By Darian Woods and Dr Sudhvir Singh
Microorganisms are becoming increasingly untroubled by the drugs we depend on to treat infections, like antibiotics. The threat posed by antimicrobial resistance is expected to cause more deaths than cancer by mid-century, prompting a meeting of world leaders at the UN on Wednesday. A critical part of our fight against antimicrobial resistance is fixing what we eat.
Micro-organisms are breeding faster than we can invent new antimicrobials. The facts are frightening. E. coli breeds a new generation every 23 minutes yet we haven't developed a new class of antibiotic for microbes like E. coli in 40 years. Harvard Medical School illustrated this by demonstrating how a 2x4 feet petri dish can quickly be overwhelmed by resistant new strains of the disease. The antimicrobial development pipeline is dry, and the food industry -- the single largest consumer of antimicrobials -- must bear responsibility for preserving the effectiveness of these life-saving drugs.
Antimicrobial-resistant diseases pose grave threats to world health -- a big problem now but even bigger for the next generation. An estimated 700,000 people died of resistant diseases last year. A report commissioned by the UK Government predicts this will grow to 10 million by 2050 if nothing is done.
Our food is part of the solution. The more that antimicrobials are used as animal growth promoters and for preventative reasons, the less that antimicrobials can be preserved for curing disease in humans and animals. In the United States, over two-thirds of antibiotics are used in pigs, chicken, cattle and other livestock. Over 700 million pigs are slaughtered a year in China, most raised in farms routinely treated with the same antibiotics we tell doctors to prescribe judiciously to patients.
The EAT Foundation brings together scientists, politicians and business leaders to catalyze and implement solutions to feed the world sustainably. In June 2016 EAT hosted expert veterinarians, microbiologists, politicians and representatives from the food industry at a forum in Stockholm. The evidence was clear: antimicrobials are overused in agriculture, and this is worsening antimicrobial resistance, threatening human health. Antimicrobial overuse in one country leads to more resistant diseases that cross borders. May's grim discovery of E. coli resistant to the last-resort antibiotic colistin in the United States illustrates this.
The good news is that we know what works. While 100% antibiotic-free is not the goal -- proper infection control will require some antibiotics to treat sick animals -- the EAT Stockholm Food Forum showcased how several countries have phased out unnecessary antibiotic use whilst increasing food production.
Pooling funds to develop fish vaccines effectively eliminated the need for most antibiotics in Norwegian salmon farming. Allowing only veterinarians to prescribe antimicrobials for animals was one of the measures that allowed Denmark to dramatically reduce its antimicrobial use whilst growing its pork industry. Establishing strong targets allowed the Netherlands to make a 56% reduction in antimicrobial use in animals over six years. Antimicrobials are now only sparingly used for producing food in these countries. Yet many countries remain slow to adopt the bold policy changes needed to halt the spread of these diseases, hence the opportunity at this week's Heads of Government meeting at the UN.
What comes out of the UN will be important. The international community needs to loudly declare that the science is strong enough for action on farms. The draft declaration states that animal health is an intrinsic part of the problem and solution. In its words, antimicrobial resistance is "mainly due to inappropriate use of antimicrobial medicines in human, animal, food, agriculture and aquaculture sectors." And the problem is of serious global, non-partisan concern: "Many 20th century achievements are being gravely challenged."
The UN's draft declaration, by supporting the Global Action Plan on Antimicrobial Resistance, also tacitly supports phasing out the use of antimicrobials as growth promoters in meat, a risky practice that can offer very small production gains in lieu of better conditions on farms. The European Union implemented this necessary ban in 2006. The UN's declaration won't go as far as Nordic countries have -- for instance, limiting the number of days an antibiotic can be prescribed -- but we need to head in that direction.
You can make a difference too. Have you thought about how antibiotics are used in your food? Choosing to buy groceries that don't come out of antibiotic-heavy factory farms sends a message that you don't want to be a part of compromising our children's health.
But without consistent labelling, how can you make the right choice? In response to consumer pressure, some food companies have been vocal about reducing their over-reliance on antimicrobials. On August 1 McDonald's announced that it had phased out the routine use of medically important antimicrobials in chicken sourced for its American restaurants, a year earlier than planned. Chain Reaction is a report on fast food restaurant's antimicrobial practices. Choosing food that states "raised without antibiotics" is a start. Intensive farms tend to use more antimicrobials: opt for grass-fed or free range meat or eggs instead. Another choice is to reduce or cut out meat altogether.
As world leaders discuss the urgent challenge of antimicrobial resistance at the UN, consumers can act now. Governments and the food industry are listening: use your food choices to tell them to keep antibiotics effective.
Darian Woods graduated in 2016 with a Master of Public Policy from University of California, Berkeley. His thesis, commissioned by the EAT Foundation, investigates how the agricultural industry contributes to antimicrobial resistance and what can be done about it.
Dr Sudhvir Singh has a background in Internal Medicine and is the Policy Director of the EAT Foundation.
Thanks to Dr Anthony So (Director, ReAct - Action on Antibiotics) for helpful comments in drafting this article.
This post is part of a series produced by The Huffington Post and the EAT Foundation, in conjunction with the high-level side event, "Urban Food Systems: The Nutrition Challenge," during the 71st United Nations General Assembly in New York. The EATx at UNGA is a collaboration with the Norwegian Ministry of Foreign Affairs. #EATx #eatforum