Reducing Antibiotic Resistance - How do the numbers add up to ONE?

Written by Roxane Feller on 21 November 2018 in Opinion Plus
Opinion Plus

The collective goal of tackling antibiotic resistance should be to ensure One Health for our people, our animals and our planet, argues Roxane Feller

Photo credit: AnimalHealth Europe


Over 33,000 deaths each year in Europe and €1bn in annual healthcare expenditure.

These are the European Centre for Disease Prevention and Control’s (ECDC) estimates on the consequences of infections due to antibiotics-resistant bacteria.

Meanwhile, the Organisation for Economic Cooperation and Development (OECD) predicts that unless more is done to stem antibiotic resistance 2.4 million, across Europe, North America and Australia, will die from infections over the next 30 years.


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And, according to the World Bank, we would need $9bn annually for Antimicrobial Resistance (AMR) containment measures in low and middle-income countries up to 2050.

Ever since their introduction some 70 years ago, antibiotics have saved hundreds of millions of lives, both human and animal lives.

The numbers are clear and they’re sending a loud and strong message around the world that urgent and effective action must be taken to address antibiotic resistance before it’s too late.

But with World Antibiotic Awareness Week now past and the latest numbers and reports all published and shared, more attention must now be paid to looking at what the numbers mean.

What do these findings and calculation tell us? Where and how do we need to take more action to ensure that we can keep antibiotics working for the foreseeable future?

"A behavioural change is taking shape in the farming community, widely supported by veterinary practitioners, and an increasing prevalence for the ‘prevention is better than cure approach’ is now recognised in many member states"

The one thing that is resoundingly clear is that our collective goal of any and all actions is to ensure One Health for our people, our animals and our planet. We all agree that we all have a role to play in order to preserve these precious tools for future generations.

Speaking for the animal health sector in Europe, a number of actions are being driven by the animal medicines industry. These actions are a mix of own-initiatives, or formed jointly with educational bodies and interested stakeholders, and in some cases through work with national authorities.

These actions have increased over the past ten years and has had a clear and measurable effect across many EU countries as demonstrated in the latest European Surveillance of Veterinary Antimicrobial Consumption report on veterinary antibiotic sales in Europe.

A behavioural change is taking shape in the farming community, widely supported by veterinary practitioners, and an increasing prevalence for the ‘prevention is better than cure approach’ is now recognised in many member states.

The animal health sector is not resting on its laurels however, as outcomes are not the same everywhere and these best practices in raising awareness, offering training, and providing guidance must be shared with the wider global community so that we can all learn from each other the best ways to ensure effective action to address antibiotic resistance.

When it comes to ensuring One Health, a key point for policymakers to keep in mind is that ‘zero’ is a number that should be avoided in decision-making discussions.

"We must ensure a more responsible use of these powerful medicines. By investing in improving hygiene in any healthcare setting, be it hospitals, nursing homes or veterinary practices we can already make a dent in the presence of bacteria"

The ‘zero-use’ or ‘antibiotic-free’ label, possibly driven by retailer response to socio-political factors, sparks serious concerns amongst many vets, farmers and the wider animal health sector.

With the very best attention and investment in hygiene, biosecurity, health management and nutrition some farms may on occasion experience periods where there is no need to use antibiotics, or where the need to use them is very low.

However, for the sake of the health and welfare of all animals, it is essential that a range of antibiotics remain available for vets to be able to treat bacterial infections when they do occur.

If an animal gets sick and is not treated with the appropriate antibiotic, not only does this impact animal health and welfare, but this can also impact our health.

When animal health is compromised, this can have a knock-on effect on food safety, or on prevention of diseases that can be transmitted to people.

Whereas we support actions taken by EU decision-makers to curb the unnecessary use of antibiotics for animal health, if we are to truly take a One Health approach to addressing the issue of antibiotic resistance, then a clear consideration of what the latest numbers tell us are a good place to start.

The ECDC report for example tells us that 75 percent of the burden of disease related to AMR is due to healthcare-associated infections while the OECD report tells us that three out of four deaths could be averted by spending just $2 more per person per year on measures as simple as handwashing and the more prudent prescription of antibiotics.

Let’s face the facts. Antibiotics are powerful medicines that stop bacteria from reproducing or destroy them. Bacteria are highly adaptable however and have been adapting to survive for millions of years and will continue to do so.

Therefore we must ensure a more responsible use of these powerful medicines. By investing in improving hygiene in any healthcare setting, be it hospitals, nursing homes or veterinary practices we can already make a dent in the presence of bacteria.

And by taking into account the true value of our antibiotics – remember the hundreds of millions of lives saved – then doctors, healthcare workers and vets, and their patients or clients should learn to respect the scientific healing brought by these precious solutions that ensure our collective One Health, and only prescribe or use them when absolutely necessary.

About the author

Roxane Feller is Secretary General of AnimalhealthEurope

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