A 2021 report produced by the European Center for Disease Prevention and Control (ECDC), the European Food Safety Authority (EFSA), and the European Medicines Agency (EMA) noted that for the first time in Europe, the overall consumption of antibiotics and other antimicrobials in food-producing animals was lower than in humans. However, the report also confirmed the association between antimicrobial consumption and antimicrobial resistance (AMR): "For certain combinations of bacteria and antimicrobials, resistance in bacteria from humans was associated with resistance in bacteria from food-producing animals which, in turn, was related to antimicrobial consumption in animals."1
It is known that the overuse of antibiotics in livestock raised for food can seriously affect human health and fuel AMR by decreasing the effectiveness of medications used for treating bacterial infections. Without effective antimicrobials, common infections will become life-threatening and certain treatments (including surgical procedures and chemotherapy) will not be possible.2 Infections, such as pneumonia, tuberculosis, and salmonellosis "…are already showing increasing resistance to antibiotic treatment,"3 and the use of antibiotics in the livestock sector is one of the primary causes.4
These concerns escape the food safety radar of many consumers. At the supermarket's meat aisle, health-conscious consumers often review the products' overall look, freshness, and use-by date. They rarely think about how consuming meat could be potentially harmful. This harm can directly threaten consumer health or impact the natural environment. For example, the meat from an animal with antibiotic-resistant bacteria can be transmitted to people through food and may infect them with those same resistant bacteria. Salmonella and Campylobacter are among the most common antibiotic-resistant foodborne bacteria that cause illnesses that are becoming increasingly hard to treat. It is estimated that up to 90 percent of the antibiotics consumed by livestock are excreted by the animals, allowing them to enter the soil and water, which leads to a buildup of antimicrobial-resistant strains in the environment.5 Even people who do not consume meat are exposed to the risks of AMR through the presence of such strains in the natural environment.
The ascendency of AMR is a preeminent, global public health issue with profound ramifications for the production and consumption of foods from animal origin, especially meat.6 Two ways to respond to this problem exist, and they are not mutually exclusive—namely, to limit the application of antimicrobials in livestock and to decrease the demand for animal-sourced products. These two trends are apparent to a certain degree in Europe, as evidenced in the 2021 report,1 but major changes are needed worldwide to mitigate this global threat to human health.
Antimicrobial Resistance Policies
Detection and acknowledgement of the risks from the use of antibiotics in food animals started to become apparent in the 1960s.7 Countries such as Denmark, Sweden, and the Netherlands were early to rectify the problem from the late 1980s and have taken measures to curb the routine use of non-medical antibiotics in animal agriculture by putting in place bans and restrictions.8,9 Denmark, for example, has banned the preventative use of antibiotics to livestock and severely restricted the application of critically important antibiotics to sick animals.10 Evidence shows that this has not negatively affected the production of meat while antimicrobial resistance has declined.11
In 2015, the World Health Organization (WHO) launched a Global Action Plan on Antimicrobial Resistance12 with the objective to increase awareness of antibiotic resistance, prevent infections, optimize the use of antibiotics, increase knowledge through research and surveillance, and ensure investment in countering antimicrobial resistance. The U.S. introduced a similar plan in 2017. As resistant bacteria threaten both animal and human health, multi-sector collaboration is required to protect the well-being of both entities;13 however, consumers can also play a major role in this process.
Curbing Meat Consumption
Since the advent of industrialization, we have witnessed an ever-increasing demand for animal-based products. This has been driving the use of antimicrobials in livestock, initially for promoting growth—a practice that has been discontinued in most places around the world—but also more recently as a prophylaxis to protect the health of animals raised in intensive, crowded conditions. The data about antimicrobial use is usually presented as milligrams of the medicine per kilogram of biomass (human or animal). As the biomass of animals raised for food by far exceeds that of humans, new, resistant mutations are more likely to emerge in livestock.4 A decrease in meat consumption could result in lower AMR risk. It would alleviate the need to raise animals in factory farms, intensive systems, or concentrated animal feeding operations (CAFOs).
Other benefits exist to decreasing human reliance on animal-based proteins, such as better population health, reduced greenhouse gas emissions, less clearing of nature vegetation, improved soil fertility, and more space for wild species.14 It is a win-win situation that protects human and environmental well-being while safeguarding the use of the valuable antimicrobials for saving lives instead of satisfying dietary excesses.
- European Center for Disease Prevention and Control (ECDC), European Food Safety Authority (EFSA), European Medicines Agency (EAMA). "Third joint inter-agency report on integrated analysis of consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food- producing animals in the EU/EEA." EFSA Journal 19, no. 6 (2021). https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2021.6712.
- Anderson, M., C. Clift, K. Schulze, A. Sagan, S. Nahrgang, D. A. Ouakrim, and E. Mossialos. "Averting the AMR crisis: What are the avenues for policy action for countries in Europe?" World Health Organization. Health Systems and Policy Analysis: Policy Brief 32. 2019. https://apps.who.int/iris/handle/10665/331973.
- Ritchie, H. "How do we reduce antibiotic resistance from livestock?" Our World in Data. November 16, 2017. Available at: https://ourworldindata.org/antibiotic-resistance-from-livestock.
- Van Boeckel, T. P., E. E. Glennon, D. Chen, M. Gilbert, T. P. Robinson, B. T. Grenfell, S. A. Levin, S. Bonhoeffer, and R. Laxminarayan. "Reducing antimicrobial use in food animals." Science 357 (September 2017): 1350–1352. https://onehealthtrust.org/wp-content/uploads/2017/10/science.0929PolicyForum-1.pdf.
- Raphaely, T., D. Marinova, and M. Marinova. "The future of antibiotics and meat." Impact of Meat Consumption on Health and Environmental Sustainability. T. Raphaely and D. Marinova, eds. Hershey, Pennsylvania: IGI Global, 2016.
- Pew Charitable Trust. "Animal antibiotic use and public health." November 2017. https://www.pewtrusts.org/-/media/assets/2017/11/animal_antibiotic_use_tables.pdf.
- Swann Committee. "Report of the Joint Committee on the Use of Antibiotics in Animal Husbandry and Veterinary Medicine." Her Majesty's Stationery Office, London, UK (1969).
- Levy, S. "Reduced antibiotic use in livestock: How Denmark tackled resistance." Environmental Health Perspectives 122, no. 6 (2014): A160–165. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050507/.
- Björkman, I., M. Röing, L. S. Sternberg, C. Stålsby Lundborg, and J. Eriksen. "Animal production with restrictive use of antibiotics to contain antimicrobial resistance in Sweden—A qualitative study." Frontiers in Veterinary Science 7 (2021): 619030. https://www.frontiersin.org/articles/10.3389/fvets.2020.619030/full.
- Alliance to Save Our Antibiotics. "Successful interventions in other countries." 2022. https://www.saveourantibiotics.org/the-issue/learning-from-others/#:~:text=keep%20animals%20healthy.-,Denmark,remains%20a%20major%20pork%20exporter.
- Pew Charitable Trust. "Avoiding Antibiotic Resistance: Denmark's Ban on Growth Promoting Antibiotics in Food Animals." https://www.pewtrusts.org/-/media/legacy/uploadedfiles/phg/content_level_pages/issue_briefs/denmarkexperiencepdf.pdf.
- World Health Organization. "Global Action Plan on Antimicrobial Resistance." Geneva, Switzerland. 2015. https://www.emro.who.int/health-topics/drug-resistance/global-action-plan.html.
- Food and Agriculture Organization of the United Nations (FAO), World Organization for Animal Health (OIE), and World Health Organization (WHO). "WHO, FAO, and OIE unite in the fight against Antimicrobial Resistance." https://www.woah.org/app/uploads/2021/03/fao-oie-who-amrfactsheet.pdf.
- Marinova, D. and D. Bogueva. Food in a Planetary Emergency. Singapore: Springer, 2022.