An Integrated Systems Approach is Needed to Ensure the Sustainability of Antibiotic Effectiveness for Both Humans and Animals

Abstract

The growing demand for animal products and the widespread use of antibiotics in bringing food animals to market have heightened concerns over cross-species transmission of drug resistance. Both the biology and emerging epidemiology strongly support the need for global coordination in stemming the generation and propagation of resistance, and the patchwork of global and country-level regulations still leaves significant gaps. More importantly, discussing such a framework opens the door to taking modular steps towards solving these challenges - for example, beginning among targeted parties rather than all countries, tying accountability to financial and technical support, or taxing antibiotic use in animals to deter low-value usage of these drugs. An international agreement would allow integrating surveillance data collection, monitoring and enforcement, research into antibiotic alternatives and more sustainable approaches to agriculture, technical assistance and capacity building, and financing under the umbrella of a One Health approach.

Combating antibiotic resistance, mitigating future threats and ongoing initiatives

“…The UK government's Swann Committee, the Food and Drug Administration (FDA) and the WHO confirm the transmission of resistant bacteria across species and the critical need to use antibiotics for therapeutic purposes (So et al . ). The Infectious Diseases Society of America proposes a limited population antibacterial drug approval pathway to incentiviSe trials by pharmaceutical companies for new antimicrobials (Oliphant & Eroschenko , part 2).…”

“…The World Health Organization (WHO), the Food and Agriculture Organization, and the World Organization for Animal Health support efforts to mitigate the spread of AR (So et al . ). Proposals to mitigate AR include the development of treatments and diagnostic strategies; incentivising pharmaceutical companies’ development of antimicrobials; public and prescribing educational programmes; and infection control practice and policies in hospitals and community practice that promote personal and professional accountability.…”

“…A two‐thirds increase in demand for antibiotics in food animal production and animal products is expected by the year 2030 (So et al . ). This relationship between human and animal health and the environment underscores the need for an integrated, global approach to address AR.…”

Drug Resistance in Bacteria, Fungi, Malaria, and Cancer

“…This will potentially involve new methods of funding research (Brogan and Mossialos 2013;Balasegaram et al 2015;Hwang et al 2015;Outterson et al 2015). There is also a need for restrictions on the use of antibiotics in animals with, for instance, the utilisation of antibiotics in animals in the USA at least three times greater than the overall use in humans (So et al 2015). However, new funding models for financing antibiotic research as well as programmes to reduce antibiotic use in animals are outside the scope of this chapter.…”

History Teaches Us That Confronting Antibiotic Resistance Requires Stronger Global Collective Action

“…As a result, the FDA failed to assert itself against industry opposition and did not convince Congress to enact Swann-inspired bans in 1972 and 1977. 13 As described elsewhere in the series, 14 beginning in the 1980s several European states began to enact more aggressive measures. Nevertheless, such approaches still retain a regional, if not national, character.…”