Trends, Achievements, and The Way Forward
Antimicrobial resistance (AMR), which renders anti-biotics ineffective against bacterial disease, is widely acknowledged as an urgent health risk facing the world in the decades ahead. Some estimates forecast a potential 10 million deaths per year due to AMR by 2050.1 At the same time, a rise in drug resistance in animals could lead to painful, untreatable illness and cause an 11% drop2 in livestock production in low-income countries, jeopardising livelihoods, and food security.
In September 2024, the United Nations will host a High-Level Meeting on AMR, resulting in a Political Declaration. The Declaration will be a key political moment to galvanise greater collective efforts towards addressing the threat of drug-resistant disease. The process has led many private and public sector groups to develop ideas and proposals for the next steps in the battle against AMR.
This article provides an analysis of what has worked in animal health over the past 15–20 years and offers five recommendations for inclusion in the Declaration based on those learnings. These recommendations centre around prevention, vaccination, investment, and innovation.
What Does the Data Say About Antibiotics in Animal Health?
Good policies are based on sound data analysis and information. So, what does the available data show about the use of antibiotics in animal health? Antimicrobial use in animal production has declined. There have been significant reductions in animal antibiotic use. Developed countries have achieved reductions ranging from -36% in the U.S. -53% in the EU, 59% in the United Kingdom, etc.3,4,5 Some middle-income countries have also delivered notable reductions, such as a -52% reduction in South Africa and -49% in Thailand.6,7 Use in low-income countries, albeit at much lower levels, is not decreasing or may be increasing in some places.
A recent report on antimicrobial use in the EU from the European Medicines Agency (EMA), European Food Safety Authority (EFSA), European Centre for Disease Control (ECDC) and OECD found there was “more progress in agriculture than in the human sector” and since 2016, “average consumption of antibiotics in humans is now higher than in food-producing animals”.8
Critically important antibiotics are a fraction of overall animal use.
The WHO maintains a list of ‘critically important’ antibiotics classes (CIAs) for human health. Some of these are also authorised for use in animals, however these account for “less than 20% of antimicrobials used in animals” according to the World Organisation for Animal Health (WOAH). Most are also considered ‘Veterinary Critically Important Antibiotics’ which means they are “essential” for animal use with no “sufficient alternatives”.
Antibiotic resistance in animals is generally low.
Governments and researchers in developed markets regularly monitor resistance levels in animals. Findings in the EU, UK and Australia show that resistance to most critically important antibiotics remains “absent” or “low”, and in some cases is even declining. Maintaining this positive global trend through continued responsible use in animals is critical.
Most antibiotic-resistant bacteria in people does not come from livestock.
Livestock can share antibiotic-resistant bacteria with people through food-borne illness or direct contact with animals. However, studies have found the majority of antibiotic-resistant bacteria are transferred through person-to-person contact, particularly in healthcare settings. A recent Lancet study analysed over a decade of data in the Netherlands to identify the source of resistant E. coli genes in people. They found: 78.6% is from human-to-human transmission, environment, and other sources.
