Antimicrobial resistance, a threat to human and animal health

September 06, 2019

Antimicrobial resistance, a threat to human and animal health

Antimicrobial resistance is the ability of bacteria to be resistant to treatments and it also stems from the misuse of antibiotics in breeding farms. A well-managed food system may help solve the problem.

According to data emerging from the last European Antibiotic Awareness Day, approximately 33,000 deaths occur each year as a direct result of infections associated with Antimicrobial Resistance (AMR). In other words, the number of bacterial infections 

 in the European population is equal to that of influenza, tuberculosis and HIV/AIDS combined. 

Experts from the European Centre for Disease Prevention and Control (ECDC) have pointed out that the main cause of the spread of antibiotic resistance is the fact that these drugs are still used in human medical practice (both in hospitals and in other contexts), but they also stressed that the food supply chain plays a key role as well. In fact, it is no coincidence that many initiatives aimed at fighting antimicrobial resistance also involve institutions linked to food production and safety, such as the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE) or the European Food Safety Authority (EFSA).

Links to antimicrobial resistance

From the food production chain to humans through more or less direct channels, antimicrobial resistance is a growing global public health problem. Breeding farms, especially in the case of intensive animal farming, play a major role in determining outbreaks of antibiotic resistance in several bacterial species, which can often infect both animals and humans. According to OIE data, 60% of human pathogens are of animal origin and, based on WHO data, many of the food-related diseases that affect humans, causing more than 400,000 deaths each year, are caused by microorganisms. Inappropriate use of antibiotics often leads to the onset of antimicrobial resistance. In fact, antibiotics are used in many countries to accelerate livestock growth or to prevent diseases rather than to treat animals that are actually ill. Statistics show that, in some countries, the total amount of antibiotics used in animals is four times higher than in humans. As if that weren’t enough, fruits and vegetables (contaminated by resistant bacteria, for example through contact with polluted water) can also help bring these microorganisms from the field to the table.

One health only

The World Health Organization (WHO) has included antimicrobial resistance among the top 10 threats to global health in 2019 and is implementing numerous initiatives aimed at preventing it from spreading, also starting with the food supply chain. “Human beings, animals and the environment are equally responsible for the proper use of antibiotics,” said Zsusanna Jakab, WHO Director-General for Europe, stressing the importance of the shared commitment of authorities in all sectors. The 2017 edition of the EU project “One Health Action Plan against Antimicrobial Resistance” fits perfectly into this scenario and is based on three main pillars: making the EU a best practice region in the fight against antimicrobial resistance, implementing research and innovation to fill gaps in the knowledge of the problem and find new solutions and, to conclude, increasing efforts to shape the global agenda on antibiotic resistance. As stated in the report, the expression “One Health” is used precisely to identify the principle that human and animal health are closely connected to each other. In order to preserve them in the best possible way, it is necessary to adopt an approach that includes both, as well as environmental health.

Solutions at all levels

The international community is well aware of the importance of curbing the spread of antimicrobial resistance, as demonstrated by the many initiatives undertaken globally. For example, the WHO Global Action Plan on antibiotic resistance, which was subsequently adopted by the OIE and FAO, was developed in 2015, whereas the Political Declaration of the High-level Meeting of the United Nations General Assembly on Antimicrobial Resistance was published in 2016. Moreover, a working document published in 2017 with the support of the Interagency Coordination Group on Antimicrobial Resistance (IACG) highlighted the close link between antimicrobial resistance and the 17 Sustainable Development Goals of the United Nations. The issue of antibiotic resistance requires an unprecedented level of international coordination (goal 17) and unquestionably puts at risk the achievement of some of the goals set by the UN, such as the elimination of hunger, health for all, the availability of clean water and the protection of life below water and on land (goals 2, 3, 6, 14 and 15). The achievement of other goals, such as the reduction of poverty and inequality and decent work and economic growth (goals 1, 8 and 10) is also, albeit indirectly, affected by the negative impact of antimicrobial resistance. As explained by the WHO experts, who in 2017 published their guidelines on the use of medically important antibiotics in food-producing animals, “the most effective strategy to reduce the transmission of antibiotic-resistant bacteria from animals to humans is to prevent the growth of such bacteria in food-producing animals.” The document recommends using these drugs only when instructed by the veterinarian for treating sick animals, and not for preventive purposes on all animals that do not show signs of disease. If an antibiotic needs to be used, it is better to start from a molecule that is less important and used in medicine.

Europe doesn’t stand by and watch

Since 1 January 2006, the use of antibiotics in animal feed to promote animal growth has been banned in Europe. The fight against antimicrobial resistance is still ongoing in Europe and, in October 2018, Members of the European Parliament (MEPs) adopted a new regulation on the use of veterinary drugs in breeding farms, which emphasizes the fact that an antibiotic should never be used to compensate for poor conditions of animal farming or to make animals grow faster. This step is closely linked to the one taken a few months earlier with regard to the adoption of a new regulation on the use of drug-enriched food. Although much has been achieved over the last few years, there is still a long way to go in the fight against antimicrobial resistance in Europe. In fact, according to data provided by the European Public Health Alliance (EPHA), almost two-thirds (74%) of the 31 European states assessed in a recent analysis have developed or improved national plans or initiatives to fight AMR, while differences between states are still too great. For example, only half of the countries that were analyzed (51%) implemented strategies in line with the One Health approach, often due to lack of funds or of well-coordinated plans between the different players involved. This analysis is completed by a series of recommendations that EPHA experts address both to the European Commission and to individual Member States in order to coordinate and increase the effectiveness of the efforts made.