Encouraging news about progress in the ongoing battle against antimicrobial resistance (AMR) is highlighted in a landmark report recently released by the World Organisation for Animal Health. 

This comes at an especially good time with Antimicrobial Resistance Awareness Week running from Nov. 18-24. It has been held every November since 2016. The campaign serves to highlight the threats that antimicrobial resistance poses to humans, animals, plants, food and ecosystems, while also promoting a global, collaborative response to these threats. 

Antimicrobial resistance, often referred to as antibiotic resistance, occurs when bacteria that cause diseases, among them pneumonia, meningitis and strep throat in humans become resistant to antibiotics that would ordinarily be able to cure them. These resistant bacteria are also referred to as “super bugs.”

The good news, according to the report, is that global antimicrobial use in animals has declined by 13 percent in 3 years, marking once again a significant shift in the ongoing efforts to preserve the effectiveness of these critical medicines. That’s important because when considering human health, the overuse or misuse of antibiotics in livestock, or humans, can result in antibiotic resistance, which can then pose a threat to human health. It’s a threat that can be as serious as life-threatening diseases or even death.

According to CDC, when animals are slaughtered and processed for food, antibiotic-resistant bacteria, if present in the animal, can contaminate meat or other animal products. And because antibiotic resistant bacteria have already made their way into the food chain, curing people sickened with the superbugs is all that more challenging — or sometimes even impossible.

Also according to CDC, 75 percent of dangerous new infections, including pandemics, spill over from from animals to human populations.

The recent report on antimicrobial resistance also showcases a decline in the use of antibiotics considered to be of critical importance for human health. 

In a welcome downward shift, less than 20 percent of antimicrobials used in animals in 2019 were deemed to be of  the highest priority and most critically important to human health. That’s especially important because these are oftentimes the sole therapy or one of few alternatives to treat life-threatening human diseases.

Going further in the fight against this threat to global health, WOAH has recently fully digitalised its global database into an online platform: ANIMUSE.   

Dr. Carolee Carlson, veterinarian and epidemiologist for the Public Health Agency of Canada, said that a key strength of ANIMUSE is its flexibility. Countries at any level of their surveillance programme can report on the platform. Even if a country’s insight on amounts of antimicrobials used in animals is limited, being able to join the platform fosters discussion and improvement over time.

This year the organization is building on last year’s theme, “Preventing Antimicrobial Resistance Together,” thus encouraging stakeholders around the world to collaborate across sectors to preserve the medicines that help save lives.

Bottomline, says the report, it becomes everyone’s responsibility to make sure that our current antibiotic arsenal remains effective for generations to come. The global health community must continue to champion this cause to safeguard tomorrow’s health.”  

Miracle drugs
Antibiotics, often referred to as “miracle drugs,” are medicines that can kill or stop the growth of some types of harmful bacteria in humans and animals alike.

However in the case of livestock and poultry, especially at large scale operations such as industrial farms, antibiotics are often used in ways that promote resistance to them. This can happen when low doses are routinely added to feed and water to promote growth and to prevent health problems caused by overcrowding and unsanitary contains. This sort of use differs from using them to treat a specific medical problem.

In the battle that develops between the bacteria and antibiotics, resistance happens when the bacteria develop the ability to evade the antibiotics designed to kill them. As a result, instead of being killed, the germs continue to grow and to outcompete the drugs, which has the potential to cause infections that are harder to treat. This is why they’re called “super bugs.”

When it comes to food safety, some dangerous strains of foodborne bacteria, such as  E. coli, Salmonella, and Listeria are now resistant to antibiotics when antibiotics have been overused or misused in livestock or poultry. If a person becomes infected with an antibiotic-resistant strain of a foodborne pathogen, what was once, in many cases, an easy-to-treat disease, can quickly develop into a life-threatening illness – one that requires expensive medical care and can even lead to death.

Public health threat
“Antimicrobial resistance is an urgent global public health threat,” warns the U.S. Centers for Disease Control and Prevention on its website about this (https://www.cdc.gov/drugresistance/about.html). According to the agency, it kills at least 1.27 million people worldwide and was associated with nearly 5 million deaths in 2019.

Also, according to CDC, antimicrobial resistance has the potential to affect people at any stage of life, as well as the healthcare, veterinary, and agriculture industries. “This makes it one of the world’s most urgent public health problems,” says the agency.

When looking ahead, the picture only gets more daunting. Some medical experts predict that worldwide by 2050 the number of deaths attributed to antibiotic resistance could reach 10 million and cost trillions of dollars — unless collective action is taken on a global scale.

Some human and animal health experts are even referring to this as a “slow moving pandemic.” 

“This is a crisis ‘here and how,’ warned Christine Ann Miller, chair of the Antimicrobials Working Group during a recent Senate subcommittee hearing. “Many medical procedures that are commonplace today will become too risky to undertake, with catastrophic consequences to medical care, including death.”

Roger Marshall (R-KS) told the group that 100 Americans die every day from AMR.

Miller explained why this is happening: the bacteria, including those that cause foodborne diseases, are living organisms that adapt, evolve and continually develop resistance to existing drugs, which means the steady innovation of newer, novel antibiotics are needed.

During the hearing, Miller joined others to voice their support of the Pasteur Act, a bi-partisan bill introduced this year, which would support development of innovative antibiotics to treat resistant infections and improve appropriate antibiotic use. This would include vaccines that show promise as a complementary tool that could help prevent future drug-resistant outbreaks.

Food safety connection
George Gitau, an advocate for community and public health, focuses on nutrition and dietetics. Currently pursuing a major in Nutrition and Dietetics at Jomo Kenyatta University of Agriculture and Technology in Kenya, he works on raising awareness about antimicrobial resistance (AMR) and its relationship with food and nutrition.

“Many factors related to food safety greatly impact the emergence and spread of AMR,” said Gitau in a report. “Consuming unsafe food increases the risk of developing food-borne illnesses, including those caused by drug-resistant microbes. In low-and middle-income countries, research shows that large quantities of antimicrobials are used to treat food-borne diseases. 

“Additionally, antibiotics are often given to animals to promote growth and prevent disease, leading to the development of antibiotic-resistant bacteria in animals, which can then be transmitted to humans through the handling and consumption of contaminated food. The use of antifungals in crop production can also lead to the spread of antifungal-resistant fungal pathogens in the environment.”

With a background as a clinical nutrition intern, Gitau has seen firsthand how devastating AMR on individuals affected by malnutrition and food-borne illnesses can be.

For that reason, he emphasizes the role of nutrition in enhancing immunity and preventing infections, contributing to the fight against AMR and protecting the future of healthcare.

Doing it right/antibiotic stewardship
On a broader scale, the CDC offers this perspective about what it refers to as antibiotic stewardship:

“Perhaps the single most important action needed to greatly slow down the development and spread of antibiotic-resistant infections is to change the way antibiotics are used. Up to half of antibiotic use in humans and much of antibiotic use in animals is unnecessary and inappropriate and makes everyone less safe.

“Stopping even some of the inappropriate and unnecessary use of antibiotics in people and animals would help greatly in slowing down the spread of resistant bacteria,” according to the CDC. “This commitment to always use antibiotics appropriately and safely — only when they are needed to treat disease, and to choose the right antibiotics and to administer them in the right way in every case — is known as antibiotic stewardship.”