With most nations pulling out all the stops to contain the devastating impact of Covid-19, there is a global focus on how best to fight this common threat. But the next global health crisis is already here and yet we have no common focus or effective plan to deal with it.
Will we learn enough lessons from this pandemic to stop the next global health emergency — antibiotic resistance? Covid-19 has got the world’s attention by infecting 8.9 million people and killing 465,000. By contrast, antibiotic-resistant “superbugs” already kill more than 700,000 people every year.
Medical experts predict that unless we take significant action, the global death rate from antibiotic resistance will continue to rise to 10 million deaths a year by 2050. The primary causes are the overuse and abuse of antibiotics in human medicine and intensive animal agriculture.
While there is increasing awareness of the overuse of antibiotics in human medicine — medical experts are currently concerned the overuse of antibiotics to prevent possible secondary infections in Covid-19 patients will lead to a surge in resistance — most people have no unawareness of the much higher levels of use and abuse of these drugs in industrialized animal agriculture. Here, animals are crowded together in unhygienic conditions, stressed — which lowers their immune systems — thereby prone to infectious diseases. Because meat production is a low-margin business designed to meet our addiction to cheap meat, the least expensive way to prevent and treat disease in these animals is to give them drugs, many of which we rely on to save human lives. (See our blog)
Dr. Sally Davies, a leading expert on antibiotic resistance and former Chief Medical Officer of England, says that “antibiotic resistance may kill us before climate change does” and without significant action “modern medicine will be lost.” Current trade discussions and recent studies show the world is continuing to sleepwalk towards this predictable yet preventable catastrophe.
For example, medical and agriculture experts are concerned that under a possible trade agreement between the US and UK, US meat products would be allowed into the UK. This threatens to undermine the UK’s progress in the fight against antibiotic resistance as antibiotic use in US livestock is five times higher.
“US farmers continue to massively overuse antibiotics despite increasing warnings about the threat this poses to human health. British consumers should be concerned if a UK-US trade deal results in increasing imports of US meat and dairy produced in this way, as we know that antibiotic-resistant bacteria can pass to humans through the food chain,” said Cóilín Nunan of Alliance to Save Our Antibiotics, a UK-based coalition of health, medical, environmental and animal welfare groups.
Despite the many warnings sounded over the last 10 years, global progress on this complex but solvable problem has been slow, uneven and alarmingly insufficient. In the meantime, bacteria continue to mutate and increase their resistance to our life saving drugs.
A recent study published in the journal Science shows how antibiotic resistance in food animals globally has tripled between 2000 –2018. For example, in developing countries antibiotics “used for treatment failed more than half the time in 40% of chickens and one-third of pigs raised for human consumption.”
Antibiotic use in livestock production. Note the proportion given to healthy animals for non-medical purposes. Source: Food Climate Research Network
This means there is a much higher risk that bacteria common in factory farmed animals and easily transmitted from animals to humans, such as E. coli, campylobacter, salmonella and staphylococcus aureus, all of which cause serious diseases in humans and animals, are resistant to the drugs we depend on to fight these infections.
The study by researchers at the Princeton Environmental Institute, ETH Zurich and Free University of Brussels, says that 73% of all antibiotics worldwide are used in livestock, mostly in the billions of animals confined to factory farms. The researchers found that antibiotic resistance in livestock was most widespread in China and India, with Brazil and Kenya emerging as hot spots. Since 2000, meat production has accelerated by more than 60% in Africa and Asia, and by 40% in South America. More than half of the world's chickens and pigs are in Asia.
“Antimicrobial resistance is a global problem. This alarming trend shows that drugs used in animal farming are rapidly losing their efficacy,” said Thomas Van Boeckel, lead study author from ETH Zurich.
The future trend line is not encouraging either. Global use of antibiotics for livestock is expected to grow by 67% by 2030 according to scientists at Oxford University.
So, what can be done? Raising awareness and making different choices are two places to start.
We can put pressure on meat producers, food companies and governments to recognize and address the problem. The UN Interagency Coordination Group on Antimicrobial Resistance says that most of the public is unaware of the size and seriousness of the issue and that without action “what is coming will be a catastrophe.” Meanwhile, the Royal College of Physicians (UK), says “the medical community must call for EU-wide measures to save antibiotics for use in unhealthy humans, not healthy animals.”
There are plans to reduce the use of antibiotics in human medicine and for animal agriculture but there is no strong, coordinated global response. Sweden and Denmark producers use less than half of the antibiotics used by US farmers and the EU is banning the preventive use of antibiotics in farm animals by 2022. However, the practice continues to be widespread in North America and developing countries. The WHO wants to reduce the use of drugs considered medically important for humans, in food producing animals. But, so far, there has been insufficient political will to make significant progress.
At a time when the pandemic is forcing us to re-examine our way of life, perhaps we can make some different choices from those that are helping to undermine our collective future.
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