“Antimicrobials: handle with care” is 2020’s theme of the world awareness week focused on this issue. This activity arose out of the need to raise awareness about antimicrobial resistance. AMR, as it is known by its acronym, occurs when bacteria, viruses, fungi, and parasites resist the effects of medicines, making it difficult to treat common infections and making animal and human diseases harder to cure. Antimicrobials are essential to fight diseases in people, animals and plants, and they include medicines to treat infections by bacteria, viruses, fungi, and parasites. Some examples are antibiotics (amoxicillin and azithromycin), antivirals (acyclovir), antifungals (fluconazole and clotrimazole), and antiparasitics (albendazole).
It is extremely important to know that although AMR is a natural phenomenon, the misuse of antimicrobials or their excessive and sometimes irrational use can accelerate the appearance of viruses and bacteria due to the resistance they develop. This is why from November 18th to the 24th, various outreach and dialogue activities on the use of antimicrobials were carried out in Chile with stakeholders from the public and private sectors, the livestock industry, academia, and regulatory agencies. The goal was to raise awareness on the global phenomenon of resistance to these medicines and to encourage the adoption of best practices to prevent this from occurring and spreading.
Currently, AMR causes 700,000 deaths a year worldwide, according to the report “Review on Antimicrobial Resistance.” Antimicrobial resistance is expected to cause 10 million deaths each year by 2050. The problem occurs because as antimicrobial resistance increases, fewer medicines are produced, and the healthcare industry loses prospects to effectively tackle the issue.
Good health in the white meat industry
Antimicrobials are essential for humans and animals as they provide health and well-being, as well as a better quality of life. Similarly, they protect public health since 60% of infectious diseases are transmissible between humans and animals. They also ensure food security, i.e. they cover the need for high-nutritional, quality proteins.
Currently, there is talk about the One Health approach, which is based on a multidisciplinary system with the commitment of the human, animal, and plant sectors, and which the World Health Organization has been adopting in its policies to design and implement healthcare programs.
In Chile’s case, several institutions are part of the national plan against antimicrobial resistance, which is structured in five stages: awareness, surveillance, control of antimicrobial use, prevention and infection control, and resistance-related research. In the case of the white meat industry, the Good Health Program is focused on optimizing the use of antimicrobials in pig and poultry farms. This project implements the five key pillars mentioned above as follows:
Industry awareness, a public-private effort to disseminate the efforts the industry has been making on the necessary and cautious use of antibiotics.
Secondly, the proper use of antimicrobials, namely, the continuous monitoring of their use, including on-site audits to control and prevent excessive use or potential bad practices. The third pillar focuses on the best healthcare and biosecurity practices included in a handbook launched in mid-2019 and prepared by the Universidad de Chile as an essential support tool for poultry and pork production. Additionally, the updating of biosecurity handbooks and specific biosecurity programs.
The next pillar is based on the regulatory framework and the support for legislation that regulate these instances under the oversight of the Agricultural and Livestock Service (SAG). Related to this, the use of antimicrobials as growth promoters is banned in Chile. Similarly, there is a control program for residues from veterinary medicinal products, led by SAG. This is a tool that helps conduct effective inspections while ensuring that Chilean livestock products comply with the maximum residue limits for veterinary medicines. Currently, compliant results for the past 15 years have reached 100%.
Lastly, there is a pillar related to innovation and development implemented by the pork and poultry sector. Regarding the use of antibiotics, the white meat industry has been developing new technologies and alternative vaccines that are increasingly safe. Two projects showcase the work the sector is conducting: “FageCapsules,” microencapsulated salmonella bacteriophages with thick and small intestine release technology (2018); and a project on the use of oleoresins from rosemary, garlic, and quillaia (2020).
In this scenario, the industry challenges related to antimicrobial resistance are outlined, as well as certain criteria that must be taken into consideration to comply with international requirements, i.e. the standardization of resistance measurement procedures; vaccine and other essential technological development to prevent animal diseases, and the need to use antimicrobials; continuous dissemination of best practices for antimicrobials use; and the need to implement an AMR surveillance system for bacteria that cause animal diseases and trigger the use of antimicrobials on farms.
AMR is not a new phenomenon; however, action must be taken today to contain and fight its progression and preserve the effectiveness of antimicrobials. Although veterinarians effectively contribute to reducing AMR through best practices, the involvement of the public and private sectors is essential to fight it. The experts maintain that sometimes medicines are not necessary and therefore it is important to use judgment to assess when to prescribe them. Furthermore, they say that hand hygiene is vital to preventing the spread of viruses and bacteria and that, thanks to the pandemic, people have acquired this habit.