The Antibiotic Resistance Crisis Has a Troubling Twist

A report published The United Nations’ Today says we’ve neglected a key component of the superbug problem: the environment. It serves as a reservoir for bacterial genes that create antimicrobial resistance, and it absorbs agricultural effluent and pharmaceutical effluent that breeds new resistance.

“The same drivers that are causing environmental degradation are exacerbating the antimicrobial resistance problem,” said Inger Andersen, executive director of the United Nations Environment Program, known as UNEP, in a statement. “The effects of antibiotic resistance could destroy our health and food systems.”

The 120-page Bracing for Superbugs policy document recognizes the environment as a place where antibiotic resistance emerges and wreaks havoc, causing up to 1.27 million deaths a year. It’s a problem that public health planners have already recognized for hospitals and emergency care centers, as well as for farms that produce livestock, fish and crops. The report provides researchers with a framework for understanding pathogens that are not limited to these economic sectors, such as: B. Resistant bacteria that occur downstream of hospital sewage treatment plants and agricultural fungicides that turn common hospital infections into untreatable ones. It said governments should legislate to curb antibiotic pollution, rely on food manufacturers to reduce antibiotic use, improve sanitation systems to remove resistant bacteria from wastewater, and establish surveillance programs should, in order to check whether environmental protection is working.

In practical terms, it makes UNEP a leader in the global fight to combat resistant bacteria, linking it with other UN agencies – the World Health Organization, the World Organization for Animal Health and the Food and Agriculture Organization – in a “One Health” approach to human concerns , animal and environment. That matters because nations are already developing plans to tackle antibiotic resistance through a UN process that began in 2016. Now countries are being urged to consider protecting the environment as they try to reduce resistant infections in humans.

It’s a long-overdue move that redefines the superbug problem, turning it from a problem caused by misbehaving users into a shared responsibility for an endangered planetary microbiome.

“The environment is the only thing that connects the different sites of selection for antimicrobial resistance in a meaningful way,” says Claas Kirchhelle, historian of science and medicine and assistant professor at University College Dublin. “And over the long term, antimicrobial exposure should get there, not just in the next two to three years, but in 20 to 30 years.”

It seems remarkable that the role of the environment has so far been neglected, as the first antibiotics were refined from the products of naturally occurring organisms. But two years ago, when Kirchhelle, along with researchers from six other countries, looked through 75 years of international policy statements on drug resistance, they found only two – out of 248 – in which the environment deserved sustained concern. “It was legitimate to look at this only from a human health perspective — after all, millions of people are dying from AMR,” he says, referring to antibiotic resistance. “But we’ve been talking about how to regulate antimicrobial resistance for half a century, and yet we still have increasing antimicrobial use and increasing antibiotic resistance. So it’s time to really think broader.”