The global quest to address one of the most pressing public health problems, antimicrobial resistance, is yielding results.
A newly released report from the Food and Agriculture Organization of the United Nations showcases the ways prevention serves as the foundation of responsible use and action against antimicrobial resistance, or AMR.
The FAO "will support agrifood producers to adopt good practices to reduce the need for antimicrobial use and preserve the efficacy of these life-saving medicines for future generations,” said Thanawat Tiensin, director of FAO's animal health and production division.
How Prevention Can Reduce the Need for Antibiotics details progress in animal agriculture since the last United Nations Declaration in 2016, and it comes as the UN General Assembly prepares to host its High-Level Meeting on Antimicrobial Resistance in New York on Thursday.
Antibiotics are a cornerstone of modern medicine. However, misuse and overuse can lead to resistant bacterial infections where antibiotics may no longer work. Addressing this challenge spans human, environmental, and animal health, and it requires action in all domains.
The FAO report states, "the responsibility of curbing AMR does not fall on any one organization or country alone. It is a collective duty that requires the cooperation of governments, industry, stakeholders, researchers, and the public.” To that end, nearly 200 nations around the world are taking collective action, and the effort is showing results. As stewardship has increased, the need for antibiotics has declined.
Specifically, a progress report from HealthforAnimals last year documents the declining need for antimicrobial use in most major markets. In the U.K., antimicrobial sales for livestock dropped by 59% between 2014 and 2022, with a 82% reduction in the use of highest-priority, critically important antimicrobials.
Across the EU, usage has decreased by 53% since 2011, with reductions of up to 68% in major markets such as Germany. In the U.S., sales of medically important antibiotics dropped 36% since 2015. According to the most recent data from the World Organization for Animal Health, antibiotic use in veterinary care declined 20% between 2016 and 2019.
These reductions were enabled by diagnostic testing and a dramatic increase in the use of prevention products, like vaccines. Using diagnostics to identify the microbial pathogen and its profile allows the industry to set up effective vaccine protocols and administer an effective treatment, reducing the need for antimicrobials.
Data from the world’s largest animal health companies shows how declines in antimicrobial sales are mirrored by increases in vaccine sales. A number of case studies of vaccination use on farms illustrates the positive connection between vaccines and reduced antibiotics use. For example, E. coli vaccination reduced antibiotic need and lowered medication costs by 80% for two-kilogram broiler birds.
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Biosecurity measures, which refer to the physical measures that are used to prevent the spread of disease on and between farms, are a vital component in reducing antimicrobial resistance.
A study of EU swine found that increasing biosecurity and vaccination led to a reduction in antimicrobial usage by 52% for fattening pigs and 32% for breeding animals. Similarly, a review of 27 studies across 16 countries found that 70% of results showed a positive association between farm biosecurity and management with a reduction in antimicrobial use.
Although the animal health sector has already made enormous contributions toward slowing antimicrobial resistance by reducing the need for antibiotics, action in animal health alone is not enough to neutralize the threat to human health.
Studies have found that the majority of antibiotic-resistant bacteria are transferred through person-to-person contact, particularly in healthcare settings. A Lancet study analyzed more than a decade of data in the Netherlands to identify the source of resistant E. coli genes in people, finding that 78.6 percent is from human-to-human transmission, environment, or other sources while 21.4 percent is from meat, seafood, or contact with farm animals.
Ultimately, a One Health approach that incorporates human and veterinary medicine must focus simultaneously on disease prevention and optimized antibiotic use where it will have outsized impacts. Growing recognition of the One Health approach has inspired a shift toward more responsible antibiotic use and stewardship. Global efforts have been coordinated between the FAO, World Organization for Animal Health, the UN Environment Program, and the World Health Organization.
Tackling antibiotic resistance in the animal health sector is only one part of the puzzle. More extensive data and surveillance of drug resistance hotspots can continue to shape more effective policies for human and animal health care.
We are hopeful that our U.S. policymakers will continue to be a strong voice for stewardship so that antibiotics can be used responsibly to protect animal health while minimizing the threat of AMR.
Alex Mathews has been the CEO of the Animal Health Institute for nearly 30 years. He is an advocate for policies and initiatives that safeguard animal health, food safety, and human health.