Friday, April 19, 2024

The post-antibiotic world: 100 years of history?

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Very few organisations would be brave enough to risk their own non-existence. 
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When the New Zealand Veterinary Association (NZVA) recently announced their strategic intent that “by 2030, NZ Inc would not need antibiotics for the maintenance of animal health and welfare”, the responses ranged from relief to disbelief. 

This isn’t just another bland statement hidden in swathes of regulators’ doublespeak. This is aspirational stuff. This is game-changing and visionary. This is noble. 

Antimicrobial resistance (AMR) is one of the greatest threats to our existence. Eighty-seven years ago, another brilliantly gifted but untidy Scotsman who was prone to long holidays came back to his lab to find all his bacterial plates stacked as he had left them, strewn all over his benches, still growing bacteria. All, that was, except for a few that weren’t growing bacteria – because they were contaminated with what Alexander Fleming later identified and named as penicillin. And the rest is history. 

And so might it all be again soon. Fleming’s other remarkable discovery was bacteria became resistant to penicillin. He realised inappropriate doses led to the development of resistance and was actually wary of penicillin’s use. It’s remarkable to think this great “antibiotic era” we enjoy might last fewer than 100 years of human history. 

Bacteria are the most successful organisms on the planet. They were the first primordial life source and they will be the last flicker before all extinction. They are good at surviving because there are so many of them, and they multiply extremely rapidly. So, whatever you expose them to, you will select for the few that are able to survive. If you overheat them, you kill most but select for the bacteria that can survive extreme heat. If you freeze them, you select for the ones that like to be frozen. And if you expose them to antibiotics, guess what? You end up with bacteria that can survive antibiotics. 

Antibiotics have saved millions of lives and Fleming alone is credited with saving more than 80 million people with penicillin. But scientists and the medical profession are now openly talking of a post-antibiotic era – a world where antibiotics no longer work. Already in Europe 25,000 people a year die of infections that are resistant to every antibiotic we have. The news is frightening and getting more so daily. 

Making new antibiotics is not an option. There have been no new classes of antibiotics developed or discovered for almost 40 years. The science of resistance is challenging – resistance can be passed between bacteria and also between animals and humans and vice-versa. But the mechanisms and directions of resistance spread are complex and cause much scientific debate. The only thing the scientists agree on is the more we use antibiotics, the more we develop AMR. 

The livestock industry is under intense attack on AMR. Eighty per cent of all antibiotic use in North America is in livestock, so you can see why. Yet in New Zealand, we are the third-lowest users of antibiotics for livestock in the world. This is a tiny tropical island of good news for our dairy industry in the current sea of utter desolation. 

And so, back to the NZVA statement. Imagine a world where we didn’t need antibiotics for animals. This is not “we won’t have any to use”, this is “we won’t need to use any”. This is taking back the agenda and positioning NZ at the top of the export tree. 

Imagine not needing to use antibiotics to treat mastitis because we can vaccinate against it or prevent it with immune stimulants or improved management strategies. Imagine not needing to treat calves with navel infections because they never get them. Imagine not needing to complain about the price of dry cow therapy because you don’t need to use any of it. 

Not needing antibiotics gives us the opportunity to completely reframe how we look at disease and how we manage it. Even in dogs and cats – imagine not needing antibiotics after orthopaedic surgery because we have such effective sterile surgery techniques. Imagine not needing antibiotics when your mum’s cat is hit by a car, because someone’s invented a chip with a GPS locator that tracks it and prevents it straying on to a road.

The “imagines” are endless but the returns are very real. NZ can produce the world’s first, or probably only, antibiotic-free milk, meat, wool, velvet. Even Fonterra’s marketing department could surely find and market some significant value-add out of that. 

The news has already reverberated around the globe. We’ve had messages of support from the United Kingdom, Canada, North America, Asia and Australia. It’s captured the attention of many people around the world, including consumers. This gives us an edge and a huge opportunity. And it also gives us the hope we’ll still be able to use antibiotics for our children. 

Most importantly, from a farm perspective, this gives us back the agenda. If we can save the planet and our children at the same time, it might even give us a fair price for our product.

Mark Bryan is a veterinarian with VetSouth based in Southland. 

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