Antibiotic resistance is sometimes called the silent pandemic – an infection which is spreading uncontrolledly and unpreventably.
However, in February this year, a study published in The Lancet estimated that 1.27 million people die each year from infections that can’t be treated with antibiotics, as the bacteria have become resistant. More people die of these infections than of malaria or AIDS.
If we don’t do something about it quickly, common infections and minor injuries will once again become fatal.
Debate during Stockholm+50
The main cause of antibiotic resistance is the overuse of antibiotics in agriculture and healthcare brought about by the intensive breeding of livestock and the lack of access to vaccines, a shortage of cheap medicines, and incorrect diagnoses.
Governments around the globe need to quickly take control and turn the tide. But is there the political will to do so? What can the world learn from COVID-19 and then apply to antibiotic resistance? These issues were discussed in a debate at the UN Conference on the Human Environment – Stockholm+50.
“We were completely unprepared”
“One of the most important lessons from COVID-19 is how unprepared we were for it. Thanks to COVID-19, we’re beginning to understand the importance of disease prevention through public health and a functioning primary healthcare system, hygiene, and clean water. We also needed to understand the link between the natural crisis and zoonoses (diseases which can spread between livestock and humans),” said Sunita Narain, an acclaimed environmental activist, researcher and publicist from India.
In India, where Sunita Narain heads the Center for Science and Environment, both antibiotic use and antibiotic resistance are among the highest in the world.
At the same time, India is a major food-producing nation which needs to feed an ever-growing number of people.
The fact that countries like India will have to produce even more food in the future, albeit in a sustainable way, is of crucial importance for the climate, biodiversity, and public health.
Intensive farming brought into question
Although Narain can see in India that knowledge is improving while the use of antibiotics is declining, the process is a slow one.
“Together with developed nations, we need to speak up more critically of intensive farming systems, develop alternatives, and change consumer behaviours. In my part of the world, we talk a lot about the fact that low and middle-income countries can’t afford to follow in the footsteps of more developed nations – destroy first and clean up afterwards. We need to maintain an emphasis on prevention and, when it comes to agriculture, ‘prevention’ doesn’t mean using antibiotics to prevent diseases. It means improving livestock health,” says Narain.
As for reducing the use of antibiotics in agriculture, the Nordic countries can contribute with their first-hand experiences.
No antibiotics in salmon farming
Sweden was among the first countries to ban preventative antibiotic use in livestock farming.
In the area of pig farming, although Denmark has the highest use of antibiotics in the Nordic Region, after several years of concerted efforts, it now has one of the lowest in Europe.
In Norway, the use of antibiotics in salmon production has decreased by 90 percent since the 1980s, and it’s now the best in the world at minimising the use of antibiotics in livestock farming.
According to Edgar Brun, Director of the Norwegian Veterinary Institute, the collaboration between the fishing industry, public authorities, and researchers was crucial for the success of the Norwegian salmon industry in reducing the use of antibiotics to almost zero.
“We needed to work together to determine the facts and find common methods for monitoring diseases in the fish farming industry. To that end, openness and transparency were very important in establishing a system for reporting all use of antibiotics and cases of resistance. The whole process brought about a focus in the industry and an awareness among consumers,” says Brun.
What’s the main driver of political will?
In certain parts of the world, the lack of knowledge and reliable diagnoses is just one explanation for the overuse of antibiotics. The medical response to the pandemic, COVID-19 testing, and COVID-19 vaccines have probably played an important role in raising awareness that antibiotics don’t always have to be the answer to disease.
Anders Nordström, Sweden’s ambassador for global health, pointed out that what’s needed now more than anything is knowledge of what it is that brings about change, what encourages political will, as well as which behavioural changes are needed in the food industry and the population at large.
Political peer pressure and consumer power
“In Sweden, people really don’t want food produced with the use of antibiotics. If they go to see a doctor about a sick child, they’ll question whether antibiotics are necessary. Awareness is quite high, and the use of antibiotics is low. Even at the global level, we can leverage political peer pressure and pressure from consumers and voters. It’s quite clear that what’s good for the planet is also good for human health, and vice versa. Let’s take advantage of that synergy,” says Nordström.