Managing antibiotic resistance: Can we prevent a zombie apocalypse?
Antibiotic-resistant bacteria are responsible for more than 2 million illnesses in the United States each year. Veterinary Medicine Dean Lonnie King discusses the work underway to eliminate these "superbugs."
Many veterinarians work on the front lines of emerging infectious diseases. But now, more than the emergence of new strains of influenza and Ebola, the biggest risk to human health may be the emergence of bacteria that threaten to spread without treatment options. While I don’t really believe zombies are imminent, uncontrollable infections that can spread without treatment options are a real threat.
Antibiotics save the lives of millions of people and animals around the world each year. However, the Centers for Disease Control and Prevention estimates that at least 2 million illnesses and 23,000 deaths are caused by antibiotic-resistant bacteria annually in the United States alone. Without bold action, we may face a future in which antibiotics become ineffective in controlling diseases.
The human-animal link
Veterinarians who work in the public health arena can offer a new perspective on the complex causes of this dangerous trend. With one foot in the world of animal care in agriculture and the other in public health, veterinarians are uniquely positioned to engage in discussions and actions to ensure we have antibiotics to treat serious diseases in animals as well as people.
The One Health concept recognizes that the health of people and animals is irrevocably linked and closely connected to our environment. One Health offers an integrated and holistic approach based on collaboration and shared responsibility.
Recently, a National Strategy for Combating Antibiotic-Resistant Bacteria was approved by the President’s Council of Advisors on Science and Technology. The executive order that was issued encourages implementing the recommendations from this report with programs to slow the spread of resistant bacteria; improve disease surveillance, diagnostics and research; and engage international collaboration to reduce resistance.
A national strategy
In early June, the White House Office of Science and Technology Policy hosted a summit on antibiotic resistance. More than 150 academic, health care, pharmaceutical and food production organizations came together to announce their support for the responsible development of a national strategy to mitigate antimicrobial resistance.
A key component to the national strategy and One Health approach is the judicious use of antibiotics for both human health and animal agriculture to ensure there are effective antibiotics to prevent and treat diseases in the future. The adoption of stewardship programs by physicians and veterinarians will help this judicious use of antibiotics.
As a veterinarian engaged in public health, I am thrilled to participate in this project, including agriculture as a full partner in these critical discussions. This opportunity to bring people together to take responsibility and develop solutions to this complex problem has never before been seen.
The FDA issued new guidelines to voluntarily stop using medically important antibiotics (those needed for human health) for promoting animal growth and to empower veterinarians with the authority to use these drugs only for prevention, control and treatment of diseases. Research will be a critical need, especially to discover alternatives to antibiotics and improvements in diagnostics, surveillance and reporting of usage.
One Health integration
Our universities and colleges can and should support the national strategy through their research, education and outreach missions and the support of a One Health approach. Antibiotic resistance is a complex and global issue that must be addressed by hospitals, clinics and public health officials. Yet, antibiotic use in agriculture is both partially responsible for our antimicrobial resistance problem and accountable to help address the issue. Integrating agricultural actions with human and environmental health in the national strategy is essential for success both nationally and globally.
With nationally recognized, comprehensive human and veterinary medical centers, seven health sciences colleges and partners in food science, environmental resources, agriculture, business, public policy and law, Ohio State is well-positioned to lead the conversation and provide strong recommendations for meeting this challenge by incorporating a One Health strategy.
A working group has been formed to support research and provide recommendations at the local, regional and national levels. Currently being led by Dr. Tom Wittum, a professor in the Department of Veterinary Preventive Medicine, this interdisciplinary collaboration offers an opportunity to explore the issues and potential solutions to this complex problem. Certainly, this effort is a demonstration of responsibility and community commitment for a land-grant institution in the 21st century.