Antimicrobial Resistance in One Health

Abstract

Antimicrobial resistance (AMR) is a slow but inexorable public health threat and a “wicked problem.” The UK Review on Antimicrobial Resistance projected that up to 10 million deaths could be attributable to AMR by 2050, whereas the World Bank estimated that AMR could independently result in global GDP falling by 1.1–3.8% by 2050 if current practices continue. AMR is, undeniably, a considerable global health security issue. In 2016, the United Nations General Assembly addressed the issue of AMR and announced a global commitment to action.

Acquired AMR occurs and spreads rapidly because of the excessive use of antibiotics in humans and food-producing industries, as well as via environmental pollution with antibiotics. Therefore, a One Health framework is necessary to understand the implications of AMR and to evaluate the impact of current and future interventions.

In this chapter, we attempt to improve the awareness and understanding of AMR as a threat to global health security, in the context of a One Health framework. We begin by defining antimicrobials and describing the emergence and transmission of AMR. We then describe the threats posed by AMR to global health security, in the context of healthcare-associated infections, malaria, HIV/AIDS, TB and fungal infections; to food security, in the context of the complex and controversial practice of industrial farming; and to economic security, in the context of the World Bank global GDP and poverty projections for 2050. We then present global initiatives that address the problem of AMR through a One Health lens, followed by future considerations for continued action against AMR and then conclude with a summary of the chapter.