Interviews with the Experts
In this series we continue to ask some of the leading experts in the field of antimicrobial resistance (AMR) and One Health for their take on progress, leadership and challenges.
Our latest interviewee is Catalina López Salazar, who works at the Aquatic Life Institute and is a veterinarian, and current Director of the Aquatic Animal Alliance. Catalina leads a coalition of 100 organisations around the world that collaborate on improving the lives of aquatic animals in the food system through science based advocacy with corporations, governments and international bodies.
Hello Catalina. We are delighted to be able to interview you. Thank you. What have you been doing on AMR in the last few years?
At the Aquatic Life Institute we advocate to improve the welfare conditions of aquatic animals exploited in aquaculture settings. Better welfare conditions lead to lower morbidity (disease) rates, therefore reducing the need to overuse antibiotics.
Antibiotic resistance is increasingly referred to as the next global pandemic. A recent study published in The Lancet has estimated that 4.95 million people died of an antibiotic-resistant infection in 2019, and for 1.27 million of these people their deaths were attributable to the antibiotic resistance of the infection. Do you think current global actions will be sufficient to tackle a problem of this scale?
Some countries are taking steps in the right direction to monitor, control and limit the use of antibiotics where they are not necessary. However, in most countries, there is not a proper monitoring system for their use. This means that current statistics of antibiotic use are not even comprehensive enough to give us a true picture of the situation. The World Health Organisation (WHO) created a monitoring tool called GLASS, which aims to compile antibiotic use information around the globe. Out of 196 countries, only 78 sent data according to their 2020 report.
Antibiotic resistance knows no borders, and if some countries fail to address the issue, there will be limited progress worldwide.
One Health is an approach that recognizes that the health of people is closely connected to the health of animals and our shared environment. To what extent do you think that there is a need for a One Health approach to tackling the spread of antibiotic resistance?
Antibiotic overuse is most concerning for animals exploited in factory farms. Factory farms produce meat, eggs and dairy cheaply, but it comes with a hidden cost. Animals are kept in overcrowded, cramped and often dark environments, without the possibility to express their natural behaviours. They experience chronic stress, pain and suffering. This causes immunosuppression, making them more susceptible to disease, and since animals are so crowded, diseases spread quickly. The industry solution is to provide antibiotics to all of the animals in an enclosure, or sometimes even the whole farm, to prevent mass mortalities. Animals that are not sick are given antibiotics as a preventative measure. And these are the animals that end up on our plates.
We cannot separate animals and humans when tackling this issue, because although detailed information about antibiotic use in animals is lacking, available data shows that around 70 percent of the total volume of all medically important antibiotics in the United States is sold for use on factory farms.
Most of the scientific literature suggests that farm antibiotic use can contribute to higher levels of antibiotic resistance in human medicine. However, this issue remains controversial with some claiming there is no link. Do you believe that tackling the overuse of antibiotics in farming can contribute to controlling the spread of ABR in human infections?
The antibiotics used on animals are in the same families of antibiotics used on humans. For example, resistance to the last resort antibiotic Colistin used in human medicine, has been found in many farm animals because of its use in factory farming. Denying scientific evidence unfortunately has become common in today’s society. However, that should not distract us from the ample and verified scientific evidence behind this concerning issue.
Do you think the global growth in intensive livestock farming is contributing to higher levels of farm antibiotic use?
The aquaculture industry has grown very rapidly over the last several decades. From 1960 to 2015, aquaculture production increased 50-fold, to over 100 million tons per year. This amounts to 73-180 billion farmed fish and around 350-400 billion shrimp being produced every year. This industry uses prophylactic antibiotics indiscriminately, mainly in the Global South, to prevent bacterial infections. It uses a wide variety of human non-biodegradable antibiotics used for human medicine,
which then remain in aquatic environments. This causes development of antibiotic-resistance bacteria and transferable resistance genes that can be transferred to disease-causing bacteria, resulting in antibiotic-resistant infections for humans, fish and other aquatic animals. The greater the volume of antibiotics used, the greater the risks of antibiotic-resistant populations of bacteria. Mixing antibiotics with fish food also causes the presence of residual antibiotics in fish meat and other seafood products. Intensive industries will always require preventative antibiotic use if animal welfare considerations are not taken into account. We need animal welfare-centered systems that are sustainable and less intensive, to ensure the health of the animals does not depend on the overuse of antibiotics.
How important do you think the environmental spread of antibiotic resistance is? Should farming industries take action to counter it?
Antibiotics are not used in a vacuum, there are always residues after their use. Animal or human waste can flow into soil or waterways, which can then contaminate crops or animal-derived products. It is the responsibility of the farming industries to ensure proper disposal of waste, and carry out thorough inspections of products to ensure there is no further contamination.
New EU legislation that came into force in the 28th of January 2022 bans routine farm antibiotic use and restricts prophylactic use to exceptional cases and for individual animals only. It also prohibits using antibiotics to compensate for inadequate husbandry and poor hygiene. The legislation limits metaphylaxis to cases when the risk of disease spread is high. Do you think these new rules are a step forward for responsible antibiotic use in farming?
Yes. Putting policies in place to restrict use of antibiotics on farms is crucial to curb the rise of antibiotic resistance. However, the most important step is to ensure these policies are indeed carried out on farms; that no exceptions are established, and accountability from the industry is ensured. Unfortunately, the animal agriculture industry does not always follow guidelines by claiming they must carry out certain inadequate practices to ensure food security. Additionally, there should be clear rules for imports, because if the same rules do not apply to imported animal products, then the impact of this legislation is very limited.
Do you anticipate that these rules will deliver responsible farm antibiotic use or is further action likely to be required?
The biggest challenge is ensuring that these rules are indeed applied at the farm level. That is where the government should focus its efforts.
Voluntary measures in the UK have seen farm antibiotic use fall by 55% over the last six years. What can the UK AMR community / farmers / farm vets/ supermarkets and food retailers / contract caterers do to maintain progress?
Farmers and farm vets can make huge improvements in this aspect, by ensuring adequate animal welfare-centred practices in production facilities, which can reduce immunosuppression, limiting the need for antibiotics. Animals are sentient beings with species-specific welfare requirements, they are not products that we can exploit endlessly without addressing their needs. Many of the problems in the industry derive from this mistaken approach. Changing the mindset of the farm sector will ultimately result in less disease, and therefore reduce the unnecessary use of antibiotics. Transitioning to a food system that relies less on animal protein and increases plant-based food consumption is also key to ensure global food security.
The UK Government has chosen not to implement the new EU rules on farm antibiotic use and is instead still promoting a voluntary approach. What is your reaction to this?
The UK has one of the strongest animal welfare legislative frameworks in the world, showing that citizens and the government understand the importance of animal protection and how establishing clear policies can make a difference. As a result, I expect the public will demand stronger action regarding restriction of antibiotic use in the near future to ensure the UK remains at the forefront of sustainability and animal welfare policies.
The UK is seeking and signing new trade deals with countries across the globe, what are the AMR risks and the opportunities of these new trade deals?
Antibiotic resistance knows no borders, therefore, if the UK does not establish clear rules and regulations for imported products, the internal efforts to address this issue will be ineffective. A coordinated global framework is necessary in order to be effective. The agreements that are being negotiated are a great opportunity for the UK to positively influence policies regarding the restriction of antibiotic use in many trade partner countries.
The world has been shaken by the impact of covid, what can we do to prevent AMR becoming the next global pandemic? What advice would you give to world leaders about their response to AMR?
The key is prevention, and we need to act now. World leaders today have a responsibility to ensure the world does not face another situation similar to the Covid pandemic. The science is evident and widespread; it unequivocally shows there is a global crisis regarding antibiotic overuse today. We can make a difference if global leaders take action and focus on creating a more sustainable food system that is less dependent on intensive animal production, so life-saving medicines can be used where they are truly needed.
What is the single most important thing to achieve if we are to win the fight against rising AMR?
If we are to avoid dire consequences in the near future, a collective sense of urgency on this issue needs to be established immediately.
If you had $1bn to fight AMR, how would you spend it?
Building a sustainable food system where plant-based foods are the main source of nutrition, and animal welfare is at the centre of policies where animal exploitation takes place.
Thank you for your time Catalina and for sharing your views and good luck with your continued work to protect aquatic life.
For more information and to follow the work of Catalina and her colleagues:
Interview with Lindsay Duncan, World Animal Protection18th April 2023