December 8, 2015

expert reaction to the latest Jim O’Neill review on AMR, specifically whether resistant bacteria in poorly cooked meat could pose a health risk

The Review On Antimicrobial Resistance chaired by Jim O’Neill has produced a report which sets out a number of suggestions in order to reduce the use of antibiotics in agriculture.

Prof. Laura Piddock, Professor of Microbiology, University of Birmingham, said:

“Since the Swann report was published in 1969, it has long been argued that antimicrobials that are used in human medicine should not be used in animals.  This latest report by the UK Review on Antimicrobial Resistance (AMR) is an excellent overview of the scale of use of antimicrobials in animals reared for food production and of antimicrobial, human and animal waste released into the environment. The Review on AMR team of economists have already reported on the cost to the global economy and human health of AMR, and this new report shows that the use of antimicrobials in animals and environmental contamination by waste is a significant driver of global levels of drug resistance. They have provided good evidence to support their recommendations of (1) a country by country target of an agreed and achievable level of drug use per kilogram of livestock and fish, and global harmonisation on which drugs should be restricted for use in people; (2) minimum standards on the amount of antimicrobial manufacturing waste that can be released into the environment; and (3) improved surveillance of drug use, waste produced and AMR in animals. There is also consensus with other reports that antimicrobial use in animals could be hugely reduced by better use of vaccines. The report also recommends the development of rapid diagnostics for use in farm animals (as are urgently required in human medicine) and increased awareness and education of the public about the use of antimicrobials in food production. Importantly, and unlike previous reports, this report was compiled by economists and so provides suggestions on the role of fiscal measures such as taxation and regulation of use. The Review on AMR is to be applauded for their calls for action at the G20 and UN General Assembly, and their role at the highest governmental level is instrumental in resolving the global crisis of AMR.

“Recently, the UK All-Party Parliamentary Group (APPG) on Antibiotics published its report on ‘Non-medical uses of antibacterial compounds (antibiotics): time to restrict their use?’ http://appg-on-antimicrobials.com/assets/Non-Human-Uses-report-final.pdf and recommended that antimicrobial use in animals should be minimised as soon as possible, and that there should be increased use of vaccines and improvements in animal hygiene and sanitation. This report was summarised in our recent article published in PLOS Biology http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002266.

“Over the last 25 years, academics have repeatedly called for a reduction in global antimicrobial use in animals reared for food production. Unfortunately, our calls have fallen on deaf ears. It is my hope that this report will provide the economic impetus to politicians to facilitate the development of new vaccines and treatments for use in animals combined with improved animal welfare so that valuable drugs such as antimicrobials can be retained for use in people.”

Prof. Brendan Wren, Professor of Microbial Pathogenesis and Dean of Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, said:

“Unfortunately a lot of our food, particularly meat products can be contaminated with bacteria which are increasingly more resistant to antibiotics. Raw food products should be handled with care and appropriately cooked.”

Prof. Mark Woolhouse, Professor of Infectious Disease Epidemiology, University of Edinburgh, said:

“Poorly cooked meat is a source of food-borne bacterial diseases in general, not just resistant forms. It is a major public health (as a recent WHO report just described) but not all food-borne infections are treated with antimicrobials and so resistance is not always an issue. Obviously, treating food animals to keep them clear of bacterial infections such as Salmonella has a public health benefit too.

“There is good evidence that antimicrobial resistance can move from livestock to humans, and from humans to livestock as well. But whether banning or reducing antimicrobial use in livestock would, by itself, have much public health benefit remains very doubtful. Drug resistant infections in hospitals develop mainly because we use antimicrobials on ourselves. What is needed is an integrated approach so that at the same time as reducing usage in farm animals, we make strenuous efforts to reduce usage in humans, saving these valuable drugs for those that most need them.”

‘Antimicrobials in agriculture and the environment: Reducing unnecessary use and waste’ by chaired by Jim O’Neill published on the review’s website on Tuesday 18th December. 

Declared interests

Prof. Laura Piddock: For her basic research, Prof. Piddock is currently in receipt of funding from the BBSRC and MRC, and has a Roche Extending the Innovation Network Award. Professor Piddock is the vice-chair of the EU Joint Programming Initiative on AMR scientific advisory board. She is also member of the Longitude Prize Advisory panel.

Prof. Brendan Wren: No conflicts of interest to declare.

Prof. Mark Woolhouse: No conflicts of interest