Human health and social welfare, ecosystem preservation, animal health and welfare. The scientific consensus on the interdependence of the three elements that characterize life on the planet is almost unanimous. And thus developed the idea of following a unified approach, One Health, for their protection.
Antibiotic resistance (AMR) is in turn listed by WHO, in its report ‘No time to wait‘ (2019), as the most serious public health threat globally. An effective solution to reduce antibiotics in animal husbandry has been developed in Italy itself, in the One Health logic, and deserves to be widely applied.
One Health, the integrated approach
One Health
represents ‘An approach to address a health threat at the environment-human-animal interface based on collaboration, communication, and coordination across all relevant sectors and disciplines, with the ultimate goal of achieving optimal health outcomes for both people and animals; a One Health approach is applicable at the subnational, national, regional, and global levels‘. (1)
The goal is to address some major health challenges (re-emerging infectious, communicable, zoonotic, and wild diseases) that seem likely to exacerbate, as the experience of Covid-19 suggests. In part because of phenomena-air pollution and climate change, urbanization, population growth and inequality-that international observers estimate to be growing (UN, ‘
The World in 2050
‘, 2018). (2)
One Health, tools and measures
The effectiveness of the One Health approach, according to the scientific community, depends on systematic reference to the complex human-animal-environment matrix in reviewing criteria for risk analysis, prevention and management. And to their concrete application in the areas relevant to it. (3)
The COHERE (Checklist for One Health Epidemiological Reporting of Evidence) standard was developed to improve the quality of research in this direction, and measure its results. With a view to fostering interdisciplinary synergies that integrate the contributions of medicine, veterinary medicine, biology and environmental science. (4)
Fig. 1 and 2. Diagram and infographic of the objectives of the One Health approach (Davis et al., 2017) (Behravesh, 2019)
Antimicrobial resistance (AMR)
Antimicrobial resistance (AMR) is an emblematic case of pathological interaction between the environment, animals, and humans. In fact, this phenomenon is attributed to the misuse of antibiotics and antimicrobials in the human-animal (medical and veterinary) sector, as well as the spread of their residues in the environment. The drastic reduction in use of these drugs is essential to comply with the three elements, also to ensure the functionality over time of the available antimicrobials. (5)
Mitigating AMR inanimal husbandry is possible, while respecting the profitability needs of farmers. But we must not lose sight of the three cornerstones of the One Health approach. (6) In the face of the real risk, for example, that merely replacing current antimicrobials with different veterinary drugs is a false solution. As noted above in commenting on the so-called ‘Veterinary Medicines Package.
Fig. 3. Modes of spread of antimicrobial resistance (McEwen et al., 2018)
Fig. 4. “One Health – Global Health” axis in antimicrobial resistance (Hernando-Amado et al., 2019)
Antibiotic resistance and international policies
Global Health
expresses the overall vision, aimed at identifying the conditions that foster antibiotic resistance (AMR) at the planetary level and the measures possibly useful to reverse the trend. (7) Interdisciplinary bibliometric analysis, from this perspective, is useful in looking for cross-references to various research fields. And the work conducted so far actually shows little consideration of the environmental sector. (8,9)
FAO and WHO member states should therefore introduce a special standard, in Codex Alimentarius, to reduce farm animal and thus human exposure to antibiotics. On this basis, the various states will be able to define reduction methods and targets, but also set appropriate entry conditions for imported food, in compliance with the SPS(Sanitary and Phytosanitary Measures, WTO) agreement. (10) In line with the SDGs(Sustainable Development Goals), among others, in UN Agenda 2030. (11)
Antibiotic resistance and animal husbandry, the Italian solution
Meat production will resume growth after the crisis generated by African swine fever in 2019(OECD/FAO Agricultural Outlook, 2020-2029). (12) It is therefore all the more imperative to adopt breeding strategies that can effectively counteract the antibiotic resistance of various pathogenic bacteria in critical sectors such as poultry and pig farming. (13)
Italy is at the forefront on this very front, thanks to 20 years of research into compounds of algae, microalgae and tannins (e.g., Algatan), which has enabled the development of egg, poultry and pork, ‘antibiotic-free’ aquaculture products (14,15). Through strengthening the gut microbiota-and thus, the immune system-of animals, so as to minimize the need for antimicrobial use.
What else to wait for?
Dario Dongo and Andrea Adelmo Della Penna
Notes
(1) FAO, OiE, WHO (2019). Taking a Multisectoral One Health Approach: A Tripartite Guide to Addressing Zoonotic Diseases in Countries. http://www.fao.org/3/ca2942en/CA2942EN.pdf (accessed 6.2.21)
(2) Butler (2012). Infectious disease emergence and global change: thinking systemically in a shrinking world. Infect. Dis. Poverty 1:5, https://doi.org/10.1186/2049-9957-1-5
(3) Behravesh (2019). One Health: over a decade of progress on the road to sustainability. Rev. Sci. Tech. Off. Int. Epiz. 38(1):21-29, doi: 10.20506/rst.38.1.2939
(4) Davis et al. (2017). Checklist for One Health Epidemiologic Reporting of Evidence (COHERE). One Health 4:14-21, http://dx.doi.org/10.1016/j.onehlt.2017.07.001
(5) McEwen et al. (2018). Antimicrobial resistance: a One Health perspective. Microbiol. Spectrum 6(2), doi:10.1128/microbiolspec.ARBA-0009-2017
(6) Van Herten et al. (2018). One Health as a moral dilemma: Towards a socially responsible zoonotic disease control. Zoonoses Public Health 66:26-34, doi:10.1111/zph.12536
(7) Hernando-Amado et al. (2019). Defining and combating antibiotic resistance from One Health and Global Health perspectives. Nature Microbiology 4:1432-1442, https://doi.org/10.1038/s41564-019-0503-9
(8) Humboldt-Dachroeden et al. (2020). The state of One Health research across disciplines and sectors – a bibliometric analysis. One Health 10:100146, https://doi.org/10.1016/j.onehlt.2020.100146
(9) Ogyu et al. (2020). National action to combat AMR: a One-Health approach to assess policy priorities in action plans. BMJ Global Health 5:e002427, doi:10.1136/bmjgh-2020-002427
(10) Anna George (2019). Antimicrobial resistance (AMR) in the food chain: Trade, One Health and Codex. Trop. Med. Infect. Dis. 4:54, doi:10.3390/tropicalmed4010054
(11) Sinclair (2019). Importance of a One Health approach in advancing global health security and the Sustainable Development Goals. Rev. Sci. Tech. Off. Int. Epiz. 38(1):145-154, doi: 10.20506/rst.38.1.2949
(12) Food and Agriculture Organization (2020). OECD-FAO Agricultural Outlook – Chapter 6: Meat. http://www.fao.org/3/ca8861en/Meat.pdf (accessed 06.02.2021)
(13) Matar et al. (2020). Editorial: Combating antimicrobial resistance – A One Health approach. Front. Cell. Infect. Microbiol. 9:458, doi: 10.3389/fcimb.2019.00458
(14) Dario Dongo, Andrea Adelmo Della Penna. Animal husbandry, algae and microalgae to prevent antibiotic use. Algatan. GIFT (Great Italian Food Trade). 9.9.20, https://www.greatitalianfoodtrade.it/progresso/zootecnia-alghe-e-microalghe-per-prevenire-l-uso-di-antibiotici-algatan
(15) Dario Dongo, Andrea Adelmo Della Penna. Antibiotic-free poultry farming, the Italian way. GIFT(Great Italian Food Trade). 12/14/20, https://www.greatitalianfoodtrade.it/progresso/avicoltura-senza-antibiotici-la-via-italiana
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.
Graduated in Food Technologies and Biotechnologies, qualified food technologist, he follows the research and development area. With particular regard to European research projects (in Horizon 2020, PRIMA) where the FARE division of WIISE Srl, a benefit company, participates.
