Resistance to Antibiotics: The Good, the Bad and the Ugly



The growing resistance to antibiotics and other antimicrobials due to their overuse and misuse both in humans and animals has become an alarming global 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 now more and more countries have adopted measures to prevent the excessive and wrong use of antimicrobials. The bad ones are that these drugs continue to be intensively utilised to accelerate the growth of animals, often for the sake of obtaining greater commercial benefits.
According to the first annual survey conducted by the Food and Agriculture Organization of the UN (FAO), the World Health Organization (WHO), and a global intergovernmental body on animal health—the World Organisation for Animal Health (OIE), more than 6.5 billion people – over 90 per cent of the world’s population – now live in country that has in place, or is developing, a national action plan on 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 17 November.
The survey’s release came at the end of the World Antibiotic Awareness Week, which kicked off on 13 November, announcing that more countries have unveiled plans to tackle AMR.
So far so good.

Ferocious Superbugs
The bad news is that careless disposal of antibiotics could produce ‘ferocious superbugs,’ warns the United Nations.
In fact, growing antimicrobial resistance linked to the discharge of drugs and some chemicals into the environment is one of the most worrying health threats today, according to new research from the United Nations that highlights emerging challenges and solutions in environment.
“The warning here is truly frightening: we could be spurring the development of ferocious superbugs through ignorance and carelessness,” on 5 December said Erik Solheim, chief of the UN Environment Programme (UNEP).
The Frontiers Report, launched on the second day of the UN Environment Assembly (UNEA), running through 6 December in Nairobi, looks at the environmental dimension of antimicrobial resistance 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 resistance to antimicrobials particularly concerning.
The other bad news is that while antimicrobial medicines – antibiotics, antifungals, antivirals or antiparasitics – are widely used in livestock, poultry and aquaculture operations to treat or prevent diseases, the survey alerts that their over-use and misuse – such as for “promoting growth”– is leading to the emergence of microbes resistant to these drugs, making the diseases they cause difficult or in cases, impossible, to treat.

Epic Proportions
“Humans exposed to these antimicrobial resistant pathogens are also affected in the same way.”
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 still need to be shored up – particularly in the food and agriculture sectors of low- and middle-income countries, key battlegrounds against ‘superbugs’ resistant to conventional medicines, FAO cautions.
“In particular, there are major gaps in data regarding where, how and to what extent antimicrobials are being used in agriculture; also systems and facilities for tracking the occurrence of AMR in food systems and the surrounding environment need to be strengthened.”
“The goal is to help them develop the tools and capacity to implement best practices in animal and crop production, reduce the need for 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 antibiotics while simultaneously ensuring access to drugs for treating sick animals,” said Ren Wang, FAO Assistant Director-General for Agriculture and Consumer Protection.

What is the Problem?
The UN food and agriculture specialised agency 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 utilized to treat sick animals and to introduce new surgical techniques, making it possible, for example, to perform caesarean sections in cattle on farms. With the intensification of farming, however, the use of antimicrobials was expanded to include disease prevention and use as growth promoters.
The use of antimicrobials in healthy animals to prevent diseases has now become common in husbandry systems where large numbers are housed under moderate to poor hygienic conditions without appropriate biosafety measures in place. Similarly, when a few members of a flock have a disease, sometimes all animals are treated to prevent its spread.