Antimicrobial resistance has been called a “silent tsunami” likely to be responsible for more deaths than cancer by 2050. But how has it become such an issue for the food industry?
The food we produce is constantly being adapted – mainly in response to the growing demand on our food supply from an increasing worldwide population. That population is set to exceed 10 billion by 2050, leading to pressure to intensify food production methods and globalise the food supply chain.
Even to get to the current position of simply meeting existing demand, the livestock industry has had to scale up production; but this hasn’t come without its challenges – namely monitoring the environmental sustainability of industry practices and maintaining a high standard of animal welfare.
This has resulted in a difficult ask for the food sector i.e. to achieve a balance between productivity, profits and the well-being of its animals (European Commission, 2007). While this has been on-going , consumers have been watching and learning, and voicing their ethical concerns regarding farm animal welfare.
A study carried out by the University of Portsmouth (2024) revealed that while consumers do consider the sustainability of food products, animal welfare has taken precedence in their purchasing decisions for meat and dairy products. The retailers have listened, with many of the UK's major supermarkets actively promoting animal welfare standards through claims and certifications like RSPCA Assured, British Red Tractor, and Organic on their animal products such as meat, milk and eggs.
The use of antimicrobials during the production of food-producing animals is a commercial reality. These drugs control and treat bacterial infections, as well as being used in a preventative manner in animal populations at significant risk of disease. With proper usage, and monitoring, they can prevent animal suffering and ensure that harmful bacteria are not being passed along the food supply chain into the food that we eat. Responsible use of medicines must be the guiding principle. However, the problem arises when they are not used properly, which is when we encounter antimicrobial resistance or AMR. This “threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi” according to the World Health Organisation.
With approximately 73% of global sales of antimicrobials used in animals, the food industries are often criticised for their role in antibiotic overuse and the accelerated spread of AMR. A specific challenge has been the need to marry the demands of production requirements, animal health and optimal growth rate which had historically seen wide spread use of antibiotics on a continuous basis at a low dose as digestive enhancers or ‘antibiotic growth promoters’ (AGP)
This threatens the globalisation of food supply chains through enabling the transfer of resistant bacteria from animals to humans, from country to country via contaminated food sources (Ceccarelli et al., 2020).
A multi-faceted and complex problem, AMR can affect humans, animals, plants and the environment through undermining the efficacy of antimicrobials (Bright-Ponte, 2019). Therefore, the challenge of combatting AMR requires a global coordinated ‘One Health’ approach in order to conduct a collaborative global solution.
The imminent threat of AMR and the potential transmission of resistant pathogenic organisms to humans has spurred interest among governments and professional organisations to review the evidence and develop policies to restrict AMU in food-animal production.
The EU was the first to set this into motion with a ban of avoparcin used as an antimicrobial growth promoter (AGP) in food producing animals in 1997, with the subsequent ban of all AGPs by 2006 (DANMAP, 2021). In addition, many EU member states have implemented stringent national AMR surveillance systems and strategies, such as DANMAP in Denmark and MARAN in the Netherlands (Birkegard, 2017) to monitor AMU and AMR among human and animal populations. The EU is now collectively going one step further and under regulations introduced in 2022, is banning imports of meat, milk and egg products which have not similarly been produced under conditions prohibiting use of AGPs.
The UK has not as yet restricted imports in the same manner but in May 2024, the UK government enacted domestic legislation prohibiting the routine use of antibiotics in farm animals to compensate for poor farm management practices such as unsanitary conditions and inadequate animal husbandry. The UK has made significant progress in reducing antibiotic use in food-producing animals as in November 2024, DEFRA reported that the total quantity of antibiotics sold for livestock in the UK sits at the lowest level to date. Moreover, Farm Vet Champions is a UK-based initiative led by RCVS Knowledge and in collaboration with major veterinary and agricultural organisations which aims to unite farm animal veterinary professionals in promoting responsible antimicrobial use.
The AMR debate has however created some tensions arising from a sometimes perceived conflict between the need to meet reduction targets for the use of antimicrobials during livestock production, balanced against a need to safeguard animal health and welfare.
The mounting significance of AMR has been researched from a global perspective, and efforts have been made to reduce antimicrobial usage within food production industries. However, the lack of consistency among national and international AMU policies is hindering effective global action from a One Health approach. When tackling AMR through a holistic and intersectoral approach, a ‘One Health’ strategy should encompass global AMU in humans and animals, and their interactions with food and the environment (Bright-Ponte et al., 2019).
While the UK has made strides in regulating antibiotic use, it has not yet fully aligned with the EU’s standards. Current systems are effective in monitoring at a country-to-country level, there is a lack of standardisation of policies and guidelines among countries, and this makes it difficult to quantify the emerging threat to antimicrobial efficacy and take effective global action from a ‘One Health’ approach.
Globalisation of food supply chains has allowed developing countries to enter the trading market. However, in many cases, low- and middle-income countries (LIC/MIC) lack systematic AMU and AMR monitoring systems (Boeckel, 2019) and this may facilitate the spread of AMR, leading to potential loss of imports/exports, and economic loss for farmers and producers. Despite this, some global efforts have been made to tackle AMR as in 2015 the World Health Organisation (WHO) set out a Global Antimicrobial Resistance Surveillance System (GLASS).
In 2022, GLASS encompassed 127 countries globally, to include some LICs and MICs such as Malawi and Kenya (WHO, 2022). However, it should be noted that registration with GLASS encompassed monitoring for AMR and AMU separately and while monitoring for resistance has been comprehensive, the number of countries engaged with usage reporting is lower and includes some significant HIC and significant global trading partners such as USA and Australia. This serves to highlight that there are still barriers to be overcome in terms of visibility of usage, and this is potentially underpinned by a belief that restrictions on use constitute an unacceptable trade barrier (not dissimilar to the long-standing dispute around the banned use of hormonal growth promoters in the UK and EU that the US still contests with the WTO)
AMR is no longer just a healthcare issue—it is a global crisis affecting multiple industries along the food supply chain, such as agriculture, food production and retail. The World Bank has warned that AMR could reduce global GDP by up to 3.8% by 2050, with global losses ranging from US$1 trillion to US$3.4 trillion per year. So, what can businesses do to address the issue of AMR?
To tackle the risks of AMR transmission in food supply chains, farmers should improve hygiene and animal husbandry practices on farms to promote the responsible use of antibiotics and reduce their reliance on these drugs. Consumers are demanding industry-wide changes, as over 63% of people prefer meat and dairy products raised without antibiotics. Retail supermarkets and manufacturers should take ethical responsibility to partner with farms and suppliers that follow sustainable practises and take accountability for the production of the products they are selling.
Additionally, AMR is firmly on the agenda as a key financial consideration, with bodies such as FAIRR co-ordinating investor efforts to address global antimicrobial resistance; arguably it will be commercial drives that support co-ordinated change in more ‘reluctant’ market places.
The UK Livestock Industry has been recognised by the FAO as a positive case study for managing to halve the sale of antimicrobials in the country’s livestock industry thanks to a multi-sectoral collaborative approach between the UK’s Department for Environment, Food and Rural Affairs and farmers, producers, and veterinarians. This has seen retailers such as Tesco embed responsible use principles in its antibiotic commitments, including the complete elimination of colistin and key Highest Priority Critically Important Antibiotics (HPCIA), while individual Industry sectors such as the British Poultry Council Stewardship initiative has delivered world leading advances in responsible use. Its 2024 report highlighting:
With various supply chain stakeholders having differing agendas around antimicrobial usage from country to country, it can be very difficult to actively tackle this issue from a One Health approach. Umbrella organisations such as FIIA (Food Industry Initiatives on Antimicrobials) have a significant role to play in developing policy and delivering improvements. However, farms and industries that adapt to stricter regulations and ethical responsibility of antibiotic use, invest in innovation, and prioritise sustainable practices will be better positioned to navigate the growing AMR challenge while maintaining a high standard of animal welfare, profitability on farms and consumer trust.