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One Health - Antimicrobial Resistance (AMR)

Dominic Mellor

Much of my work over the last few years has been to try to coordinate efforts by animal keepers to minimise the impact of infectious agents that become resistant to drugs that should kill these agents. Right now, antimicrobial resistance (AMR) is a hot topic in science, and in government policy worldwide, because microbial infectious agents (essentially microscopic bugs and germs) cause health problems in people as well as animals. The drugs used to treat and control diseases caused by these agents are often the same or similar in animals and people. So, reduced ability of these drugs, principally antibiotics, to kill infectious agents can have direct negative impact on human health whether the drugs are being used in humans or animals. There is an additional indirect impact through compromising animal health and welfare and the availability of foods we get from animals, such as meat, eggs and dairy products. Almost all these drugs are based on naturally occurring substances produced by microscopic bugs and germs in their competition with one another wherever they occur. Over time, it has become evident that human development and exploitation of these substances for use in medicine has hastened and amplified the appearance bugs and germs that can withstand the effects of the drugs. In the past, there has been some controversy between animal health and human health communities about the relative contributions of each’s prescribing of these drugs to the shared problem of drug resistant infections. 

A coherent ‘One Health’ approach has never been more relevant or important.

 A great deal of research has been focussed on antimicrobial resistance and understanding its mechanisms and drivers in human and animal populations worldwide. Much of this research has helped to inform government and industry led policies and plans of action at national level to reduce the threat and impact of antimicrobial resistance. In the last few years, a so-called ‘One Health’ approach has been recognised and largely accepted as an optimal way to tackle the problem of antimicrobial resistance. ‘One Health’ means that evidence and efforts from all relevant sectors, in this case principally human health, animal health, food and the environment, are combined and balanced to develop a shared set of responsibilities and actions to address the problem in question.

The key elements of such actions focus on the following: 

1. Efforts to reduce the likelihood of microscopic bugs and germs spreading between people and between animals (and the places where they are kept). In human health, this is referred to as Infection Prevention and Control, whereas in animal health it is better known as Biosecurity or Disease Avoidance. This also involves using things like vaccines to prevent diseases rather than having to rely on antibiotics to treat those diseases. 

2. Monitoring the occurrence of drug resistant bugs and germs in specimens collected from humans and animals. Analysis and careful comparison of the outputs of this monitoring is likely to make clearer the very complex interrelationships between microscopic bugs and germs and different host populations (including but not limited to humans and animals) and their environments. This understanding should help identify safe interventions to reduce the development and impact of drug resistance.

3. Responsible use of antibiotics and other antimicrobial drugs by all prescribers (doctors, nurses, dentists, pharmacists, vets) to keep these drugs working. 

4. Raising awareness of the problem and the coordinated efforts being made to tackle drug resistance and the actions and responsibilities of all parties to adopt best practice to preserve these important medicines for future generations. 

Having been a small part of some of this unfolding story in Scotland in recent years, I am more convinced than ever that these efforts need to be coordinated not just across the ecosystem but also across hitherto different branches of science and practise. A coherent ‘One Health’ approach has never been more relevant or important.

 

Views expressed are those of the guest blogger and do not necessarily reflect those of the EPIC project or funders.

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