Targets that aimed to reduce the use of antimicrobials in the livestock industry have been dropped from the latest version of the draft UN Political Declaration on Antimicrobial Resistance (AMR), reportedly as a result of pressure from major meat-producing nations and the veterinary drug industry. 

The draft declaration, which aims to curb growing pathogen resistance to leading antibiotics, antiviral and antiparasitic drugs, was distributed amongst UN member states on 9 September ahead of the United Nations High-Level Meeting (HLM) on 26 September.

 The May version of the declaration had a target of “at least 30%” reduction in “the quantity of antimicrobials used in the agri-food system globally” by 2030, as reported earlier by Health Policy Watch.  The latest, near final, draft, includes only a vague commitment to “strive meaningfully” to reduce use.

By far the biggest use of antibiotics worldwide is agriculture, and particularly the livestock industry, with an estimated 80% of antibiotics in the US alone administered to animals, not people.  Drug resistant bugs, meanwhile, are estimated to kill nearly 5 million people a year. 

With regards to reducing the use of antibiotics in livestock production, Dr Holy Teneg Akwar from the World Organisation on Animal Health (WOAH) told a media briefing on Wednesday that “countries will develop their own targets taking their respective contexts into consideration”.

“There were a lot of sensitivities around the commitments on antimicrobials in farm animals,” added Javier Yugueros-Marcos, head of AMR at the World Organization for Animal Health (WOAH).

The media briefing was convened by the “Quadripartite” group managing AMR globally – the World Health Organization (WHO), Food and Agricultural Organization (FAO) UN Environment Programme and  WOAH.

The targets were dropped as a result of pressure from the US as well as other meat-producing nations in the developed world, including Australia, New Zealand and Canada, according to a report by the US-based non-profit, Right to Know..

“The massive overuse of antibiotics on factory farms in the United States is a serious threat to public health,” US Senator Cory Booker said in a statement on the outcome of the final UN draft.

“Federal agencies have a troubling history of deferring to corporate interests on this issue, and I am very concerned about any role that the United States played in weakening international commitments to reduce antibiotic use in farm animals,” said the Democratic Party Senator, who is campaigning for improved control of antibiotics in food-producing animals in the US.

 Animal vaccination plan

The declaration does direct countries to use antimicrobials in animals and agriculture “in a prudent and responsible manner in line with the Codex Alimentarius AMR Standards” and WOAH’s “standards, guidance and recommendations”.

It also commits to a global animal vaccination plan by 2030, based on WOAH’s list of priority diseases to reduce antibiotic use.

The declaration directs the UN FAO to develop further global guidance to also prevent and reduce antimicrobials in plant agriculture – another source of AMR risk.

“The misuse of essential drugs in food production, whether in livestock farming, aquaculture or crop production, accelerates the emergence and spread of resistance,” Junxia Song, FAO senior animal health officer, told the media briefing.

Some “common [animal] bacterial infections have become harder, and sometimes impossible, to treat”, she added.

“These resistance strains can transfer from animals to humans through direct contact or through the agri-environment or the food chain, creating a cycle that worsens the AMR crisis.”

AMR threatens the livelihoods of 1.3 billion people who depend on livestock, said Song. 

“The World Bank  projects that in a high AMR impact scenario, livestock production in low income countries could decline by 11% by 2050, raising costs for farmers and driving up food prices,” she added.

Reducing mortality by 10% and raising $100 million

Two key targets for reducing AMR-related mortality, as well as raising funding to combat AMR, did survive member state negotiations into the present draft. There is a commitment to reducing global AMR deaths by 10% by 2030 against the 2019 baseline of an estimated 4.95 million deaths associated with AMR every year.

A target of raising $100 million “from international cooperation” has also been set to ensure that 60% of countries develop and implement national AMR action plans by 2030.

Aitziber Echeverria, UNEP’s AMR co-ordinator, warned that drug resistance was being developed and transmitted in the environment.

“Global attention to AMR has been dominated by a focus on human health,” said  Echeverria. “But there is a widespread agreement that tackling it requires a multi-sectoral One Health approach that considers the health of humans, animals, plants and the wider environment, including ecosystems, as interconnected and interdependent.

“The most important sources of microorganisms with antimicrobial-resistant genes in the environment is the human waste that ends up in sewage, wastewater or landfills,” she warned.

WHO priorities

Dr Yvan Hutin, director of  the WHO AMR division, told the media briefing that resistance to antibiotics was often rapid, often happening within 10 years.

“Every time we are smart at inventing an antibiotic, nature is quite fast in evolving and finding a counter-measure. 

“The problem is that our pipeline is dry. Our capacity to actually even add some more antibiotic on this graph is not what it used to be. Resistance is emerging and the pipeline is running out.”

The WHO has proposed four steps to address AMR: preventing infection (through ensuring access to clean water and sanitation, immunization and infection prevention control); universal access to affordable, quality diagnostics and appropriate treatment of infection; strategic information science and innovation (guided by science); and effective governance and finance. 

The WHO has also developed “stop light” characterisation of antibiotics, with “green antibiotics” for common infections that have the lowest resistant potential; orange antibiotics  that have higher resistant potential and are for less common infections, then “red” reserve antibiotics only to be used when they’re absolutely necessary. 

The Quadripartite leaders expressed their “cautious optimism” about the political declaration and the expected outcome of the HLM. The last HML was held in 2016.

Image Credits: International Federation of Red Cross and Red Crescent Societies / The Kenya Red Cross Society, Yvan Hutin/WHO.