A woman in Uganda lets her chickens out to forage during the day (via Flickr by Jennifer Wilmore/Bread for the World).

A commentary published in The Lancet last month supporting a series of five papers on antimicrobials recommends prohibiting use of antibiotics critically important for human medicine to promote the growth of livestock or to prevent routine livestock disease.

The commentary was written by Tim Robinson, a principal scientist in spatial analysis at the International Livestock Research Institute (ILRI), and colleagues in partner organizations.

‘One of the major public health challenges this century is the development of antimicrobial resistance in many important and common pathogens, such as Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. . . .

‘A substantial share of antimicrobial consumption is attributed to animal production.

Recent findings conservatively estimate that, from 2010 to 2030, global consumption of antimicrobials in livestock production will increase by two thirds, and that it will double in the rapidly growing economies of Brazil, Russia, India, China, and South Africa.

‘In China, already the largest producer and user of antibiotics in the world, the livestock sector could consume a third of the antibiotics produced worldwide by 2030. . . .

The evidence that links antimicrobial use in animal production and the development of antimicrobial resistance in medically important pathogens is growing, thanks largely to advances in genetic analysis which allow the origins of genes conferring such resistance to be traced.

‘Using whole-genome sequencing and phylogenetics, an international team of researchers described the evolution of meticillin-resistant S aureus (MRSA) in livestock from meticillin-susceptible S aureusin humans. This livestock-associated MRSA (clonal complex CC398) now frequently infects people both inside and outside of the livestock industry, and is an unequivocal example of the evolution of a multidrug-resistant pathogen that emerged in livestock and was subsequently transmitted to humans. . . .

In developing countries, there can be a dual problem of lack of access to antimicrobials among smallholders and overuse in intensive production.

Agricultural practices in developing countries have a higher dependency on antibiotics because of a more disease-prone environment and lower levels of biosecurity than in high-income countries.

Global policies intended to reduce antibiotic consumption must be highly context-specific lest they have negative effects on livelihoods, nutrition, and food security.

‘. . . Although we recognise the challenges involved in enforcement of legislation on antimicrobial use in low-income and middle-income countries acknowledged by Osman Dar and colleagues and the importance of ensuring that antibiotics remain available to control animal diseases, we strongly support working towards a global prohibition on animal growth promotion or routine disease prevention with any antibiotic deemed critically important to human medicine.

‘With growing transportation networks and international trade, pathogens travel quickly around the world making antimicrobial resistance a global problem in need of global solutions such as coordinated policy interventions.

‘But antimicrobial resistance is also a multisectoral issue that involves consumers of animal source foods, the retail industry, farmers in livestock and aquaculture whose livelihoods rely on the ability to keep healthy animals, the feed industry, animal health practitioners, regulatory bodies, the pharmaceutical industry, and the public health sector.

‘To be successful, policy interventions will require buy-in from diverse stakeholders.

If we are to ensure the future universal access, sustainability, and effectiveness of antimicrobials to treat disease in people and their livestock, these issues must be tackled from the health perspectives of people, animals, and the environment.

This perspective sits at the very core of the One Health approach, which recognises that the health of people is connected to the health of animals and the environment.

Such an inclusive approach will be needed to reduce selection pressure for antimicrobial resistance genes and protect our medically important antibiotics.

Tim Robinson receives funding from the Consultative Group on International Agricultural Research (CGIAR) research programs on Integrated Systems for the Humid Tropics (Humidtropics); Climate Change, Agriculture and Food Security (CCAFS); and Agriculture for Nutrition and Health (A4NH).

Read the whole commentary in The Lancet: Animal production and antimicrobial resistance in the clinic, by Timothy Robinson, Heiman Wertheim, Manish Kakkar, Samuel Kariuki, Dengpan Bu and Lance Price, 18 Nov 2015, DOI: http://dx.doi.org/10.1016/S0140-6736(15)00730-8

Read a related report by ILRI scientists Delia Grace: Review of evidence on antimicrobial resistance and animal agriculture in developing countries. Report produced by the International Livestock Research Institute (ILRI) for Evidence on Demand with the assistance of the UK Department for International Development (DFID), Jun 2015.

Read related articles about this topic on the ILRI News blog:
UK chief scientific adviser visits Kenya: Part 3—The dual rise of the global livestock sector and antimicrobial resistance, 23 Jul 2015
The rise of antimicrobial resistance (lethal) and animal agriculture (critical): Their links in developing countries, 18 Jun 2015
First global map of the rising use of antimicrobial drugs in farm animals published in PNAS, 25 Mar 2015

and on the ILRI Clippings blog:
New publication warns of rising use of antibiotics and other antimicrobial drugs in farm animals, 30 Mar 2015
Livestock in poor countries need drugs to stay alive and productive, but how to avoid the rise of ‘super bugs’?, 23 Mar 2015

and on ILRI’s AgHealth blog:
The Lancet marks World Antibiotic Awareness Week with series on access and effectiveness of antimicrobials, 19 Nov 2015