One health-its importance in helping to better control antimicrobial resistance

Abstract

Approaching any issue from a One Health perspective necessitates looking at theinteractions of people, domestic animals, wildlife, plants, and our environment. For antimicrobialresistance this includes antimicrobial use (and abuse) in the human, animal and environmentalsectors. More importantly, the spread of resistant bacteria and resistance determinants within andbetween these sectors and globally must be addressed. Better managing this problem includestaking steps to preserve the continued effectiveness of existing antimicrobials such as trying toeliminate their inappropriate use, particularly where they are used in high volumes. Examples arethe mass medication of animals with critically important antimicrobials for humans, such as thirdgeneration cephalosporins and fluoroquinolones, and the long term, in-feed use of antimicrobials,such colistin, tetracyclines and macrolides, for growth promotion. In people it is essential to betterprevent infections, reduce over-prescribing and over-use of antimicrobials and stop resistant bacteriafrom spreading by improving hygiene and infection control, drinking water and sanitation. Pollutionfrom inadequate treatment of industrial, residential and farm waste is expanding the resistomein the environment. Numerous countries and several international agencies have now includeda One Health Approach within their action plans to address antimicrobial resistance. Necessaryactions include improvements in antimicrobial use, better regulation and policy, as well as improvedsurveillance, stewardship, infection control, sanitation, animal husbandry, and finding alternativesto antimicrobials.