One Health, More Than One Resistance to Consider

Ever heard the term “One Health”? It is used to describe a wellness concept that focuses on the health of our planet and its inhabitants. With this comprehensive focus, various health- and wellness-related organizations (i.e. government agencies, scientific groups and universities) aim to create awareness, drive best practices and offer guidance on how to keep us, animals and the Earth healthy.

In an effort to bring more awareness to One Health and to highlight related global initiatives, the One Health Commission, the One Health Initiative Autonomous pro bono Team and the One Health Platform Foundation created One Health Day. Every year, One Health Day takes place on November 3.

The IFIC Foundation celebrates One Health Day annually to showcase global health initiatives that support our food supply. A major health concern associated with One Health that has gained a significant amount of attention in recent years is antibiotic and antimicrobial resistance.

What Is Antibiotic/Antimicrobial Resistance?

When people or animals get sick due to an infection, either from bacteria, viruses, fungi or parasites, medications that are used to treat the infection are called antibiotics or antimicrobials. However, in recent times some of these medicines have become ineffective due to resistance.  When you see or hear “antimicrobial resistance,” this means that the bacteria, virus, fungi or parasite causing an infection is not killed by the medicine. But the term “antibiotic resistance,” is specific to bacterial infections.

If an antibiotic/antimicrobial is not effective in alleviating an infection, it can lead to long-term health issues or death. This can happen in both humans and in animals. Microbes can spread from animals to humans and vice versa—hence, this is a major concern for those of us carrying the One Health torch. Microbes can develop this resistance in nature as part of their natural evolution (yeah, they do that) or with the use of antimicrobials by humans and animals. Scientists and health professionals have also determined that the improper use of antibiotics and antimicrobials in animals or people can increase the risk of resistance.  Therefore, it is important that these medicines are properly used as prescribed by a health professional.

What Are One Health Tactics to End Antibiotic Resistance and Who Is Taking Action?                

As stated above, resistance is an issue for people and animals; therefore, it requires both veterinarians (alongside farmers)  properly treating animals and physicians properly treating human patients to diminish the threat of the resistant microbes.

Notably, the World Health Organization, the Food and Agriculture Organization of the United Nations and the World Organization for Animal Health have developed a collaborative initiative to minimize the emergence and spread of antibiotic and antimicrobial resistance. Their objectives are to:

  • “ensure that antimicrobial agents continue to be effective and useful for curing diseases in humans and animals;
  • promote prudent and responsible use of antimicrobial agents; and
  • ensure global access to medicines of good quality.”

In addition to these global health agencies working together to decrease the incidence of drug resistant infections, the U.S. Food and Drug Administration (FDA) has also taken action to help cut back the use of antibiotics and antimicrobials in food-producing animals to support this effort.

For example, the FDA in 2015 issued the Veterinary Feed Directive final rule. This rule lays out what veterinarians must do when they need to authorize the use of antimicrobials in feed to protect the animals they serve. In January 2017, FDA completed the implementation of Guidance for Industry #213, which prohibits the use of antimicrobial and antibiotics for production purposes and changed the marketing status of these medicines from over-the-counter to prescription status, meaning the drugs can only be administered via a veterinarian's prescription. And the proof is in the pudding with FDA’s actions — a recent FDA report has shown that sales of antibiotics and antimicrobial treatments used in animals raised for food dropped in 2016 from the previous year. This is the first time sales haven't increased since FDA's first report in 2009.

In addition to implementing change in the U.S. food supply, the Centers for Disease Control and Prevention (CDC) is urging healthcare providers to change antibiotic and antimicrobial use in clinical settings. The CDC is looking to help improve antibiotic and antimicrobial prescribing and use with their Antibiotic Resistance Solutions Initiative, a “comprehensive approach to combat antibiotic resistance that includes aggressive responses to outbreaks, groundbreaking approaches to research, and new investments in state and local infection prevention and control.” To expedite advances and help healthcare facilities and physicians make the best decisions to treat and protect their patients, the CDC provides various tools for implementation, action, innovation and education.

One Health, One Future

While antibiotic and antimicrobial resistance may not be 100 percent eliminated, a united effort is needed to lower its health impact on people, animals and the environment. One Health activities encourage treating infectious diseases by acknowledging the link between human, animal and environmental health and developing best practices to support these important outcomes.