Superbug Silos

There has been some encouraging movement in the United States over the last year in the battle against superbugs. A few major poultry companies and retailers have committed to decreasing antibiotic use in broiler chickens. And President Obama has created a national action plan to combat the growing threat of antibiotic resistance. This is certainly movement in the right direction, but silos -- both perceived and real -- are preventing us from making faster and better progress.

First, there is an insidious belief that antibiotic-resistant bacteria exist in silos. Said another way, some food-animal producers and drug companies have suggested that bacteria in animals and bacteria in humans stay in their respective corners and never cross over. As a microbiologist, I have dedicated my career to studying bacteria, and I know that this notion is false. Science tells us that bacteria move about freely in the environment and some superbugs flow seamlessly between people and animals. Studies dating back to the 1960s have shown repeatedly how antibiotic use in food-animal production contributes to the growing crisis of antibiotic-resistant infections in people. This body of research shows how antibiotic overuse breeds superbugs that end up in our bodies, food, air and water.

While superbugs don't stay put in silos, the stakeholders concerned about antibiotic resistance do. Scientists doing the groundbreaking research are talking to other scientists, not policymakers, journalists and the general public. Industry representatives are talking to each other, while lobbying policymakers for the status quo. Public health organizations and non-profits working on this issue would like to bridge the gaps, but the gaps often seem unbridgeable. These silos prevent progress in combatting antibiotic resistance at a time when we desperately need action.

Even at the White House Forum on Antibiotic Stewardship on June 2nd, which I was honored to participate in, attendees were brought together for an inspiring opening session then quickly split into two tracks -- human stewardship and animal stewardship -- and kept separated for the rest of the forum. Not only did this prevent meaningful exchange, but it also perpetuated the false notion that these are independent issues.

When it comes to human health, antibiotic use in food-animals and humans are inextricably linked. The antibiotics used in animals encourage the growth of resistant bacteria that spread to people. When these bacteria cause infections in people, physicians have fewer therapeutic options, which drives them to use more precious antibiotics. Furthermore, the solutions needed for both human and animal stewardship are almost identical: better surveillance, rapid diagnostics, fewer prescriptions, better sanitation. These solutions should not be developed on separate tracks. We should integrate these systems and learn from each other. We should monitor the emergence of new pathogens in hospitals and on farms and study how the bacteria find their way between people and animals.

Earlier this week, I was also honored to attend a global forum on antibiotic resistance in Annecy, France. Much like the White House Forum, this was a small, invitation-only event that brought together some of the top clinicians, scientists, and thought leaders on the issue of resistance. The theme of this year's forum was "Antimicrobial Resistance: One World, One Fight!" and included experts from more than 30 countries. In sharp contrast to the White House Forum, we were not separated into human and animal stewardship tracks. We discussed the two issues as they are: two inseparable parts of one of the greatest public health challenges facing the world today.

I hope that the White House Forum was just one step in the administration's commitment to the issue of resistance. And I'm eager to see better integration of the human and animal stewardship in the Advisory Council on Combating Antibiotic Resistance that is currently being formed. These silos need to be broken down to ensure meaningful collaboration among all stakeholders to truly tackle the serious and growing problem of antibiotic resistance. We must break out of these silos and work together to stop the flow of superbugs and protect antibiotics for future generations.