3
economic cooperation and development (OECD), about 2.4 million people will die
as result of antimicrobial resistance in Europe, North America and Australia only in
next 30 years from now. The worldwide distribution of antibiotic resistance bacteria
is aided by many factors including international travel, immigration and other activities (Church 2004). The realization of antimicrobial resistance started in 1950s and
since then many studies have unequivocally reported an increasing trend (Davies
and Davies 2010). In 1959, scientific group of World Health Organization (WHO)
advocated research on antimicrobial resistance (The Work of WHO, 1959, Official
Records of WHO no. 98) and later (1981) released guidelines for regulated usage of
antibiotics (WHO/BVI/PHA/ANT/82.1).
Subsequent meetings and research has generated huge amount of information
about inefficacy of available antibiotics and rapid emergence and spread of resistant
microbial strains among humans and animals. The previous gap in pharmaceutical
research towards novel antibiotics coupled with increasing antimicrobial resistance
has further worsened the situation due to less treatment availability against such
conditions. However, now the issue is being recognized globally and many task
forces have been established in different countries. Rapid efforts are being made to
fill-in existing knowledge gaps and improve realization of interconnectedness of
animals, humans and environment in context of antimicrobial resistance. Many
measures have been proposed to regulate the emergence of antimicrobial resistance
and its containment in different ecological domains.
There is an interrelation between the different ecological niches like humans,
animals, poultry, agriculture, environment and even waste. Recent outbreaks of zoonotic diseases and direct interaction with animal carriers of the disease have further
underscored the importance of ‘One Health’ concept. This concept refers to a collaborative, trans-disciplinary, and multi-sectoral approach of actions applied at
local, national and inter-national levels. The omnipresence of drug resistant
microbes has made it necessary for a collaborative approach across different sectors, involving humans, animals, agriculture/livestock and environment. Thus using
this approach an optimal outcome is achievable across all the different sectors due
to the interrelatedness among humans, plants, animals and their overlapping environment (https://www.onehealthcommission.org/). Although, it is wide in definition
and scope but it is particularly important in context of antimicrobial resistance. The
underlying principles of One Health such as Human-Animal bond, ensuring safe
food and water supply, responsible agricultural production, disease surveillance,
detection of environmental agents, aligning of public policy and regulations and
communication and global outreach, are critical towards global cooperation against
antimicrobial resistance. Potential outcomes of this approach would be more interdisciplinary policy decisions and programs in research, education; training, disease
prevention, detection and diagnosis, and rapid development of novel therapies and
treatment strategies. These outcomes are also highly warranted in strategies against
antimicrobial resistance, which requires highly concerted efforts across different
domains (Fig. 1.1). But, as clear till now, the mitigation of the issue of antimicrobial
resistance warrants careful understanding of different factors involved in the
1 Antimicrobial Resistance Paradigm and One-Health Approach
economic cooperation and development (OECD), about 2.4 million people will die
as result of antimicrobial resistance in Europe, North America and Australia only in
next 30 years from now. The worldwide distribution of antibiotic resistance bacteria
is aided by many factors including international travel, immigration and other activities (Church 2004). The realization of antimicrobial resistance started in 1950s and
since then many studies have unequivocally reported an increasing trend (Davies
and Davies 2010). In 1959, scientific group of World Health Organization (WHO)
advocated research on antimicrobial resistance (The Work of WHO, 1959, Official
Records of WHO no. 98) and later (1981) released guidelines for regulated usage of
antibiotics (WHO/BVI/PHA/ANT/82.1).
Subsequent meetings and research has generated huge amount of information
about inefficacy of available antibiotics and rapid emergence and spread of resistant
microbial strains among humans and animals. The previous gap in pharmaceutical
research towards novel antibiotics coupled with increasing antimicrobial resistance
has further worsened the situation due to less treatment availability against such
conditions. However, now the issue is being recognized globally and many task
forces have been established in different countries. Rapid efforts are being made to
fill-in existing knowledge gaps and improve realization of interconnectedness of
animals, humans and environment in context of antimicrobial resistance. Many
measures have been proposed to regulate the emergence of antimicrobial resistance
and its containment in different ecological domains.
There is an interrelation between the different ecological niches like humans,
animals, poultry, agriculture, environment and even waste. Recent outbreaks of zoonotic diseases and direct interaction with animal carriers of the disease have further
underscored the importance of ‘One Health’ concept. This concept refers to a collaborative, trans-disciplinary, and multi-sectoral approach of actions applied at
local, national and inter-national levels. The omnipresence of drug resistant
microbes has made it necessary for a collaborative approach across different sectors, involving humans, animals, agriculture/livestock and environment. Thus using
this approach an optimal outcome is achievable across all the different sectors due
to the interrelatedness among humans, plants, animals and their overlapping environment (https://www.onehealthcommission.org/). Although, it is wide in definition
and scope but it is particularly important in context of antimicrobial resistance. The
underlying principles of One Health such as Human-Animal bond, ensuring safe
food and water supply, responsible agricultural production, disease surveillance,
detection of environmental agents, aligning of public policy and regulations and
communication and global outreach, are critical towards global cooperation against
antimicrobial resistance. Potential outcomes of this approach would be more interdisciplinary policy decisions and programs in research, education; training, disease
prevention, detection and diagnosis, and rapid development of novel therapies and
treatment strategies. These outcomes are also highly warranted in strategies against
antimicrobial resistance, which requires highly concerted efforts across different
domains (Fig. 1.1). But, as clear till now, the mitigation of the issue of antimicrobial
resistance warrants careful understanding of different factors involved in the
1 Antimicrobial Resistance Paradigm and One-Health Approach