As a part of World Antimicrobial Awareness Week 2022, we spoke to Coilin Nunan, the Scientific Advisor for the Alliance to Save our Antibiotics, about how antibiotics are utilized in farming and why the overuse of antibiotics in farming contributes to the issue of antimicrobial resistance. 

Please are you able to introduce yourself and tell us about your skilled background in addition to your current role on the Alliance to Save our Antibiotics?

My name is Cóilín Nunan, and I’ve worked on various issues related to healthy and sustainable farming and food for a few years. During this time, the principal issue that I even have focused on has been the overuse of antibiotics in farming. For a few years I worked for the Soil Association, which is a number one certifier of organic farming within the UK, and I worked on their campaign against the abuse of antibiotics in farming.

Subsequently, about ten years ago, the Soil Association decided to expand the scope of its campaign and to get greater involvement of the medical community. Along with Compassion in World Farming and Sustain, it founded the Alliance to Save our Antibiotics, which now has 67 member organizations that support the goals of the Alliance. I work because the scientific advisor for the Alliance to Save our Antibiotics.

Are you able to tell us a bit about The Alliance to Save Our Antibiotics? What are your principles and goals?

The Alliance goals to attain more responsible use of antibiotics in farming. We usually are not a bunch that campaigns for no use of antibiotics in farming as we accept that there are cases when use is responsible and good for animal welfare. However the Alliance campaigns against all types of routine farm antibiotic use, particularly the usage of antibiotics for purely preventative group treatments.

We also campaign for restrictions on the highest-priority critically vital antibiotics like fluoroquinolones and the fashionable cephalosporins and an end to using the last-resort antibiotic, colistin, in farming. But along with our deal with improving the regulation of antibiotic use in farming, we very much campaign for improvements in animal husbandry and animal health and welfare to assist make sure that animals don’t routinely turn out to be sick and due to this fact don’t, as a general rule, need medical treatment including a specific antibiotic use.

What will we currently know in regards to the state of antimicrobial resistance, and the way is antimicrobial resistance predicted to vary over the following few a long time?

Currently, the estimates are that, within the human population, in 2019, 4.95 million people died of an antibiotic-resistant infection and that in 1.27 million of those cases, antibiotic resistance was the explanation for the death. Antibiotic resistance is already a large global problem, and a review commissioned by the UK government published a couple of years ago, called the Review on Antimicrobial Resistance or the O’Neill Review, forecast that, unless motion was taken, by 2050, 10 million people a yr could be dying from antibiotic resistance.

In each human medicine and farming, we all know that the degrees of antibiotic resistance are very much related to antibiotic use. We now have clear evidence that countries with high levels of antibiotic use in cattle have much higher levels of antibiotic resistance. In contrast, those countries with the bottom levels of use can have vastly lower levels of antibiotic resistance.

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In reality, in some European countries, similar to Norway or Sweden, antibiotic resistance in cattle is a minor problem in comparison with the remainder of the continent. We all know that reducing antibiotic use may also reduce antibiotic resistance in some cases. We now have examples of this happening.

While antibiotic resistance is already a large problem, the worldwide projections are that farm antibiotic use will keep increasing. Due to this fact, antibiotic resistance from farming will keep increasing; we realize it is feasible to tackle this problem by tackling the excessive use of antibiotics.

Worldwide it’s estimated that 66% of all antibiotics are utilized in cattle, not people. How are antibiotics utilized in farming, and why is the overuse of antibiotics in farming an issue?

Antibiotics globally are utilized in 4 alternative ways in farming. Firstly, as growth promoters. They affect the gut bacteria within the animals in a way that makes them put weight on faster. Secondly, they will be used for purely preventative mass medication, which may be very much like growth promotion, except that you just need a veterinary prescription. Then they will be used, what known as metaphylatically. So these are group treatments where there may be an infection in among the animals, but not in the entire animals, but the entire animals get treated to stop the infection from spreading. Finally, they’re used therapeutically in individual sick animals.

The usage of antibiotics as growth promoters is regularly being phased out worldwide. It’s banned within the EU. It’s banned within the UK, but greater than 40 countries proceed to make use of antibiotic growth promoters worldwide.

But ending antibiotic growth promotion doesn’t necessarily reduce farm antibiotic use if antibiotics proceed to be permitted for routine preventative use. Fairly often, countries will allow the identical antibiotics they’ve banned as a growth promoter for use at sometimes the exact same dose for so long as the farmer or the vet wants to make use of it. So all that has modified in those cases is the label. The actual usage can remain the identical.

Image Credit: The World Health Organization

What is required is to finish all types of routine antibiotic use, including purely preventative mass medication. The EU has done this at the start of this yr. On the twenty eighth of January, the EU banned all types of routine antibiotic use and purely preventative group treatments. Still, most countries worldwide, including the UK, haven’t done this, and that is a serious area where we campaign.

In most countries, including the UK, most antibiotic use is for group treatments or mass medication slightly than for treating individual animals. The explanation for that is that the animals are kept in such intensive conditions with poor hygiene that this sort of mass medication with antibiotics is usually needed. This use of antibiotics can increase productivity by making the animals grow faster and enabling the farmer to push the animals harder and harder.

As an illustration, breeds of chicken are bred to grow faster and faster. Today, an intensively farmed chicken will reach slaughter age after they’re just five weeks of age, whereas, within the Nineteen Fifties, it took them 4 months to get to the identical weight. This rapid growth causes health problems, that are controlled with higher levels of antibiotic use.

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Similarly, piglets are weaned very early and develop diarrhea problems. Still, they are sometimes fed antibiotics to manage this, enabling the farmer to get the sow pregnant rapidly. Dairy cows now produce greater than 3 times as much milk per cow as they did within the pre-antibiotic era. This causes quite a bit more mastitis, and their abnormally large udders mean they struggle to face straight, which causes foot problems controlled by antibiotics.

In some ways, antibiotics are used as a productivity tool in farming, and that is what we oppose. We consider that higher husbandry should help to cut back antibiotic use.

What impact is antimicrobial resistance in farming having on the human population?

Excessive use of antibiotics in farming results in antibiotic resistance in bacteria in cattle. Though this can be a controversial issue, we all know that a few of these resistant bacteria can transfer to humans through the food chain and cause antibiotic-resistant infections. Now, most antibiotic resistance in humans is attributable to the human use of antibiotics. Still, we all know that, for certain infections in humans, many of the resistance comes from farm use, after which there are infections where it is a bit of each.

The query, “How much resistance comes from cattle and ends in resistant infections in humans?” is usually considered too difficult to reply precisely. Still, we realize it contributes, and we all know that reducing antibiotic use in cattle contributes to lower levels of resistance in humans.

What impact is antimicrobial resistance having on wildlife and the environment?

As much as perhaps 80% of antibiotics taken orally will be excreted in an lively form, so when slurry is spread on land, a whole lot of antibiotic residues and antibiotic-resistant bacteria could make their way into the environment. Many antibiotic-resistance genes have been present within the environment for thousands and thousands of years. Still, we even have clear evidence that antibiotic use in humans and in cattle contributes to higher levels of resistance within the environment.

The resistance probably doesn’t directly affect wildlife because they don’t seem to be fed antibiotics. They are not treated with antibiotics, however the spread of resistance through the environment and back into the clinic is a problem considered a potentially significant source of antibiotic resistance.

We still do not know enough about how much this happens, nevertheless it is widely understood to be occurring. Also, some antibiotics are toxic, and among the most generally used antibiotics in farming could have toxic effects when large quantities are released into the environment.

The precise theme of World Antimicrobial Awareness Week (WAAW) 2022 is ‘Stopping antimicrobial resistance together.’ What does this theme mean to you personally, and the way do you suspect we are able to take steps toward this goal?

I agree that everyone can take motion. We will take motion personally by not putting pressure on doctors to over-prescribe antibiotics. We may also take motion through our diets. Within the wealthy world, we are inclined to eat an excessive amount of meat and an excessive amount of dairy, so we are able to reduce our antibiotic footprint by reducing our meat and dairy consumption. Also, by in search of higher quality meat and dairy produced with lower levels of antibiotic use, similar to occurs, as an illustration, in organic or free-range farming, we are able to reduce it further.

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That said, I do not think all of the responsibilities needs to be placed on individuals. To actually have proper effective motion, we want leadership and governments to take motion to ban certain practices known to be harmful, similar to the routine use of antibiotics in lots of countries for intensive farming. So governments must be taking motion too.

How has the COVID-19 pandemic impacted antimicrobial resistance, and what can the pandemic teach those working inside the AR field about coping with a worldwide health crisis?

One among the interesting points of the COVID-19 pandemic was that, definitely initially, there have been very high levels of antibiotic use in hospitalized patients because doctors were concerned about secondary bacterial infections. But despite this, overall antibiotic use fell significantly in England in 2020. It was happening anyway, however the fall was significantly larger than in previous years, and a part of that is undoubtedly since among the actions that were taken, similar to social distancing, reduced infections typically and due to this fact reduced the necessity for antibiotics.

What can we find out about this? Well, we are able to find out about how diseases generally are transmitted. Throughout the pandemic, we were told to socially distance, and we were told that after we were meeting people, it was preferable to fulfill outdoors slightly than indoors, and I feel there’s quite a bit to be learned about that relating to farming.

By way of farming, we haven’t got social distancing in intensive farming. We now have very high densities of animals kept together. A big majority of them are kept entirely indoors where all forms of transmission is made easier, whether bacterial or viral infections.

The typical chicken raised on an intensive farm has lower than an A4 sheet of paper by way of space allowance, and as much as perhaps 50,000 chickens will be kept in a single shed. Obviously, there is not any social distancing. There’s terrible hygiene, and it’s all indoors. This is right for disease transmission.

We must be moving to a farming system where animals have more access to the outside and where they usually are not kept in nearly as intensive conditions, and this can reduce all forms of infections, not only bacterial, but things just like the sorts of viral infections that we see in cattle as well, including coronavirus infections.

What are the following steps for you and your work? Do you may have any exciting projects coming up?

We’re taking a greater interest within the environmental spread of antibiotic resistance, but we’re also very much inquisitive about trying to collect higher data on antibiotic use, and the way husbandry practices can affect antibiotic use. We try to encourage data collection by different farm systems because that is an area where we still do not know enough in regards to the differences between how the animals are raised and the degrees of antibiotic use.

We expect that governments in all places needs to be collecting this data in order that we are able to start to know, more scientifically and rationally, the link between husbandry and disease and antibiotic use so that each one types of farming will be improved and develop more responsible antibiotic use.

Where can readers find more information?

About Cóilín Nunan

Cóilín is the scientific adviser to the Alliance to Save Our Antibiotics, an alliance of 67 member organizations co-founded by Compassion in World Farming, the Soil Association and Sustain to campaign against the overuse of antibiotics in livestock farming. He has co-authored quite a few reports on antibiotic resistance and antibiotic residues that highlight the human-health impact of excessive antibiotic use in intensive livestock farming. The Alliance’s work goals to encourage a move to more responsible use of antibiotics in farming through higher regulation, voluntary actions, and enhancements in production systems, which might also improve animal health and welfare.