Farming represents 73% of antimicrobial usage (AMU) worldwide, and is a considerable contributor to antimicrobial resistance (AMR). Despite growing concerns that excessive usage of antibiotics is a key driver to this pressing global health concern, a new study published last week anticipates that veterinary antibiotic usage will grow from 99,502 tonnes in 2020 to 107,472 tonnes in 2030.
Antimicrobials are a key part of modern life, used to treat the vast majority of bacterial, fungal, viral or parasitic infections. However, in the face of overuse and misuse of antimicrobials, the world has been experiencing accelerated rates of AMR, where bacteria, fungi, viruses and parasites no longer respond to the medicines used to treat them.
In the case of bacteria, the new antimicrobial-resistant strains are known as “superbugs.”
The World Health Organization (WHO) has declared antimicrobial resistance one of the top 10 global health threats facing humanity.
What’s more, new antimicrobials are incredibly scarce, while the spread of pathogens unresponsive to these medicines threatens the ability to treat common illnesses including urinary tract infections, sepsis, and sexually transmitted infections (STIs). It also makes routine medical operations, like surgery, chemotherapy, and organ transplants far riskier.
Overuse and misuse of antibiotics are the leading causes of antimicrobial resistance. Without effective #antibiotics💊 and other antimicrobials, we will lose our ability to treat common infections like pneumonia.
The future of antibiotics depends on all of us. pic.twitter.com/U2xgxiHRhg
— World Health Organization (WHO) (@WHO) November 18, 2019
In a report published earlier this week by the United Nations Environment Programme (UNEP), Inger Anderson (the programme’s executive director), said that “AMR was, directly and indirectly, responsible for an estimated five million or so deaths in 2019. By 2050, up to 10 million deaths could occur annually – on par with the 2020 rate of cancer deaths.”
AMR is also a considerable economic threat. “If unchecked,” Anderson continued, “AMR could shave 3.4 trillion USD off GDP annually and push 24 million more people into extreme poverty in the next decade.”
Given the gravity of the threat, the lack of available and cohesive data worldwide is astounding.
The World Organization for Animal Health (WOAH) annually collects, on a voluntary basis, data from up to 157 countries on their AMU in animals. However, before release, the data is collated into five regions: Europe, Africa, Americas, Middle East, and Asia/Far East/Oceania, with national data not available within that.
Forty-two countries – which were mostly high-income – did however have publicly available data on their AMU in animals, and the scientists conducting the antibiotic usage study were able to use this to extrapolate data for the total 187 countries.
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However, due to the limitations of wealth-bias and small sample-size, they were obliged to supplement this data with the WOAH regional data and other sub-national data, noting that even the vast majority of this available data was unusable.
After overcoming the many pitfalls surrounding the lack of viable AMU data, this study focused on farming cattle, sheep, chicken and pigs, which make up 91.1% of all animal biomass raised for food annually.
The researchers found that China used the most antimicrobials in farming worldwide, accounting for just under a third at 32,776 tonnes. The next biggest consumers were Brazil, India, the US, and Australia. Between the five of them, these countries made up 58% of global AMU.
Pakistan and Australia were set to have the largest relative increases of AMU, at 44% and 16% respectively.
The study modelled AMU in Africa to be around twice what the WOAH reported, while usage in Asia was 50% higher. These discrepancies were most likely due to the fact that most countries in these regions do not choose to report to the WOAH.
So why are so many antibiotics being used in farming?
Although antibiotics can be medically necessary in farming, they are also often used to prevent diseases in crowded, unsanitary conditions and to speed up animal growth.
And despite governments’ attempts to respond to the issues at hand, vendors of veterinary antibiotics can bypass bans of antibiotics that promote growth by marketing them as disease-preventing.
As the global population grows, so does the demand for animal protein as a food source, expanding the market for intensive farming. Unchecked, this also increases the demand for antimicrobials for use in treating animals.
Happening now! The @GLGAMR discusses opportunities to strengthen animal health systems to mitigate #AMR including improving diagnostics, strengthening surveillance, quality control and access to rapid, affordable diagnostic tests & alternative to antimicrobials. pic.twitter.com/l2lwmNksB2
— Global Leaders Group on Antimicrobial Resistance (@GLGAMR) February 8, 2023
However, there have been some effective national efforts to tackle the overuse of antimicrobials. In 2021, the average AMU in animals was lower than in humans for the first time in the European Economic Area.
The study tentatively attributes this to laws in Nordic countries which state that administering antimicrobials to animals requires a veterinarian’s prescription, and must also follow the country’s guidelines on antimicrobial treatment of animals. In addition to this, veterinarians are not allowed to make a profit from these sales, removing the incentive to overprescribe.
Major meat producer, China, has been actively implementing strategies for reducing AMU, banning colistin as a feed additive in 2017. However Brazil, the largest meat exporter in the world, still has very little legal framework on the use of antimicrobials.
The unsustainability of global farming practices
On Tuesday, UNEP once again drew attention to the importance of a One Health approach (the idea that the health of people, animals, and the environment are all interdependent) to combatting the AMR crisis.
UNEP advocates tackling issues associated with pollution from sewage, community and municipal wastes, healthcare delivery, pharmaceutical manufacturing, and intensive agriculture and aquaculture as methods to prevent and slow the development of antimicrobial-resistant pathogens.
“Limiting the discharge of antimicrobial-laced waste to the environment is important for everyone – because every sector is guilty of adding to the AMR burden.”@andersen_inger this week in Barbados at launch of #AntimicrobialResistance report: https://t.co/ljmYOi3OrW pic.twitter.com/gB07BmitPe
— UN Environment Programme (@UNEP) February 8, 2023
Crowded and unsustainable farming practices are certainly a key concern for animal welfare, for example, poultry that have not been outdoors in four months (which may exceed their lifespan) are still being marketed as “free-range.” However, this issue is not independent of human health and the AMR crisis.
The NGO, Compassion in World Farming (CIWF), released a 2020 report finding that in the Netherlands, the slower-growing breed of chickens introduced into the industry required as little as three times fewer antibiotics than their fast-growing counterparts.
Intensive farming is in fact currently the source of an ongoing global health crisis in the form of the avian influenza, or bird flu pandemic. H5N1, the current variant, was first detected in 1996 in China in commercial geese farming. This virus has been circulating to differing extents since then, but the latest outbreak has devastated wild bird populations, and has even recently spilled over to mammals.
This has put considerable strain back onto the poultry farming industry, as 193 million farmed birds have been culled in response to the outbreak.
Accounting for almost three-quarters of global AMU, the intensive farming industry could once again be at the heart of a global health crisis. Only this one would be directly devastating to humans.
The AMR crisis is global, and therefore requires a response on that scale. This study, although it relies heavily on extrapolation, indicates above all else that the first step in achieving that is more accurate and widespread sharing of information.
Editor’s Note: The opinions expressed here by the authors are their own. Not those of Impakter.com — In the Featured Photo: A commercial meat chicken production house in Florida, USA. Featured Photo Credit: Larry Rana