Critical Analysis Essay on the Risk to Human Health From the Use of Antibiotics in Food-Producing Animals

Introduction

Antimicrobial Resistance (AMR) is described as the ability of microorganisms such as bacteria or viruses to stop antimicrobials like antibiotics from fighting them thereby rendering the standard treatment measures ineffective, which, in turn, enhance the spread of infections (Health and Food Safety, 2018, n.p). AMR has become a major threat to world public health and needs prompt action from all government sectors. This is because the resistant viruses and bacteria are difficult to treat since they require alternative medications or a higher dosage of expensive drugs, which may be toxic to the body. Therefore, AMR is a risk to human health because new resistance mechanisms keep emerging and spreading all over the world thereby threatening the ability of the human immunity and the administered drugs to fight the common infections.

Overview of the Problem

The usage of antimicrobials in food-producing animals has routinely been described as a contributor to AMR (Health and Food Safety, 2018, n.p). Even though the link between the use of antibiotics in agriculture and the risk to human health is likely, there are no data that irrefutably show the extent of the threat that emerges from the use of antibiotics in farming. The significance of the use of antimicrobials in food-producing animals that causes the emergence and spread of AMR has become a matter of debate and dispute with most commentaries asserting that agricultural antibiotics are responsible for the rise of resistant bacteria, viruses, and parasites (Torrence and Isaacson, 2008, p.62). According to Tavernise (2013, n.p), the Centers for Disease Control and Prevention (CDC) estimated in 2013 that AMR causes close to 23,000 deaths yearly in the US, which is half the number of deaths in the United Kingdom (UK). The Antibiotic Research UK points out that sepsis, which is triggered by AMR, causes 44,000 deaths annually (Antibiotic Research UK, 2018, n.p).

The rise in the prevalence of microorganisms and genes that are resistant to drugs has led to the rise in the use of antibiotics in the medical and agricultural settings (Morris, Helliwell and Raman, 2016, p.57). Human beings are always at risk of exposure to the new resistant microorganisms from animals either through touch, eating unclean food or getting into contact with other infected people (Oyarzabal, 2015, n.p). According to WHO, in scenarios where antibiotics can be used for treatment purposes without prescription, the spread of AMR would be made worse (World Health Organization, 2018, n.p).

Risk Ranking

The case fatality rate of AMR and the associated infections caused by the resistant bacteria is much higher than other conditions and infections such as obesity and blood pressure due to the increased virulence. Additionally, the increased and prolonged exposure of the body to the resistant bacteria due to either delayed or inappropriate therapy leads to an increased risk of fatality for AMR (McCrackin et al, 2016, p. 56). In the UK, AMR triggers sepsis which causes 44,000 deaths a year while lung cancer causes 35,000 deaths and bowel cancer causes only 16,000 deaths annually (Antibiotic Research UK, 2018, n.p). However, EU estimates that AMR alone causes 25,000 death in the region and a total of 700,000 deaths globally, which is expected to reach millions by the year 2050 due to inaction making it a common cause of death than cancer (Health and Food Safety, 2018). Similar to US and UK, the United Arab Emirates (UAE) and other Middle Eastern countries such as Saudi Arabia and Kuwait also experience a serious case of superbugs resistant to antibiotics (Bardsley, 2018, n.p).

The Origin of AMR

The origin of AMR is in the misuse of drugs as outlined by the European Centre for Disease Prevention and Control (ECDC) (Greenfacts.org, 2017, n.p). First, the antibiotics are often unnecessarily prescribed for certain viral infections, against which they do not have an effect leading to the buildup of a resistance. Secondly, whenever a diagnosis has not been made accurately by the physician, an antibiotic is prescribed to kill a large spectrum of bacteria, a measure that does not kill the responsible bacteria or viruses. Thirdly, whenever the antibiotics are used incorrectly, especially when the dosage is too low or the treatment does not comply with the right frequency, the bacteria present in the body would become resistant (Davies and Davies, 2010, n.p).

Alexander Fleming, who discovered penicillin predicted and warned in the year 1943 that its misuse could result in mutant microorganisms. Since bacteria can transfer genes horizontally, the threat of the development of a resistance to penicillin grew. The 1950s leading to the 1970s saw the development of new antibiotics that were readily made to the public, leading to the development of a resistance easily. In 1976, Stuart Levy, who was a researcher at Tufts University, became the first to detect an antibiotic resistance due to their use in livestock and helped in raising awareness of the issue (McKenna, 2010, p.152).

Risk Perception

Not much is known about the publics perception of the AMR or antibiotic misuse that could lead to the development of AMR. Even though most people recognize AMR as a problem, they do not understand the relation between the use of antimicrobials and the development of resistant bacteria, viruses, and parasites (Doelle, Rokem and Berovic, 2009, p.63). Therefore, there is a strong need to educate the consumers about the biological events that could lead to AMR. The main knowledge gaps are that the antibiotics are effective against microorganisms rather than viruses and that the AMR is developed by bacteria rather than human beings. Since most people trust their doctors and nurses, they may be the most effective at advising the consumers about proper usage of antibiotics (Doelle, Rokem and Berovic, 2009, p.63).

Occurrence of AMR

AMR happens when the microorganisms like viruses mutate when they are exposed to antibiotics, thereby making drugs ineffective. This, in turn, makes the infections persist in the body. The bacteria in the body can become resistant to antibiotics by neutralizing an antibiotic and changing it in a manner that makes it harmless. Other types of bacteria manage to pump out the antibiotics from their system before any changes are done while other bacteria alter their outer structure to prevent the antibiotics from attaching to it (Sosa et al., 2010, p. 59). After the exposure to the antibiotics, some of the bacteria can survive after finding a way to resist the administered antibiotics and then multiply to replace all the bacteria that were killed (Aitken et al., 2016, p. 108).

Use of Antibiotics in Food-Producing Animals

Antibiotics have been used for treating disease, enhancing growth, and enhancement of production in food-producing animals. However, this comes with issues such as the development of resistance to antibiotics. Several debates and arguments have ensued about the use of antibiotics in animals as most people believe that the resistance to antibiotics, which is crucial to human medicine, is generated in animals and spread to humans beings with the probability of causing harm (Efsa.europa.eu, 2017, n.p) Recently, it became clear that Staphylococcus aureus, which is methicillin-resistant, can be transferred to human beings from food-producing animals proving the link between the use of antibiotics in livestock and the development of AMR in humans (World Health Organization, 2018, n.p).

It is projected that the volumes of antibiotics used in food-producing animals exceed the amount used by human beings worldwide and almost every class of antimicrobials used by man are used in livestock. The transmission of resistance from animals and human beings can occur through ingestion of contaminated food or contact with animals. The resistant bacteria can also be spread widely in the environment, especially through manure where crops can be affected. The human health consequences due to the use of antimicrobials on food-producing animals include the increase in treatment failures, increased morbidity, mortality, and severity of the infections. Moreover, irrational use of antibiotics leads to increased risk of obesity, diabetes, and asthma in the later in ones life. Insulin resistance leads to the development of type 2 diabetes (T2D), increases the risk of obesity and several cancer types and cancer mortality (Berger, 2014, n.p).

Transfer of Antibiotics Resistance

Bacteria can share their genes with each other in a process referred to as horizontal gene transfer that can happen between bacteria of the same species or different species. The gene transfer process leads to a genetic variation in bacteria that enhances the spread of AMR. Bacteria can share their gene through the conjugation process where two bacteria can attach to each and connect via the structures in their cell membranes that would enable them to share their DNA (Abc.net.au, 2018, n.p). This makes it possible to transfer any gene, including the antibiotics resistance genes, between bacteria.

Global and EU Approach to Tackle the Problem

The global approach to tackle the AMR problem involves prevention and treatment of the infectious diseases with safe and effective drugs. The WHO supports a global action plan that helps in improving awareness of AMR, strengthening surveillance and research studies, reducing incidences of infection, optimizing the use of antibiotics, and outsourcing investors that support the action plan. The WHO currently supports the Global Antimicrobial Resistance Surveillance System (GLASS) and the Global Antibiotic Research and Development Partnership (GARDP) that collect, analyze and share data associated with AMR (World Health Organization, 2017, n.p). EU regulates the genetically modified food, a precautionary measure that would ensure the reduction in the use of antimicrobials in the food-producing animals. The European Food and Safety Authority asserted in April 2017 that over 97 percent of food samples that were sampled across the EU in the year 2015 met the legal requirements and 53 percent were free of residues (Efsa.europa.eu, 2017, n.p)

Data Collection and Analysis

As the Chief Executive of the Food Safety Authority, I collected data from the Health and Social Care Information Centre (NHS Digital), which showed that at least 6,060 people die from antibiotic resistance in the English hospitals alone excluding Scotland, Wales and Ireland. In total, 25000 people die from AMR in the EU and the worldwide deaths are estimated at 700,000 by the ECDC (European Centre for Disease Prevention and Control, 2018, n.p). The high number of deaths in the UK enabled the Food Safety Authority of Ireland (FSAI) to raise awareness about how serious a public health issue, the use of antimicrobials in food-producing animals is. The FSAI plans to use the figures from the data collected from NHS Digital to obtain funding to try and prevent the distribution of livestock fed with antibiotics.

Education and Role of Consumers

Educating the consumers and raising public awareness on the importance of behavioural change using public communication programs targeting various audiences in human and animal health helps in tackling the issue of AMR (Thomas, 2012, p. 114). The role that consumers can play in tackling the spread of AMR resistance is taking medication precisely as directed by the pharmacist and completing the full dosage even when one is feeling better because if the treatment is stopped too soon, it may not kill all the disease-causing...