Health Care without Harm Europe: Reducing antibiotic usage in agri-food systems vital for human and livestock health
26 Aug 2024 | Health Care without Harm Europe
Contemporary agri-food systems depend on antibiotic use, leading to health concerns for livestock animals and humans. We discuss the issues of antibacterial and antimicrobial resistance with Erik Ruiz, safer pharma program manager at the European branch of the international organization Health Care without Harm. Ruiz further tells us about the significance of the upcoming UN General Assembly High-Level Meeting on antimicrobial resistance in September 2024.
Hi, everyone.
This is Milana for Nutrition Insight.
Today, I'm joined by Eric Cruz of Healthcare Without Harm Europe to discuss the use of antibiotics in the agri-food sector.
Eric, could you first tell us about the organization and your role in it?
Yeah, of course.
Thank you, Milana for inviting us to this, to this interview.
My name is Eric, as you said, and I'm Safe PAA program manager at Healthcare Without Harm Europe, which is an organization that focuses on reducing the environmental impact of the healthcare sector and my program in particular addresses pharmaceutical pollution and its contribution to antimicrobial resistance or antibiotic resistance.
Great.
And what would you say are the main drivers behind the high levels of antibiotic use in the agri-food sector?
It seems pretty obvious, but the, the main driver of antimicrobial resistance is, antimicrobial use, antibiotic use.
So first we need to assess which are the main, reasons why, there is this need of, of antibiotic use and let me start with the.
With something that it's, it's important to, to say, so that people can, can frame also the, the kind of work that we do.
When an animal is sick there and there is need to take antibiotic, they need to take an antibiotic.
It's like humans, so it's not that we are advocating for no antibiotics for animals or, or something similar.
The problem is that when, when antibiotics are introduced to sustain poor farming practices, for example.
Then, I would say that it's very important, for example, that farms have a high biosecurity standard, standards.
It's also important that animals are kept in proper conditions, that animal welfare is respected.
And by taking into account this kind of interventions and by improving this kind of interventions, the use of antibiotics could be reduced a lot.
Now, the current farming system, we know that it's very focused on productivity, right, on having a lot of animals, let's say in and then out in form of a finalized product, let's say, which is the transposition a bit of the industrial way of producing.
But there, there are some concerns about that.
One of them, it's obviously ethics, right?
Animals are not just, like a manufactured product.
They are sentient beings, so it, it raises a lot of ethic questions and then it raises also the very big question is, is the one where we work more of the environmental impact that this has, so.
For example, farmers would argue that their work is essential and I agree with them also in a way and that the, the, there is need to produce food and there is need to produce in some cases meat but.
We have to assess also what's the impact that this has on our environment and in turn on our health.
And this is something that it's a bit difficult to picture for some people.
But obviously, if we have a big production, a big group of animals that live together.
There will be a lot of animals that will get sick.
So now with, with animals, we are also tending to, to have the same approach to have like an, an, a process that it's, it boosts productivity and sometimes antibiotics are used for that, so it's, something that we call routine use of antibiotics, prophylactic use as , and it's giving antibiotics to animals that are, that are not sick.
But to prevent potential infections.
It happens also with some processes like, in piglets, for example, it's very common to talk about winning, which is the moment when the piglet.
Ends up, ends starts, taking like solid, solid elements instead of the milk of, of their moms, so this is quite a stressful period, right?
And in some farms.
They remove the piglets, they wean the piglets early so that they can produce more piglets basically, but this has an impact also on their health, like, for example, they, they are more keen to have infections.
And, and this is something that, that it's quite dangerous because actually the antibiotic used for, for treating, this kind of infections in piglets is, it's a, it's an antibiotic called called colitin from the class of polymixins and it's a last resort antibiotic in human health.
So if these antibiotics stops working, we won't have any treatment for certain infections in humans.
So it's quite dangerous.
There is a clear link.
And it's something that needs to be taken very seriously.
Oh, and could you perhaps measure how this relates to human health as?
Mhm.
Yeah, for, let me explain a bit how, how people think that resistance happens.
Many people, including, for example, my parents, They, they thought or they think that, antibiotic resistance happens if you take a lot of antibiotics and then your body somehow gets resistant to that and it's a far more complex, process than that.
Obviously that can happen in your body and that happens, many, many, many times in, in human health settings, so it makes sense to think that, but it also happens through the environment.
It also happens through the contact with other animals.
This was something that was more complicated to explain before COVID.
Cause people wouldn't picture.
You know, how zoonosis work, but now it's quite a bit easier.
Now we understand that animals can transmit these diseases and can have an impact on our health.
It happened the same with animals.
They can transmit as a resistant bacteria, but it can also happen through a very natural process.
For example, when we take a medicine, also humans, not only animals, we don't absorb 100% of that medicine.
We absorb a part of it and the other part, we have to, to exe it.
Yeah, and we do that through urine and feces.
It happens the same to animals, so animals that that.
Take anti are given antibiotics, for example, they would excrete some of the antibiotics into the environment, so that can lead to, to, to the acceleration of resistance in the environment because antibiotic resistance is a natural process.
It's not something that it's driven only by humans.
It's something that it's happening in nature.
Like in the end, bacteria have been living in nature for millions of years.
And we are the newcomers, let's say like we are the ones that are now trying to fight something that has been living and adapting for millions of years.
It's kind of a suicide strategy.
So that's how, how sometimes antibiotic residues end up in the environment.
They.
Interact with bacteria in low doses.
The bacteria gain resistance obviously because they, they understand how this antibiotic work and which are the mechanisms to, to defend themselves from, from it and this is something that ends up.
Creating a problem, right?
And some people may argue that this is not something that it's has a very big impact or that you know the use of, of pharmaceuticals in, in farming is not that.
Big compared to the use of antibiotics in humans, but it's also true that around 70% of antibiotics used in food production in, sorry, around 70% of antibiotics used globally are used in food production.
This is not the case in Europe.
So in Europe for the first time a couple of years ago, humans had a higher intake of antibiotics than animals, but in some countries this is quite, quite a thing.
So yeah, it's, there is a big need now to reduce the use of antibiotics and obviously this needs to come with an increase in animal welfare, standards because obviously if you reduce antibiotics and you don't increase animal welfare, then you will have another problem.
Many animals can die, can suffer from, from a disease that is preventable or that it's curable, so that's, that's something that we should.
Put the focus on in the next years, more biosecurity and better animal welfare standards.
Mm.
And on this note, could you tell us a bit about the upcoming UNGA high-level meeting on agriculture and the development of antimicrobial resistance and how it might address these issues?
Yes, so for those who don't know about this, in September, I think it's the twenty-sixth of September, there is going to be a high-level meeting at the United Nations General Assembly where there will be, many targets will be discussed about reduction of antibiotic use and reduction of, antibiotic resistant infections.
This is, basically, this will be basically one of the key milestones in terms of assessing AMR or anti antibiotic resistance.
And it's going to get together governments of, of the whole planet and and also organizations like ours, for example.
And it's, it's not going to be only about antibiotic use in farming, it's also going to be about antibiotic stewardship in humans and I think it's a, a very important moment.
Because we will be shaping the, the future of, of young generations, for example, and sometimes we don't, we don't picture how important antibiotics are, but since antibiotics were invented or discovered, not invented, the lifespan of people has grown exponentially.
It's true that there are other measures that were taken at the same time, for example, all the.
Hygiene measures that now we, we respect very, very thoroughly, earlier was not the case.
The conditions where we live have improved, everything has improved, but we need antibiotics for many, many things in our life.
We need antibiotics for other treatment like people who are following, chemotherapy, for example, they need antibiotics to, to go through that as.
So it's really important that now we are sitting together in the same place, in the same room.
And discussing this.
I it's something also quite urgent because Now, around 1.2 million people die every year due to antimicrobial resistance.
But if no further action is taken, by 2050, this could be 10 million people a year.
And almost 4000 in in Europe, which is a lot.
Like imagine cities like Florence or Zurich.
Every year one city like Florence would be removed from Europe, let's say, and countries like Portugal, for example, every year the equivalent to the population of Portugal or to the population of New York City, would be erased from the earth.
So it's, it's quite a tricky issue.
It's quite a complicated issue and I think that we are on time to, to discuss and hopefully this United Nations General Assembly high-level meeting will help us to define new targets to give the countries, the, the, especially the lower and middle income countries, the tools they need to address this situation.
And again I'm, I'm gonna refer back to COVID again but as COVID didn't have any passport, it was very easy for for COVID to spread around the world.
That happens also with, with resistant infections.
So we need also to have a specific focus on on countries in that don't have the capacity to address that and give them the, the tools, give them the time to adapt and give them all the, all the knowledge that they need to, to start.
Advancing on this because it's gonna be a very serious issue.
