Since the monumental discovery of penicillin nearly a century ago, many more types of antibiotics have been developed with intent of saving millions of lives. However, antibiotics are by no means a “miracle drug” as their increased use can bring about serious consequences. Over the years, bacteria have been able to develop resistance to various antibiotics and thus gain immunity to their treatment. This resistance can lead to persistent infections and even infect other people with strains of resistant bacteria.
According to the latest report from the US Centers for Disease Control and Prevention (CDC) from 2019, about 700,000 people worldwide die each year after being infected with antibiotic-resistant bacteria. According to current projections, this figure is expected to skyrocket to 10 million annually by 2050. In Israel alone, 5,000 people die from resistant infections each year. Therefore, bacterial resistance to antibiotics is one of the major challenges facing both Israeli and worldwide health systems today, with the exception of the ongoing COVID-19 pandemic.
A new report from the Ministry of Health found that strengthening the regulation and supervision of veterinary preparations is an effective strategy in reducing the use of antibiotics in farm animals as well as addressing the issue of antibiotic-resistant bacteria in humans.
According to the author of the report, Dr. Tali Berman-Alport, who is currently pursuing her postdoctoral fellowship at the School of Zoology at Tel Aviv University, “Veterinary preparations include not only antibiotics, but all medicines intended for animals.”
“In Israel, the Ministry of Health is the competent authority that supervises the licensing of veterinary preparations. However, the preparations in question do not include two groups: vaccines and disinfectants for external use. The approval of these preparations is the responsibility of the Ministry of Agriculture,” she elaborates.
“The main factors for the development of bacterial resistance are the increased and unwise use of antibiotics,” says Dr. Berman-Alport. “While there is an increased use of antibiotics towards humans in hospitals, the fact is the majority of antibiotic use occurs in the treatment and feed of farm animals.”
Beyond disease treatment and prevention, antibiotics also stimulate and accelerate growth leading to 15-20% increases in animal weight. As a result, about 73% of all antibiotics sold around the worlds are used for animals intended for human consumption.
But because antibiotics are not 100% effective, the remaining resistant bacteria can multiply and persist, thus having cascading consequences for us as the consumers. Infections such as pneumonia, tuberculosis, gonorrhea, and salmonellosis become increasingly difficult to treat as the antibiotics used to treat them become less effective.
“Resistant bacteria can be transmitted from farm animals to humans through direct contact with infected animals, through the consumption of meat, and even through the consumption of agricultural produce treated with animal manure,” Dr. Berman-Alport explains.
What is Israel’s Plan?
In recent years, there has been growing evidence that the ongoing and large-scale use of antibiotics in livestock feed is responsible for escalating antibiotic resistant bacteria. According to the CDC, one in five antibiotic-resistant infections originates in bacteria from infected food or direct contact with animals. Thus, the continued spread of antibiotic-resistant bacteria in humans and animals may exacerbate the dimensions of the antibiotic-resistant bacterial infections.
Many countries, in fact, restrict the use of antibiotics in livestock feed. For example, as early as 2006, the European Union banned the addition of antibiotics to avoid the creation of “superbugs” resistant to antibiotics used in human medicine. Three years ago, the World Health Organization (WHO) published a list of guidelines on the use of antibiotics and growth catalysts in food-producing animals to preserve the effectiveness of medically important antibiotics for humans.
Israel, on the other hand, did not ban the unregulated use of growth catalysts and preventative antibiotics until 2018 despite legislation proposed four years prior. With the Animal Feed Supervision Law now in effect, alternative arrangements for animal feed production and marketing are being established to better protect public health as well as animal welfare.
However, Israel has not yet formulated a national action plan to reduce the use of antibiotics and control the proliferation of antibiotic-resistant bacteria in farm animals.
“Apart from resistant bacteria, antibiotic residues can also be found in animal food products,” says Dr. Berman-Alport. “Veterinary services, therefore, regularly inspect residues in animal products—meat of all kinds, fish, eggs, milk and honey, etc.— to identify trends of incorrect or illegal use of antibiotics and other substances, and to assess the extent of public exposure to these residues as a result of consuming animal products.”
Adopt a “One Health” Model
Many countries around the world are currently taking a holistic approach in promoting national action plans to address the development of bacterial resistance referred to as One Health—the collaboration of multiple sectors to achieve an effective balance between human, animal, and environmental health.
“These programs are mainly based on monitoring the consumption of antibiotics and resistant bacteria, limiting the use of antibiotics in livestock, improving the growing conditions of farm animals, raising public awareness and promoting intelligent use of antibiotics, strengthening regulation, supervising veterinary preparations, and promoting alternative solutions such as vaccines,” says Dr. Berman-Alport.
So far, these actions have led to impressive results. In the EU, for example, there has been a 32% drop in the sale of antibiotics intended for farm animals in recent years. Also, many studies demonstrate that awareness to the problem and setting guidelines and strict rules lead to a decrease in unnecessary use of antibiotics, and subsequently to a decrease in the development of resistant bacteria.
In addition, the report outlines policy and farm-level action recommendations, drawing attention to the importance of regulation on the supply and consumption of livestock antibiotics by both importers, manufacturers, and veterinarians who prescribe them.
Collect All the Data
“There is an urgent need to collect data on the sale and consumption of antibiotics in the Israeli livestock sector, so that a more accurate risk assessment can be performed,” says Dr. Berman-Alport. “In addition, a general system for monitoring resistant bacteria should also be established, which will increase the ability of national preparedness for this significant challenge.”
Today, the monitoring of antibiotic-resistant bacteria in farm animals is divided between several bodies: the national centers of the Public Health Laboratory in Jerusalem, the Veterinary Institute, the Poultry Industry Council, and the Dairy Council.
“One of the significant recommendations in the report is the creation of a department capable of looking at all the collected data regarding the use of antibiotics and the development of bacterial resistance in the animal industry in the country. Today this is not happening so much,” says Dr. Berman-Alport.
“Right now, each department collects its own data and the cooperation between departments is not always simple. The aim is to create a departmental system that will collect the data regarding the provision of veterinary drugs and antibiotics to farm animals so that it will be possible to issue an annual and cohesive joint report.”
“In Israel, the main problem is that there is currently no data being collected regarding the consumption and use of antibiotics in farm animals. Yes, there is important monitoring of resistant bacteria, but it is only partial. Without information on the amount and frequency of use of antibiotics in animals, it is difficult to say what the acute nature of the condition is,” Dr. Berman-Alport adds. “It is important to strengthen the supervision around veterinary preparations, starting from the registration stage, through the supply of appropriate preparations, and at the economy level,” Berman-Alport emphasizes. “Only in this way will it be possible to reduce the use of antibiotics in farm animals, and it is time for Israel to join this campaign for the sake of public health.”
This ZAVIT Article was also published in The Jewish Journal on 15 Mar. 2021