The complex challenges of addressing antimicrobial resistance (AMR) make it a prototypical “One-Health” issue, according to five new papers published in the Annals of the New York Academy of Sciences.
The One-Health concept is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment. The researchers note that the AMR problem and its solutions involve complex interrelationships between antimicrobial use in humans and animals, pathogens affecting multiple species, persistence of antimicrobials in soil and water and environmental influences on the prevalence and transmission of pathogens.
Addressing the AMR issue from a One-Health perspective involves decisions at all levels of society.
Physicians decide when and why to prescribe antibiotics to their patients, while also considering recommendations for non-drug interventions or preventive strategies including vaccines, nutrition and lifestyle changes.
Patients decide whether to follow prescription instructions and their physician’s advice on lifestyle, vaccines or other preventive measures.
Farmers and veterinarians decide when and how to use antimicrobials, along with designing waste-management systems to minimize environmental contamination and management systems impacting animal immunity and levels of exposure to pathogens.
Food processors, wholesalers and retailers all make decisions that affect customer exposure to potentially drug-resistant pathogens.
Consumer education is entwined throughout the AMR issue, involving personal hygiene, food-safety practices and following advice from medical professionals, along with better understanding of the AMR issue overall.
The authors note complexities associated with addressing AMR, including:
- Considerations of the criticality of different classes of antimicrobials used for human and animal health; and of the divergences between international, national and other agencies in the classes of antimicrobials across specific industries.
- The recognized importance of the environment as a reservoir of resistant bacteria and resistance genes, as well as a pathway for the dissemination of AMR between human and animal host populations.
- Established and novel solutions for measuring and containing the AMR problem that range from animal husbandry and herd management changes, to technological innovations such as vaccines and bacteriophage therapy.
- Effective strategies for communicating to consumers the risks of AMR spreading from food production.
Animal agriculture can and should embrace the One-Health approach for addressing the AMR problem. The agricultural community, often with good reason, feels singled out as the primary scapegoat in perpetrating the problem. The One-Health approach acknowledges the complexity of the AMR issue and addresses the interrelationships between all the factors involved. Farmers and veterinarians certainly play a role, and should strive for continuous improvements in antibiotic stewardship, disease prevention and environmental management. But those efforts can only succeed in cooperation with human-health professionals, all food-system sectors, pharmaceutical manufacturers, policy makers, research scientists and consumers.
See the full report in the special issue of the Annals of the New York Academy of Sciences titled Antimicrobial Resistance from Food Animal Production.
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