The advent of antibiotics ignited the hope of elimination of infectious diseases in humans and animals. However, this did not happen because of two reasons: the ingenuity and survival instinct of germs and the irrational use of antibiotics in humans and animals. Most of the germs have acquired the capacity to resist the action of affordable antibiotics. This phenomenon is known as antimicrobial resistance (AMR). The inability of antibiotics to treat patients and animals is wreaking havoc on human health, nutrition safety and economies. The long-term impact of AMR is almost comparable to that of the COVID-19 pandemic. AMR is estimated to cause 10 million deaths annually by 2050, unless concerted actions are initiated now. It will result in 7.5 % reduction in livestock production and negatively impact the global GDP by 3.5%.
Tackling the AMR challenge
There are two major possible solutions to combat the AMR menace: discovery of new drugs, before the emergence of resistance in germs; and prudent use of available antibiotics. The first is an expensive and unpredictable process. Since 1984, no new class of antibiotics has been developed. The estimated cost for developing a new antibiotic exceeds $1 billion. With rapid development of resistance, the life of new antibiotics becomes limited and the return on investment on new molecules gets diminished. This discourages the pharmaceutical industry to invest in these initiatives. The world is left with only one option: to use the available antibiotics carefully to ensure their efficacy for as long as possible.
The World Health Organization Global Action Plan on AMR (2015) provides a road map for tackling this challenge. This plan has been endorsed by the UN General Assembly. Almost 80 countries have developed their respective national action plans in alignment with this Plan.
The rational use of antibiotics in humans, animals, and agriculture warrants coordinated action in all sectors. These multi-sectoral, multidisciplinary and multi-institutional actions constitute the ‘One Health’ approach. This has gained currency across the world as an efficient and cost-effective response to AMR and several other challenges, especially endemic zoonoses (diseases transmitted between animals and humans) and pandemics. It is reinforced by the fact that all the epidemics in the current millennium (SARS, MERS, bird flu and COVID-19) have originated from animals because of unwanted excursion of humans into animal domains. The COVID-19 pandemic has emphasised the urgency of implementing One Health. India’s National Action Plan on AMR is an excellent example of the One Health approach and can be used as a guiding document to develop a workable road map for the country to respond to other similar public health challenges.
One platform for experts
One Health should not be construed as a standalone or new programme that has to be built de novo. This endeavour utilises existing expertise and infrastructure in various sectors with a focus on inter-sectoral coordination, collaboration, and communication. The purpose of One Health is to provide a formal platform for experts to plan and work together towards shared objectives.
Implementation of One Health warrants a strong and continuous national narrative on zoonoses. It advocates a multi-sectoral response to public health problems, particularly pandemics, as also to address issues related to AMR. The approach supports focussed actions on the human-animal-environment interface for the prevention, detection and response to the public health events that influence global health and food security. AMR is one of the biggest challenges to human and animal health. There is a need to optimally utilise emerging technologies to improve human health and development. One Health has been acknowledged as the optimum approach to counter the impact of AMR and future pandemics and must be adopted expeditiously.
Tomio Shichiri is FAO Representative in India and Dr. Rajesh Bhatia is Technical Advisor, FAO India