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Good, bad and ugly of antibiotic resistance

THE growing resistance to antibiotics and other antimicrobials due to overuse and misuse, both in humans and animals, has become an alarming threat to public health, food safety and security, causing the deaths of 700,000 people each year.

This is a fact.

The good news is that more and more countries have adopted measures to prevent the excessive and wrong use of antimicrobials. The bad news is that these drugs continue to be extensively utilised to accelerate growth in livestock, often to obtain greater commercial benefits.

According to the first annual survey conducted by the United Nations Food and Agriculture Organisation (FAO), the World Health Organisation (WHO) and the World Organisation for Animal Health (OIE), more than 6.5 billion people, or over 90 per cent of the world’s population, are living in a country that has, or is developing, a national action plan to curb antimicrobial resistance (AMR).

“Nearly all of these plans cover both human and animal health in line with the recommended ‘one health’ multi-sectoral approach,” FAO said on Nov 17.

The survey’s release came at the end of the World Antibiotic Awareness Week, which kicked off on Nov 13, announcing that more countries had unveiled plans to tackle AMR.

But careless disposal of antibiotics can produce “ferocious superbugs”, warns the UN.

In fact, growing AMR is linked to the discharge of drugs and chemicals into the environment, which has become one of the most worrying health threats today, according to new UN research that highlights emerging challenges and solutions in the environment.

The Frontiers Report, launched on the second day of the UN Environment Assembly in Nairobi, Kenya on Dec 6, looked at the environmental dimension of AMR in nanomaterials; marine protected areas; sand and dust storms; off-grid solar solutions; and environmental displacement — finding the role of the environment in the emergence and spread of AMR is particularly concerning.

While antimicrobial medicine — antibiotics, antifungals, antivirals and antihelminthics — are widely used in livestock, poultry and aquaculture, the survey alerts that their overuse and misuse in “promoting growth” are leading to the emergence of resistant microbes, making the diseases they cause difficult or, in some cases, impossible to treat.

And here comes the recurrent alert: despite progress, the global push to address this problem — which is taking on “epic proportions” — is still in its early stages.

There are weak points that need shoring up, particularly in the food and agriculture sectors of low- and middle-income countries. They are key battlegrounds against the “superbugs”, says the FAO.

“The goal is to help develop the tools and capacity to implement best practices in animal and crop production, reduce the use of antimicrobials in food systems, develop surveillance capacity to assess the scale of AMR and efforts to control it, and strengthen regulatory frameworks to minimise the misuse of antimicrobials while simultaneously ensuring access to those drugs when treating sick animals,” said FAO assistant director-general for agriculture and consumer protection Ren Wang.

The FAO provides the following sound explanation:

Since the introduction of penicillin in the middle of the 20th century, antimicrobial treatments have been used not only in human medicine, but in veterinary care as well.

At first, they were utilised to treat sick animals and develop new surgical techniques. For example, to perform Caesarean section on cattle. With the progress in farming, however, the use of antimicrobials has expanded to include disease prevention and growth promotion.

The use in healthy animals to prevent diseases has become common in husbandry systems, where large numbers of livestock are housed under moderate to poor hygienic conditions without biosafety measures in place.

Sometimes, when a few animals get sick, the whole livestock is treated to prevent the disease from spreading.

Besides treatment and disease prevention, the FAO warns that antimicrobials have been added — in low dosages– to animal feed to promote fast growth, despite more and more countries prohibiting such usage.

Although the UN agency does not say explicitly why this happens, it can be easily deduced that it is due to the voracious appetite for greater profits.

FAO goes on to warn that in the coming decades, the use of antimicrobials in animal production and health will likely rise as a result of economic expansion, a growing global population, and higher demand for animal-sourced food. Indeed, their use in livestock is expected to double within 20 years.

And the more antimicrobials are misused, the less effective they are as medicines in both veterinary and human healthcare, as the misuse drives AMR to evolve and emerge in disease-causing microorganisms.

Another major specialised UN agency, WHO, explains that antimicrobial resistance describes a natural phenomenon where microorganisms, such as bacteria, viruses, parasites and fungi, lose sensitivity to the effects of antimicrobial medicines, like antibiotics that were previously effective in treating infections. IPS

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