Antimicrobial resistance – a challenge for trans-sectoral approaches

The post-antimicrobial era has begun. I dare to look into the crystal ball and describe two developments that I believe will be closely linked to this era:

1. Global research into new active ingredients and groups of active ingredients is dramatically lagging behind medium-term demand. Without a substantial change in the use of antimicrobial agents in agriculture, animal husbandry, veterinary medicine and human medicine, research and development will have great difficulty in providing reliable agents in 30 years' time.
2. Agriculture will therefore still have to work largely with the existing spectrum of antimicrobial agents and alternatives (such as phage therapy, vaccinations, animal husbandry changes) in 30 years' time. This poses major challenges not only for veterinary medicine. The long-term health (in animals and humans) and economic consequences will be enormous to devastating in terms of reduced average life expectancy.

As Vétérinaires Sans Frontières, the term antimicrobial resistance is very important to us, because the development of resistance affects both microorganisms (including bacteria and fungi) and endo- and ectoparasites. The area of anthelmintics in particular – deworming agents – is often neglected, but plays a key role in the treatment of worm diseases, both curatively and preventively in humans and animals. If we take the two crystal ball challenges mentioned at the beginning of this article seriously, it follows that:

1. In order to be able to continue to use effective agents against microorganisms and parasites in the future, we must invest more in research and development of these groups of agents, active substances and alternative treatment methods, but also in monitoring their use in all areas. In particular, we need to explore new approaches such as phage therapy and vaccinations even more. 

2. Something urgently needs to change: The current global use of antimicrobial agents and the resulting resistance cannot be countered with research and development. We need a change in livestock husbandry, a significant reduction and the binding safeguarding of the proper use of these substances in both humans and animals. And quickly. Neither veterinary medicine nor human medicine can tackle this challenge alone; we need interdisciplinary cooperation involving all sectors in order to find and implement sustainable, long-term solutions.

Christian Griebenow
Chair of the Board of Vétérinaires Sans Frontières Germany
Member of the Steering Committe of the Global Health Hub Germany
Finance Director of the German umbrella organisation of development and humanitarian non-governmental organisations - VENRO
Co-Chair of the German Centre for the cross-sectoral control of neglected tropical diseases (DZVT)


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