What is antibiotic resistance?
The WHO (World Health Organisation) classifies antibiotic resistance as “one of the biggest threats to global health, food security, and development today.” Antibiotics are antimicrobial drugs provided to humans and animals to fight off infections and prevent harmful bacteria from multiplying. Examples include penicillin, amoxicillin, and doxycycline. Antibiotic resistance, conversely, is when bacteria alter their genetic code through mutations to adapt and survive in response to antibiotic use. This is when bacteria become antibiotic-resistant. As a result, previously insignificant infections can become concerningly dangerous.
The WHO says that a “growing list of infections – such as pneumonia, tuberculosis, blood poisoning, gonorrhoea, and foodborne diseases – are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.”
Why is antibiotic resistance escalating?
Antibiotic resistance is becoming an increasingly large issue due to the misuse and overuse of drugs that are unnecessary or incorrectly administered. Back in 1945, a Scottish physician credited with the world’s first broadly effective antibiotic (penicillin), Sir Alexander Fleming, predicted that someday “the thoughtless person playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection with the penicillin-resistant organism.”
Who is responsible?
There are numerous reasons why antibiotic resistance is escalating (as illustrated by the WHO) with examples including lack of access to clean water, adequate hygiene and medicine, poor infection and prevention of diseases, and overuse of drugs in developed nations. However, one reason – listed on virtually any page regarding antibiotic resistance – traces to animal agriculture. According to the National Library of Medicine, of all antibiotics sold in the United States, approximately 80% are sold for use in animal agriculture. In Australia 700 tonnes of antibiotics are imported annually; of which more than half goes to agriculture. To place that into global perspective, the Antimicrobial Resistance Department classes Australia as “a world leader in minimising the use of antibiotics in food producing animals.”
Antibiotics are administered to animals for growth promotion as a scheme to speed up production, despite the inhumane suffering that stems from such practice as a result. Moreover, due to the monopoly of intensive factory farming, another reason for antibiotic use is to suppress infections that can easily spread throughout tight, unhygienic conditions. Another National Library of Medicine finding revealed bacteria in agriculture still reach humans because as antibiotics are administered, susceptible bacteria die allowing resistant bacteria to thrive. Thereby, entering the food chain after slaughter. These findings have been replicated with another publication stating that the “growing evidence that antibiotic resistance in humans is promoted by the widespread use of nontherapeutic antibiotics in animals.”
In response to the harsh association between animal agriculture and antibiotic use and resistance, it’s also worth mentioning that crop production consumes antibiotics too. Though, the difference here is that the use of antibiotics for crops is due solely to bacterial infections and serious issues, rather than a means of improving growth rates. Moreover, the National Library of Medicine explains that most of the use in crop production is for fruits, ornamental plants and vegetables. For vegetables like soy, over 80% of which are fed to animals anyway. Additionally, contrary to the staggering consumption of antibiotics in animal agriculture, “antibiotics applied to plants account for less than 0.5% of total antibiotic use.”
In 2020, the World Counts estimated that 145 million kilograms of antibiotics are provided to the livestock industry annually, with that number set to tip 181 million kilograms by 2030 as the demand for food and the presence of infections escalates.
Do antibiotics harm the environment?
Factory farming operations – due to their compact and huge animal capacity – generate monumental amounts of waste. Pace University claims that “Factory-farmed animals produce more than 1 million tons of manure every day.” In contrast, New York City produces 7 million tonnes a year. Give it a week and factory farming will have produced as much waste as New York does every year. As a result, factory farms produce seemingly-unbelievable amounts of daily runoff, which (unsurprisingly) contain traces of antibiotics. When runoff is exposed to aquatic sources, over-enrichment leads to algae blooms, less oxygenation and aquatic death.
Studies have revealed that “waste streams will contain both the antibiotics and resistance genes; both considered as pollutants.” The author of the paper also found “stockpiled animal manure may seep through the pile to surface and groundwater, and also into the soil” and that “dust contaminated with antibiotics from farms could equally serve as another route of environmental release of these drugs.”
Environmental exposure to antibiotics leads to resistance throughout the environment, subsequently harming microbial life in soil and water and the animals that consume the given flora contaminated with resistant bacteria – increasing susceptibility to disease.
The human health impacts:
A 2016 study reviewed by nature explained how antimicrobial resistance could kill as many as 10 million people by 2050 annually. In perspective, around 10 million people die from cancer every year – which (in 2019) was the second biggest killer globally. As aforementioned, previously ‘basic’ infections like pneumonia are becoming increasingly difficult to treat. Server pneumonia could be fixed with a hospital stay and antibiotics, which may now be rendered ineffective and possibly fatal.
Penicillin in 1943 – widespread resistance in 1945 (2 years)
Vancomycin in 1972 – widespread resistance in 1988 (16 years)
Imipenem in 1985 – widespread resistance in 1998 (13 years)
Daptomycin in 2003 – widespread resistance in 2004 (1 year)
Maryn McKenna in her TedTalk on antibiotic resistance claimed “there are infections moving across the world for which, out of the more than 100 antibiotics available on the market, two drugs might work with side effects, or one drug, or none.” Numerous infections – many of which few people worry about – are returning with now-fatal consequences as the spread of resistance escalates.
Expressing concern over the potential lethality of basic health issues in the future seems like an overreaction. However, the only thing that has stood between numerous bacterial health implications and mortality – for nearly a century – is antibiotics. Render them ineffective and we might as well be living in the pre-antibiotic era.
Case(s) in point:
A North Carolinian visited a hospital seeking antibiotic treatment in 2000, nearly all were ineffective. This bacteria called KPC has since spread to 47 States, South America and the Middle East. This group of highly resistant bacteria are “associated with significant morbidity and mortality.” Moreover, a gene that forms extremely strong antibiotic resistance – identified in India in 2008 – has since trickled into America, Europe, Africa, the UK, Asia, Australia, Russia, and New Zealand.
What happens to surgical practices?
During surgery, a surgeon effectively opens someone up. Subsequently, they need to be sealed back up; with this comes the risk of infection. Hence, patients who undergo surgery will typically take prophylactic antibiotics. A 2015 study published in The Lancet Infectious Diseases (explained in The Atlantic) claimed “If antibiotics became 30 percent less effective when used before surgery, that would result in 120,000 more infections a year, and 6,300 deaths from those infections.” These figures represent only the United States and only the top 10 surgeries and chemotherapies.
Based on the 3 recommended antibiotics used in adult surgical prophylaxis by the National Library of Medicine, 2 already have resistant bacterial mutations.
Won’t Big Pharma start making superbug antibiotics?
As mentioned in Maryn Mckenna’s TedTalk, pharmaceutical companies are no longer producing as many antibiotics as they previously did due to the accelerated rate of resistant bacterial strains. Explained in nature: “Fewer new antibiotics are reaching the market […] One reason is that discovering and bringing antibiotics to market is often not profitable for pharmaceutical companies. 2017 estimates for research into new antibiotics is around $1.5 billion yet the annual return on such discovery comes in at only $46 million.
A lack of new antibiotic development to contain drug-resistant bacteria is an increasingly-large threat, according to the WHO, with the 60 products currently in development providing “little benefit over existing treatments and very few target the most critical resistant bacteria (Gram-negative bacteria).” The paper by the WHO revealed more and more “large pharmaceutical companies [are] continuing to exit the field.” Kaiser Health News found that 7 of the 12 Big Pharma companies that successfully brought a drug to market in the past decade went bankrupt or left the antibiotics business because of poor sales.
How can we reduce antibiotic resistance?
There are numerous reasons why antibiotic resistance has become a problem. When we consider the monumental consumption of antibiotics in the animal agriculture industry, we ought to take action against unnecessary use.
In Scandanavia antibiotic usage in the animal agriculture industry is 50 – 100 times lower than in other European countries. According to Our World in Data, in the 1990s the nations phased out their usage for growth promotion, consequentially leading “to a significant decline not only in antibiotic use for growth, but also for therapeutic uses.”
|Reducing administration of antibiotics in animal agriculture|
|Petitioning to stop antibiotic use in agriculture|
|Purchasing organic meat|
|Adopting meatless Monday|
|Going vegetarian or vegan|
|Adopting better husbandry practices|
|Voting in favour of legislation to ban factory farming|
This blog isn’t a case for veganism; rather a message of concern regarding the latest global health emergency that – like many other modern issues – happens to tie back to our inhumane husbandry of animals. As more lethal bacteria emerge and fewer effective antibiotics are produced, we now stand in the post-antibiotic era; a modern society where over 10 million are killed annually by infections of the past. Nevertheless, by reducing our consumption of meat and dairy and advocating for change throughout the industry, resistant bacteria can be swiftly restrained. Whether that happens or not boils down to what’s on your dinner plate tonight.