Report released Today, the United Nations says we have neglected one of the main components of the superbug problem: the environment. It serves as a reservoir for bacterial genes that create antimicrobial resistance, and receives farm and pharmaceutical runoff that promotes new resistance.
“The same factors that cause environmental degradation exacerbate the problem of antimicrobial resistance,” said Inger Andersen, Executive Director of the United Nations Environment Programme, known as UNEP. “The consequences of antimicrobial resistance can destroy our health and food systems.”
120-page policy paper “Superbug protectionrecognizes the environment as a place where antibiotic resistance emerges and wreaks havoc, causing up to 1.27 million deaths per year. This is a problem that public health planners have already recognized for hospitals and emergency centers, as well as farms that raise livestock, fish and crops. The report gives researchers a framework to understand pathogens that do not remain confined to these sectors of the economy, such as resistant bacteria that are emerging. after hospital wastewater plants and agricultural fungicides that make common hospital infections incurable. It says governments should develop regulations to curb antibiotic pollution, rely on food manufacturers to reduce antibiotic use, improve sanitation systems to remove resistant bacteria from wastewater, and establish monitoring programs to check if environmental protections are working.
In practical terms, it places UNEP at the forefront of the global fight against resistant bacteria, linking it with other UN agencies – the World Health Organization, the World Organization for Animal Health and the Food and Agriculture Organization – through a One Health approach that links issues people, animals and the environment. This is important because countries are already developing plans to tackle antibiotic resistance through a UN process that began in 2016. Countries are now being urged to think about protecting the environment as they try to reduce resistant infections in humans.
This is a long overdue move that will reframe the superbug problem from a problem created by inappropriate user behavior to a shared responsibility for an endangered planetary microbiome.
“Environment is the only thing that meaningfully links different breeding sites for antimicrobial resistance,” says Klaas Kirchelle, historian of science and medicine, associate professor at University College Dublin. “And in the long term, that is where antimicrobial management should be directed, not just over the next two to three years, but over the next 20 to 30 years.”
It seems remarkable that the role of the environment has so far been ignored, given that the first antibiotics were derived from the products of naturally occurring organisms. However, two years ago, when Kirschhelle and researchers from six other countries reviewed 75 years of international policy statements on drug resistance, they only found two– out of 248 – in which the environment deserved constant concern. “It was legitimate to think of it solely in terms of human health — after all, millions of people die from AMR,” he says, referring to antimicrobial resistance. “But we’ve been talking about how to regulate AMR for half a century, and yet we still have an increase in antimicrobial use and an increase in antibiotic resistance. So it’s time to really think big.”