Resisting resistance: How animal health can prevent a global crisis

Antimicrobial resistance (AMR) has long been labeled the “silent pandemic,” yet it claims more than 1.27 million lives annually, with estimates suggesting it indirectly contributes to up to 5 million deaths each year globally.

By comparison, the first year of the COVID-19 pandemic recorded 1.8 million deaths. Despite the staggering toll, efforts to combat AMR have lacked the urgency and coordinated attention that defined the global response to COVID-19, even as AMR continues to threaten health systems, economies and food security worldwide.

This lack of focus is particularly concerning when talking about animal health, which serves as a critical frontline in the fight against AMR. Resistant bacteria originating in animals do not stay on farms; they spread through food, water and the environment, threatening both animal and human health. Furthermore, the health of livestock and poultry is essential to maintaining food security and supporting agricultural livelihoods worldwide. Safeguarding animal health through smarter antibiotic use and preventative measures is not just an agricultural priority — it is a cornerstone of protecting public health and ensuring resilient ecosystems.

Bacterial resistance occurs when bacteria adapt to survive exposure to antibiotics designed to kill them. Over time, these resistant strains multiply and spread, rendering antibiotics ineffective. In the past, bacteria typically developed resistance after antibiotics were widely used in clinical settings. Now, resistance is being detected even before new antibiotics are commercially released and during their development or pre-clinical phases. This means that by the time a new antibiotic reaches the market, some bacteria may already be immune to its effects — a shift clearly illustrated in the following timeline.

In animal agriculture, antibiotics are indispensable for maintaining animal health, treating infections and ensuring productivity. However, the overuse of these medications, such as their use as growth promoters, can inadvertently fuel antimicrobial resistance. Recognizing the value of antibiotics makes it crucial to use them judiciously as part of an integrated approach.

Without intervention, AMR in animal health could:

Endanger food security: Resistant infections could impact livestock and poultry populations critical to feeding an increasing global population.

Escalate economic strain: The need for costlier disease prevention measures and trade restrictions on products from regions with AMR could push up food prices worldwide.

Threaten public health: Resistant bacteria can leap from animals to humans, blurring the lines between species and ecosystems.

The interconnected nature of AMR highlights the urgency of a One Health approach, which integrates human, animal and environmental health into a unified framework.

AMR’s silent nature contrasts starkly with COVID-19’s immediate visibility. The pandemic fueled unprecedented public-private collaboration, leading to the rapid development of vaccines and global policy shifts. For AMR, the response has been slower despite the looming threat of a future pandemic fueled by drug-resistant bacteria.

To match the urgency seen during COVID-19, governments and private sectors must:

Invest in diagnostics and alternatives: Technologies like rapid bacterial testing and phage therapy need accelerated development and implementation.

Modernize regulations: Streamlining the approval processes for innovative solutions can make them more readily accessible.

Elevate global awareness: AMR demands the same visibility and commitment as climate change or infectious disease outbreaks.

The fight against AMR is not going to happen without scientific and technological progress. Breakthroughs like phage therapy, a precision approach using viruses that infect and kill specific bacteria, are already making strides. Diagnostic tools that enable rapid, targeted antibiotic use are improving, and sustainable farming practices are gaining traction globally.

Denmark has significantly reduced antibiotic use in agriculture through stronger regulations, innovative practices, and effective public-private partnerships. These measures have successfully maintained animal health and productivity while minimizing antibiotic misuse. This approach serves as a model for integrating human, animal, and environmental health to combat antimicrobial resistance globally.

AMR is a global health crisis, but it is also a solvable one, and animal health lies at the heart of this solution. By embracing a One Health approach, investing in innovation, and fostering collaboration across sectors, we can stem the tide of resistant infections. The tools to combat AMR already exist; what is needed is the collective will to implement them on a large scale.

As Alexander Fleming warned in his Nobel Prize lecture: “It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body.” While Fleming likely could not have envisioned the scale of antibiotic use today, his warning about the dangers of misuse was prescient. The widespread overuse and misuse of antibiotics, in both humans and animals, has allowed resistant bacteria to thrive and spread, making his caution even more relevant today.

History shows us that pandemics can be defeated through collaboration, innovation and urgency. Fleming’s foresight reminds us that resistance was predictable, but it also shows that responsibility and collective action can change its course. AMR might be silent, but it is not unbeatable.