Antibiotics are one of the key discoveries upon which modern medicine depends. Successful treatment of bacterial infections using antibiotics has not only helped to reduce mortality caused by these infections, but also makes invasive or dangerous procedures such as surgery, cancer treatment, and organ transplants possible, resulting in increased life expectancy and improved quality of life. Unfortunately, industrial farming techniques pose a growing threat to human health through the misuse of antibiotics for growth promotion and preventative treatment for healthy animals.
Antimicrobial resistance (AMR) develops when microorganisms are exposed to antimicrobial treatments. In the case of bacterial infections, treating humans and animals with antibiotics triggers a natural selection process that creates survival benefits for any bacteria carrying specific genes that make the bacteria resistant to the antibiotic used. Today, 70% of all bacteria carry at least one “resistance gene” and bacteria are fast becoming multi-resistant on a global scale. When bacteria are resistant to all available classes of antibiotics, we will have no viable treatment options for bacterial infections that are treatable today.
Already, 700,000 people die every year from AMR and this number is predicted to increase to 10 million annual deaths globally by 2050. This would be higher than the mortality caused by cancer and diabetes combined, and 16 times higher than current deaths from the coronavirus. The World Bank estimates that AMR could result in a 3.8% loss in global GDP, an impact comparable to that of the 2008 financial crisis, and could cost the global community $100 trillion by 2050. If current antibiotic practices continue, the likelihood of the world entering and remaining in the post-antibiotic era is high.
Resistance is driven by several factors, although misuse and over-use within industrial animal farming is recognised as a leading cause of the rise in AMR. An estimated 70% of medically important antibiotics are sold for use in animals rather than humans. Good animal welfare practices require animals with bacterial infections to be treated with antibiotics. Currently, however, animals are not predominately given antibiotics to treat infectious diseases, but for non-therapeutic purposes such as growth promotion and preventative treatment of groups of healthy animals - so-called prophylactic use.
Data from countries with long-standing growth promotion bans suggests that the impact on production is minimal and there is evidence that the prevalence of several resistant bacteria declined after growth promotion was banned. The preventative use of antibiotics also allows poor animal welfare practices within industrial animal farming to continue, by compensating for inadequate hygiene standards and the overcrowding of animals. Overcrowding, especially of pigs and poultry, can facilitate the transmission of zoonotic diseases such as the coronavirus and may increase virulence.
While the link between antibiotic overuse and the development of AMR is well known, the global use of antibiotics is expected to continue to rise. The scale of animal farming is already massive, with an estimated 50 billion animals processed each year. The global human population is predicted to grow to 9.7 billion by 2050, and with consumption of animal protein anticipated to increase due to a growing middle class and shifting diets, so is the scale of industrial animal farming, and with it the use of antibiotics.
To stem the rise in AMR and preserve the efficacy of antibiotics, the World Health Organization recommends that the use of all classes of medically important antibiotics in food-producing animals be substantially reduced and that the current practices of growth promotion and disease prevention without diagnosis be curbed.
To support this goal, we engage with companies across the animal protein value chain including protein producers, animal health companies, consumer goods companies, retailers and restaurants to ensure that responsible antibiotic practices are put in place. We ask companies to provide public disclosure of antibiotic policies banning the use of antibiotics for growth promotion purposes and restricting the preventative use of medically important antibiotics. Where appropriate, time-bound reduction targets should be made public and transition plans for antibiotic replacements introduced.
Animal health companies should remove growth promotion indications on labels and “last resort” antibiotics from their portfolio and ensure they have guidelines for responsible marketing at global best practice levels, regardless of local regulation.
Loss of efficacy of antibiotics is a material business risk for any company dependent on an animal rearing system that relies on antibiotics. Protein portfolio diversification into sustainable non-animal proteins would increase companies’ resilience in light of this challenge, while meeting growing consumer demand for alternatives to meat. Also, any new classes of antibiotics that are developed are now unlikely to be made available for use in animals, which raises additional questions around the long-term feasibility of current industrial farming practices.
While it is clear that strong and sustained action is required to implement responsible antibiotic practices on a global scale to preserve the efficacy of existing antibiotics, we face an additional challenge - the lack of research and development of new antibiotic classes, which we will cover in the next article in our series.