One Health and How it Relates to Antimicrobial Resistance

Antimicrobial

One Health and How it Relates to Antimicrobial Resistance

Antimicrobial Resistance Fighter Coalition

2/10/2023

The interconnection between humans, animals, and the environment is undeniable; our activities have an inherent impact on each other. This fact is especially evident in the case of antimicrobial resistance (AMR), which is a growing crisis that can be attributed to the overuse or misuse of antibiotics in humans, animals, and agriculture.

One Health is a concept that recognizes this interconnection and emphasizes the need for collaborative approaches to solving health issues at all levels — human, animal, and environmental.

The collaborative strategy of a One Health approach has been endorsed by the World Health Organization—gaining momentum globally. Through this approach, we can develop better solutions to the AMR crisis that take into account all of these factors.

So, let’s explore further how One Health and AMR impact humans, animals and the environment.

Humans

When it comes to humans, One Health matters because antimicrobial resistance is a significant threat to human health.

In 2014, a review titled Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations was produced, estimating that, by 2050, 10 million people will die every year due to antimicrobial resistance (AMR) unless a global response to the problem of AMR is mounted. In fact, a publication from 2022 estimated the impact might be far greater with 1,270,000 deaths directly attributable to AMR annually with an estimated 4.95 million deaths that were associated with AMR.

Antimicrobial resistance can cause infections that are difficult or impossible to treat and can lead to longer hospital stays, higher medical costs, and worst-case scenario—death. When pathogens are exposed to antibiotics regularly, they can evolve resistance to them. And unfortunately, the widespread use of antibiotics is accelerating this crisis.

The misuse of antibiotics occurs when they are used for conditions they are not intended to treat, such as a common cold. Antibiotics are also misused when they are not taken as prescribed; for example, when people stop taking them before completing the full course. This can allow resistant bacteria to survive and multiply — yikes.

A One Health strategy can help us address this issue by identifying and promoting new ways to prevent infections and treat AMR. For example, we could use better monitoring practices to track antibiotic consumption or develop new methods for diagnosing and treating infectious diseases.

Animals

The overuse and misuse of antibiotics in animals is another major contributor to AMR because it raises the risk of transmitting drug-resistant bacteria to humans.

A recent analysis by NRDC, conducted with the Center for Disease Dynamics, Economics & Policy, estimated that 65% of medically important antibiotics sold in the United States are being used in food-producing species, compared with 35% in humans.

There are several reasons for this, including the fact that antibiotics are used to treat, prevent, and control animal diseases and increase the productivity of animals and operations. However, there is concern that routine antibiotic use in livestock will contribute to antimicrobial-resistant pathogens, with repercussions for human and animal health.

One of the most obvious ways that AMR and One Health are interconnected is through the spread of zoonotic diseases — that is, illnesses that originate in animals and can be transmitted to humans; examples that you may be familiar with include the West Nile virus and Bird Flu.

Scientists estimate that more than 6 out of every 10 known infectious diseases in people can be spread from animals, and 3 out of every 4 new or emerging infectious diseases in people come from animals.

This underscores the importance of using One Health strategies to address AMR in animals. For instance, we could improve monitoring and surveillance efforts for antibiotic use and resistance, better regulate the antibiotics used in food animals, or promote more sustainable farming practices that reduce reliance on antibiotics. A 3^rd Global High-Level Ministerial Conference on Antimicrobial Resistance was held in November. The conference agreed the Muscat Ministerial Manifesto, which sets out the three global targets. Two of the targets focus on the use of antimicrobials in animals:

Reduce the total amount of antimicrobials used in agrifood systems by at least 30 – 50% by 2030, galvanizing national and global efforts;
Preserve critically important antimicrobials for human medicine, ending the use of medically important antimicrobials for growth promotion in animals.

Environment

The environment is also a key piece of the puzzle when it comes to One Health and AMR. Since the 1950s, antibiotics have been used to protect a variety of high-value plants including fruit, vegetables and decorative flora from bacterial illnesses.

The haphazard and improper use of antibiotics can result in elevated levels of antibiotic waste entering our environment, thus creating a phenomenon called “antibiotic pollution.”

There are two types of evidence that show human pathogens have gotten resistance genes from environmental bacteria. These are phylogenetic evidence (evaluating gene sequences in context to identify potential signs of resistance determinants from the past), and epidemiologic evidence from locations that don’t have very good sanitation, especially areas with inadequate drinking water quality.

There are numerous ways for antibiotics to be released into the environment; some of these include human wastewater, veterinary products, and wastes from livestock farming. This poses a serious risk to the overall health of our environment, as antibiotic-resistant bacteria can transfer their resistance genes to other microbes in this ecosystem.

To prevent AMR from spreading through environmental pathways, we need to adopt new strategies that focus on reducing antibiotic waste and improving sanitation practices.

AMR is a global problem that requires a One Health approach to solve it

It’s clear that there is a lot of work to be done when it comes to mitigating the threat of AMR. However, One Health is a promising approach that brings together experts from various sectors — human medicine, animal health, agriculture, public health — to address this urgent challenge. And with collaboration across disciplines and sectors at all levels, we believe that we can make real progress towards reducing the impact of drug-resistant bacteria on human health.

For help in developing effective strategies for tackling AMR, the Antimicrobial Resistance Fighter Coalition has developed AMR Activation Kits that you can download for free to create awareness of the growing silent pandemic and help make a difference now before it’s too late.

Share Your Story and Become an Antimicrobial Resistance Fighter

Share Your Story