Register for OECD Forum virtual event: What Can We All Do to Help Prevent the Silent Pandemic now!
The Forum Network is a space for experts and thought leaders—from around the world and all parts of society— to discuss and develop solutions now and for the future. It aims to foster the fruitful exchange of expertise and perspectives across fields, and opinions expressed do not necessarily represent the views of the OECD.
The discovery of antibiotics proved a marvel, providing a cure for diseases where none had previously existed. Yet, in the space of less than a century, the use of these treatments now presents a seemingly intractable problem for modern medicine, and for public health. While they remain effective treatments, increasing numbers of bacteria are displaying resistance to their effects – the phenomenon known as antimicrobial resistance (AMR). All too recently, we have seen how much damage and disruption a major health crisis can create; the increasing spread of AMR means that it now poses a substantial worldwide threat; an issue we need to recognise and tackle head-on.
So why does AMR pose such a significant risk to human and animal health? The reason is that if bacteria become tolerant or resistant to antibiotics, then we risk returning to a time where commonplace infections – even those we now consider as easily treatable – can pose a risk to humans of serious illness or even death. The advent of antibiotics had promised a future free from bacterial disease, but the emergence of AMR now not only imperils human health but also our food production systems.
More on the Forum Network: Win-win scenarios: Advancing emerging health and sustainability priorities through a Circular Health model by Ilaria Capua and Luca Mantegazza
COVID-19 has made clear we should embrace the One Health approach. But could the SDGs roadmap also serve as an accelerator of convergence for health? Ilaria Capua and Luca Mantegazza argue it is time to approach health in a more inclusive manner through a new Circular Health model.
As the number of antibiotics without resistance issues becomes fewer, governments, and multilateral organisations have adopted policies to restrict their use in order to preserve their remaining effectiveness. This is understandable, given the need to maintain a high level of human health protection and to protect our livestock, particularly our food production model. Implementing ‘One Health’ policies can make a significant impact in advancing the fight against AMR by prioritising disease prevention ahead of reactive treatment.
It's important to recognise, however, that dramatically reducing antibiotic use in animals will not be without challenges or consequences. It will pose social and economic issues for farmers and veterinarians, lead to unnecessary suffering and mortality among animals, as well as increasing the risk of disease transmission - not only between animals but also among humans. At the same time, it is also important to recognise that there will be times - such as when animals are sick - when antibiotics represent the only available option. However, in those circumstances, we must do all that we can to preserve their effectiveness; this means using the right antibiotic, at the right time, in the right dose, administered by the right route.
We also need to adopt high standards of animal welfare to promote general health and a strong immune response.
To do so effectively means relying on the expertise and knowledge available to us to make a positive difference. Veterinarians and veterinary paraprofessionals are at the forefront of the fight against AMR. They are trained in how to use antibiotics responsibly, minimising animal suffering while limiting the risk of resistance. In addition, the livestock industry needs to play its part, slowing the rate at which resistant micro-organisms are emerging by reducing the need for antimicrobials.
How do we go about this? Wherever possible, we need to adopt a range of management approaches that prioritise disease prevention. These include high biosecurity standards to shield farms against incoming disease, along with good management, husbandry, and hygiene practices to restrict the spread of infection within the farm. We also need to adopt high standards of animal welfare to promote general health and a strong immune response. By better protecting animals from the threat of disease, identifying health issues earlier, and treating them quickly and responsibly, we can decrease our need for antibiotics while ensuring the constant monitoring of animal health and welfare.
Vaccination - the process of developing immunity or resistance to a particular infection – is key.
The sooner an individual animal can be identified, isolated, and treated, the less sick it will become and the fewer antimicrobials you need, as the disease spread can be more easily contained. This demands maximising the long-term and preventative health benefits of tools such as vaccination, nutrition, antiparasitics, biosecurity, disease surveillance, diagnostics, husbandry, and other animal health technologies. Together, these tools will improve the prevention, detection and treatment of animal disease and provide a more sustainable route to reducing the need for antibiotics. Among these, vaccination - the process of developing immunity or resistance to a particular infection – is key. Preventing or reducing infection means less need for antimicrobial use.
Progressing towards the One Health vision will require committed action, both from the animal health industry, and the wider animal and public health sector, including governments, international agencies, and the private sector. This means prioritising disease prevention as the first line in tackling public health risks and encouraging vaccination wherever feasible. We also need to prioritise the use of integrated surveillance systems to effectively monitor animal behaviour, and of data analytics tools to minimise the spread of disease. This way - by identifying, isolating, and treating sick animals as early as possible -we reduce our need for extensive use of antimicrobials.
To learn more, check out the following resources recommended by MSD Animal Health:
Time to include preventive vaccination among housing, nutrition, hygiene, ventilation and other natural ways to ensure the well-being of farm animals and the sustainable production of quality milk and beef.
Our Roadmap to Reducing the Need for Antibiotics offers a clear vision for
And read the OECD report: Embracing a One Health Framework to Fight Antimicrobial Resistance
Antimicrobial resistance (AMR) – the ability of microbes to resist antimicrobials – remains an alarming global health threat. This is despite the efforts made by OECD and EU/EEA countries to curtail it. Unless additional effective interventions are scaled up quickly, AMR rates are forecasted to increase in the next three decades across OECD and EU/EEA countries, with costs exceeding the healthcare expenditure on the COVID-19 pandemic. Using microsimulation and machine-learning techniques, this report analyses critical policy levers to inform the next generation of AMR initiatives.