The problem is so epic the United Nations General Assembly is meeting about it in September – which is only the fourth time the 70-year-old intergovernmental body has dealt head-on with a health crisis. The others included the HIV/AIDS pandemic in 1996, non-communicable diseases in 2011, and the Ebola outbreak in 2014.
To guide the UN, a group of 11 experts on antibiotic-resistant bacteria – including Ramanan Laxminarayan, the director of Center for Disease Dynamics, Economics and Policy – published a call-to-action in the scientific journal The Lancet this month. They urge cooperation between governments, and various agencies and industries – including the agriculture sector.
Roughly two-thirds of global antibiotic use is for livestock, with the rest used in humans, according to Laxminarayan. According to the FDA, about 80 percent of antibiotics are used for livestock and 20 percent for humans in the United States (although the agency later urged caution on making a direct comparison). Regardless, livestock are often given antibiotics not to cure a diagnosed illness, but to increase the animals’ size, or to act as a preventative measure in crowded industrial-scale farming operations. Because of this, the drugs can lose their potency. And when antibiotic-resistant bacteria develop in livestock, the bacteria can make the jump to humans through direct contact or through meat and other animal products, helping to spread diseases that are increasingly becoming harder to cure. (See figure below.) In the U.S. there isn’t an enforceable policy in place regarding the use of antibiotics for livestock – only a set of voluntary guidelines from the USDA that are suggestions for best practices.
A Center for Disease Control and Prevention diagram of how antibiotic resistance spreads. Click to enlarge; Courtesy of the CDC
“Make no mistake, the animal consumption [of antibiotics] is growing at a faster rate than the human consumption,” Laxminarayan told Modern Farmer last September. “There’s a huge increase in the demand for animal protein globally, and that means more farms are moving towards a more intensive form of agriculture.”
Antibiotic resistance is a global problem, and it hits close to home. In fact, more than two million people in the United States get infections that are resistant to antibiotics every year and approximately 23,000 people die as a result, according to the Centers for Disease Control and Prevention (CDC). While cases of Methicillin-resistant Staphylococcus aureus (MRSA) – probably the best-known bacteria resistant to antibiotic drugs – have declined in the U.S. over the last eight years, there are other even more dangerous “superbugs” coming to the fore.
In May, the first case of E. coli resistant to the antibiotic colistin, considered a drug of last resort, was found in a 49-year-old Pennsylvania woman suffering from a urinary tract infection. That same month, colistin-resistant E. coli was found in a pig intestine analyzed by the USDA. This drug-resistant E. Coli was first observed in China in 2015 from samples of live animals and raw meat, and it was later discovered in humans in both China and Europe. It’s believed the bacteria leapt from livestock to humans through food, Yohei Doi, an infectious-disease doctor at the University of Pittsburgh told the Washington Post in May. This is a significant development representing the breach of the final line of defense in our arsenal of antibiotics.
The UN has quite a road ahead in order to coordinate the safeguarding of antibiotics for future generations. The authors of the call-to-action describe the General Assembly meeting in September as “a rare opportunity to change how we as a global community use the only currently feasible method to treat bacterial infections. It is an opportunity that should not be squandered because of lack of ambition.”