimicrobial resistance amongst civilians?

[Jonny Diamond]

I think it's fair to say there has been a much greater focus on it in recent years. There's been a really big push on what they call antibiotic stewardship. Now, that means that governments and medical institutions are being called on to promote the responsible and effective use of antibiotics. So that means not using them too widely for treating conditions on which they'll have little or no impact. That's especially important in countries where antibiotics are legally available over the counter or you can just get them online without prescription. And that comes down to educating us, people, patients, about their usage. And managing our expectations is key. Managing the expectations of patients that leads to the prevention of infections in the first place. And that's perhaps even more important than controlling responsible use of antibiotics, simply because every use of antibiotics carries with it the risk of resistance developing.

[Dominic Hughes]

We talked about the growth of antimicrobial resistance in war zones and you mentioned, you know, that you were pretty pleased you weren't in a part of the world where there were diseases that had become resistant to antimicrobial drugs. It begs the question, how much of a global problem is this really? Or is it more about bad luck? You've been born there, bad luck, you happen to be in a war zone.

[Jonny Diamond]

No, it's a properly global problem. It affects high, medium, low income countries across the world. And, you know, it requires a globally coordinated response. It's very much like Covid, for example. One country just can't take it on alone. So In September of 2024, world leaders agreed the first global targets to try and control what is now clearly an antimicrobial resistance crisis. There's a whole series of measures the World Health Organization have outlined that countries can adopt. For example, they talk about boosting and encouraging more research into the next generation of antibiotics, trying to make it a more attractive proposition for the big pharmaceutical companies. And there has been a commitment to actually reducing the number of deaths globally associated with bacterial AMR. They want to cut it by 10% by 2030 against that 2019 baseline of nearly 5 million deaths. But MSF has said it's good that there's been this acknowledgement of the significant gaps in addressing AMR in what it calls humanitarian and low resource settings, in other words, conflict zones, much poorer countries. But they say there's a lack of concrete, really practical steps to try and translate these commitments into tangible action.

[Dominic Hughes]

A good start, but a long, long way to go.

[Jonny Diamond]

Exactly that.

[Dominic Hughes]

Dom Hughes, thank you so much for joining us. It's been brilliant to have you on the show. Always a pleasure and thanks so much to you for listening. If you want to get in touch, you can email us at the global storybc.com or you can send us a message or a voice note on WhatsApp. Our number is 44331 239480. You can find those details in our show notes wherever you're listening in the world. This has been the Global Story. Thank you for having us in your headphones and we'll catch you next time.

[Oliver Conway]

If you enjoyed listening, there's a new episode every weekday. Just search for the Global Story wherever you get your BBC podcasts and be sure to click subscribe or follow. We'll have another edition of the Global News Podcast later. Until then, goodbye.