By Tri Satya Putri Naipospos (Center for Indonesian Veterinary Analytical Studies)

16 Juli 2021

The death toll from the global Covid-19 pandemic is very high as we can clearly see with our own eyes, but there is another pandemic that will lead to another devastating end if it is not tackled seriously.

We are talking about the silent pandemic of antibiotic resistance that had begun long before the Covid-19 pandemic emerged.

If Covid-19 is able to destroy the lives of a country’s people in just a few months, antibiotic resistance may move more slowly but has the same destructive potential.

According to the World Health Organization (WHO), annual deaths from antibiotic resistance number around 700,000 people worldwide. However, experts estimate that annual fatalities will reach 10 million people by 2050 to beat out major diseases such as cancer and diabetes.

Antibiotic resistance has become a serious global health threat that can cross the boundary between human and animal species. Many countries around the world have recognized that antibiotic resistance must be a priority issue in human medicine, veterinary medicine, and food systems because of the threat it poses to public health, food security and the global economy.

Global Situation

WHO Director-General Tedros Adhanom Ghebreyesus has said that if policymakers failed to address the threat of antibiotic resistance, we would see this pandemic escalate quietly, with grave consequences that we never expected.

The fact remains that more infectious agents will become resistant to antibiotics, and this means that it will become more difficult to treat infections and cause more deaths.

In developed countries like the United States, more than 35,000 people die each year from antibiotic resistance. In the European Union, antibiotic resistance is responsible for the deaths of 33,000 people every year. Meanwhile, in developing countries such as Thailand, deaths due to antibiotic resistance reach 38,000 people every year. Indeed, there is no definitive data on deaths due to antibiotic resistance in Indonesia, but it is estimated from hospital records that the death rate will continue to increase.

To date, the emergence and spread of antibiotic resistance have been linked to the misuse, overuse or indiscriminate use of antibiotics for human and animal health. Even the regular use of antibiotics in animals as growth promoters or for the prevention and treatment of nonspecific infections, which has long been practiced, has increased antibiotic consumption and bacterial resistance in animal habitats.

Detailed data on the actual global consumption of antibiotics is difficult to find. Scientists estimate that 75 percent of antibiotics in the world was consumed by livestock. A 2020 study estimated that global antibiotic use in livestock reached 93,300 tons in 2017 and projected it would increase 11.5 percent to 104.1 tons in 2030.

Likewise, the use of antibiotics in humans is projected to increase 15 percent between 2015 and 2030.

The antibiotic resistance crisis has emerged because the development of new antibiotics cannot keep up with the exponential growth of bacterial resistance. It took an average 21 years for bacteria to become resistant from the first use of an antibiotic. For example, penicillin was discovered in 1928, became widely available to the public in 1940, and became resistant in 1947. Today, it only takes one year on average for bacteria to develop antibiotic resistance.

Food chain

The spread of antibiotic resistance through the food chain is currently increasing at an alarming rate. Food plays a key role in the development and spread of antibiotic resistance. Food processing environments can be areas of potential risk in the proliferation and spread of antibiotic-resistant bacteria.

Animal food producers have long used antibiotics, including those critical to maintaining human health, to accelerate animal development to reach their slaughter weight target while preventing infection in livestock from unhygienic conditions and overcrowding in cages.

The presence of antibiotic-resistant bacteria in livestock production systems and food chains is a potential route to human exposure. Antibiotic resistant bacteria and genes can spread easily at any stage in the food chain from farms to consumers.

A 2015 study found that 40 percent of sampled animal food products contained bacteria that were resistant to one or more antibiotics. Antibiotic-resistant bacteria in the food chain, such as campylobacter, salmonella, and Escherichia coli, have become an important health issue because they can be isolated from food and food processing environments.

If the bacterium is not pathogenic, it can still contribute by transferring resistance genes to other, pathogenic bacteria.

We can be exposed to resistant bacteria in the food chain, for example by eating chicken meat. If the bacterium is pathogenic, it will cause a person to become sick, and they will not respond to antibiotics or other treatments. If the bacterium is not pathogenic, it can still contribute by transferring resistance genes to other, pathogenic bacteria.

The wide distribution of food will accelerate the spread of antibiotic resistance. However, how we are exposed is highly dependent on our decisions in choosing clean and quality foods. Animal food products are still safe, as long as consumers follow good hygiene and cooking practices.

‘One Health’ strategy

To meet the demand for food, especially those of animal origin, antibiotic use in the livestock sector is expected to increase substantially in several parts of the world, including Indonesia. The double challenge that we face now and in the future is how we can protect the effectiveness of antibiotics while still producing safe animal food products in sufficient quantities.

In recent years, a global effort has been made to unite all countries under the auspices of the United Nations to bring the antibiotic resistance issue to the center of global attention and to ensure political commitment in taking collective action.

The “One Health” strategy approach aims to overcome antibiotic resistance by focusing on reducing the use of antibiotics in humans and animals, and by ensuring wise and responsible antibiotic use by all stakeholders. Hygiene and sanitation along the food chain, from livestock farms to slaughterhouses, from retail outlets to restaurants, and to consumers, are not only fundamental to improving food safety but also key to overcoming antibiotic resistance.

The effort to overcome antibiotic resistance also needs to be supported by an effective monitoring and surveillance system to track antibiotic use and identify the spread of antibiotic resistance in the food chain.

Regulatory compliance, product labeling requirements, consumer awareness, and the role of the media are also important contributing factors in achieving our goals in improving the food chain.

(This article was translated by Hendarsyah Tarmizi).

Source: Kompas.id