If you want to reduce something, a good place to start is with a target. That’s what the U.K.’s Review of Antimicrobial Resistance suggests in its new report on antibacterial use in agriculture.
More antibiotics are used on animals than humans, and bacteria that become drug-resistant as the result of overuse can infect humans through direct contact with animals, through the food chain, or through the environment.
The Review, commissioned by British Prime Minister David Cameron last year and chaired by economist Jim O’Neill, analyzed 139 academic studies and 280 published, peer-reviewed research articles that address the issue of antibiotic use in agriculture. Only seven argued that there was no link between antibiotic consumption in animals and resistance in humans, while 100 (72 percent) concluded that there was evidence to support limiting the use of antibiotics in agriculture.
“I find it staggering that in many countries most of the consumption of antibiotics is in animals, rather than humans,” O’Neill said. “This creates a big resistance risk for everyone, which was highlighted by the recent Chinese finding of resistance to colistin — an important last-resort antibiotic which has been used extensively in animals.”
The Review’s report released Tuesday, Dec. 8, 2015, proposes three global interventions that would substantially reduce the use of antibiotics in agriculture and the quantities being dispersed into the environment.
The first step is to establish a global target.
“We believe an ambitious but achievable target for reducing antibiotic use in agriculture is needed, to reduce use over the next 10 years,” the report stated.
This target could potentially be based on Denmark’s average of less than 50 milligrams of antibiotics used a year per kilogram of livestock in the country, but the exact level would have to be discussed and tested by experts and low- and middle-income countries may need more time to achieve such a target.
Steven Roach, senior analyst for the Keep Antibiotics Working coalition, notes that matching Denmark would require the U.S. to reduce its agricultural antibiotic use by two-thirds.
But not everyone supports target-setting. Sean Wensley, president of the British Veterinary Association, said that antibiotic use in agriculture “is just one piece of the jigsaw when tackling AMR,” adding that his organization “is opposed to the introduction of arbitrary, non-evidence based target setting; such targets, to reduce antibiotic use, risk restricting vets’ ability to treat disease outbreaks in livestock, which could have serious public health and animal welfare implications.”
As a second piece of the target recommendation, the Review said that the types of antibiotics used are just as important as the quantity.
“Currently many antibiotics that are important for humans are used in animals. Countries need to come together and agree to restrict, or even ban, the use of antibiotics in animals that are important for humans,” it noted.
The Review’s other two recommendations are for the the rapid development of minimum standards to reduce antimicrobial manufacturing waste released into the environment and improved surveillance to monitor problems and progress.
“It’s time for policy makers to act on this,” O’Neill said. “We need to radically reduce global use of antibiotics and to do this we need world leaders to agree to an ambitious target to lower levels, along with restricting the use of antibiotics important to humans.”
The Review will spend the next few months working with governments, NGOs and industry to discuss and further develop these proposals before presenting a more detailed final package of actions in the late spring of 2016 covering the whole antimicrobial resistance landscape.
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