My name is Ryan and welcome to the Vegan Report. Today we are examining up close one, if not
the greatest threat to our future, something called antibiotic resistance. To discuss this
topic I have with me, Colin Nunen, Colin is the scientific advisor to the Alliance to
save our antibiotics. An alliance of health, medical, environmental and animal welfare
groups working to stop the overuse of antibiotics in livestock farming. Colin, welcome to the show.
Thank you so much for being here. Thank you very much for inviting me on to your show, Ryan.
So my first question for you was about how this threat of antibiotic resistance,
is it relevant to every one of us in this world? Most of my listeners are in the US,
the non-profit you work for works from the UK. Is this a European problem, Asia problem, or is
this a concern for everyone? Yeah, this is definitely a global problem. So it is a problem
everywhere in the world and it's a greater problem in certain parts of the world than in other parts
of the world. I would say that in the global south, I would say that it is an even greater problem than
it is in Europe and in North America, but it is a problem in Europe and North America as well.
In fact, it's probably worse in the United States than it is in most European countries.
The estimates, for instance, of the global deaths that are directly caused by antibiotic
resistance is over a million deaths every year, are directly caused by antibiotic resistance.
And about four and three-quarter million deaths in total are in some way associated with antibiotic
resistance. That's a very large number of deaths. If you consider that during the COVID pandemic,
during those three years of the COVID pandemic, there were about two million deaths a year
caused by COVID. So antibiotic resistance really is a major global threat. And if we don't tackle it,
it is forecast that it's going to be getting worse. How worse? Do we have an idea of how
much this number will increase? Well, the most recent, so I suppose the good news
has been that there has been some action. So some of the more recent estimates for what's going to
be happening in the future are not quite as bad as they were. But present, the estimate is that by
2050, there will be 1.9 million deaths directly caused by antibiotic resistance
and about eight million deaths that are associated with antibiotic resistance each year.
So yes, it's a huge global problem. The thing about antibiotics is that they're not just used
so antibiotics are medicines that are used to treat diseases caused by bacteria. So as we know,
diseases can be caused by viruses, but antibiotics are generally not effective against
viruses. But they have their effects against bacteria. But they're not just used to treat
bacterial infections, they're used also to prevent them. So for instance, if somebody is undergoing
cancer chemotherapy, they are at greater risk of becoming infected. And so they may receive
preventative antibiotics, also called prophylactic antibiotics. Or if somebody is undergoing
surgery, for example, a hip replacement, you need to make sure that that wound does not become
infected. And so antibiotics are needed. They're needed for when a woman has a caesarean, they're
needed for organ replacements. They're needed for so many things that we take, well, not necessarily
for granted, but that are characteristics of modern medicine, which we really weren't able to do
safely in the same way before we had antibiotics. So antibiotics have really helped transform
modern medicine because the risk of it being infected when you're undergoing certain procedures
has become much, much lower than it was before. And the reality is that if we start to lose
antibiotics, then this undermines not just the treatment of somebody who happens to have, say,
a urinary tract infection or some other infection, but it undermines so many other treatments as well.
And so that's why organizations like the World Health Organization are very concerned that the rise
of antibiotic resistance is really going to undermine the foundations of modern medicine.
And of course, in some parts of the world, resistance levels are already really high,
and it's really a major concern. I want to get into the problem that it poses, which is grave.
But first, and this is a great segue to this question, let's define the problem of antibiotic
resistance. I think most of us, we know about antibiotics because we use them as treatment.
So this is how we interact with that medicine. And we have been told by doctors to limit our
use of antibiotics. So doctors will be hesitant to prescribe antibiotics for certain medical
problems because they don't want to create this problem of antibiotic resistance. Yet,
most antibiotics are used in the factory farms, in the agriculture business, on animals and not on
humans. So let's define this problem. What's the cause? Is it really the humans or it's using
agriculture? And let's get also into the science of it. What's the bacteria? How come it becomes
resistant to our antibiotics? All of that. Yeah. So antibiotics, a lot of them are naturally occurring
substances, which have been discovered by humans. Sometimes they've been slightly tweaked so that
they work more exactly as we want them to work. But essentially, they have an effect of either
killing certain bacteria or preventing those bacteria from reproducing. And so what are bacteria?
Bacteria are very small, single celled organisms. They, unlike human, animal, plant and fungi,
the cells don't have a nucleus. So they are simpler cells, they're smaller cells, and they are
single cells. Bacteria ultimately have been on earth for billions of years, and they're very
good at evolving. So they evolve by either just kind of reproducing, in which case, their
descendant cells, they spit into two and their descendant cells have the same sort of DNA as
the mother cell, but they can also exchange genes between bacteria. So they can produce copies of
their genes and pass them on to other bacteria. And so some of these, because antibiotics have
existed in the environment for millions of years, the bacteria have already, some of them,
evolved resistance to these antibiotics, some of them, others have not. So whenever an antibiotic
is used, there will tend to be some of them that are already resistant, so they are not killed by
the antibiotic and they're able to continue reproducing, then the other ones will be killed off.
And then so if you use these antibiotics repeatedly when they are not needed, then gradually you're
killing off the sensitive bacteria and you're increasing the resistant bacteria. And so you
gradually tend to get more and more antibiotic resistant bacteria. And the thing is that many
of these resistance, so the bacteria will have certain genes that make them resistant to a
particular antibiotic. And those genes are very often on little pieces of DNA that are easily
transferable to other bacteria. And so they produce copies of these little pieces of DNA and pass
them on. And so this is called horizontal gene transfer because it's passing through the environment,
essentially into another bacterium. And a lot of antibiotic resistance evolves in this way.
Sometimes it also, it's just a mutation so that the genes might just mutate and the bacteria becomes
resistant. But very often it's passed on through this process of horizontal gene transfer, so
different, it can even happen between different species of bacteria. So one species of bacteria
and a completely different one and the genes can be passed between these different species of bacteria.
And so a species of bacterium that used to be sensitive to an antibiotic can evolve to become
resistant. And this gene transfer happens more frequently the more you tend to use these
antibiotics. And so the best way to use antibiotics tends to be to use them infrequently, you know,
ideally only when they're necessary and usually at a high enough dose that you sort of kill off
the bacteria and use them for relatively short periods of time, you know, as short as can be.
What's not good is to use them for long periods of time at lower doses, which is ideal conditions
for the bacteria then to, they're not killed off as much and they have time to evolve to get used
to the antibiotic and to gradually become more resistant. And unfortunately a lot of antibiotic
use in farming tends to be for longer periods of time, very often at lower doses. So it provides
ideal conditions for bacteria to evolve resistance. Now it is true that globally, probably about two
thirds of all antibiotics are used in livestock, not in humans. So clearly a lot of antibiotic
resistance can emerge from livestock. However, we do have to recognize that most bacteria
evolve more, rather sort of transfer more easily from human to human than they do from animal to human.
So bacteria definitely can pass from animal to human, we know this, but it's more easy because
bacteria tend to be adopted to living in a certain species. And so human antibiotic use
is generally thought to be the cause of most resistance in human medicine, but it's not the
cause of all of the resistance. And there are certain infections where the use of antibiotics in
animals is actually the main cause of resistance in humans. So it kind of depends on the infection
and it depends on the antibiotic. Another issue is that there is also transfer from the environment.
So the reality is that when an antibiotic is taken, say orally, perhaps up to 80% of that antibiotic
is excreted from the human or from the animal, primarily in the urine. And that antibiotic is
still active and it can still select for resistance and then it ends up ultimately in the environment.
And so the overuse of antibiotics ultimately also enables bacteria in the environment to
gradually become more and more antibiotic resistant. Okay, that's a lot of information.
Let me try to tell you what I understood from that. So I guess we're all facing a threat
of antibiotic resistance as individuals every time we use antibiotics because every time we
do, then there is a large part, which is the majority of bacteria is causing our
health problems that are destroyed from that antibiotic treatment. But then there's a small part
of bacteria that do not react to that treatment and are actually resistant. And the threat is that
those resistant bacteria, if we keep that antibiotic treatment going, will have this
evolutionary advantage over the other bacterias and will multiply or will transmit the information
of the key, the shield from antibiotics to other bacterias. Is that a good understanding?
Yeah, so for example, let's say you have an infection. Okay, now sometimes it's difficult
for a doctor to know exactly what's causing your illness because we don't have tests
most of the time that can just tell you in one minute or five minutes what your infection is.
The doctor has to sort of try and figure it out and sometimes they may have to guess,
they don't know exactly what you are, but what infection you have. Well, let's say you take
antibiotics. Now, whether those antibiotics work against your infection, what we do know is that
you have bacteria in your gut and those bacteria in your gut, which play an important role in your
general health and are usually not doing you any harm, those bacteria are going to be affected by
the antibiotic and some of those bacteria are going to develop antibiotic resistance. Now,
one thing that can definitely happen is that at a later stage, sometimes those bacteria infect us
usually they don't, but sometimes they may, they may cause, for example, a urinary tract infection.
And when that happens, if you've consumed too many antibiotics, if every time you go to the doctor,
you put pressure on them to prescribe antibiotics for you, then you're more likely to have
resistant gut bacteria in your intestines and so and those are the ones that ultimately
tend to cause the urinary infection. Now you've got an antibiotic resistant urinary tract infection
and you need antibiotics to treat these infections. Another problem can be, of course, that you may
take the antibiotic if you are infected and some of those bacteria then develop resistance and
they get passed on to other people and now those other people have an antibiotic resistant infection.
Now what can happen with food? So if somebody is consuming, say, meat that has resistant bacteria
on it because what happens is the animals are consuming antibiotics a lot of the time.
Their gut bacteria become resistant. Then when they go to the abattoir and their intestines are taken out,
it contaminates the carcass and you end up with bacteria on the carcass and ultimately some of that ends up on the meat.
And then the consumer handles the meat, the bacteria gets maybe on the hands or maybe they don't cook the meat well.
And so some of the bacteria are not killed and this ultimately ends up being consumed by the human.
And then if some of those bacteria infect that human, they may be antibiotic resistant.
But another thing that can happen is that they can pass on some of the genes that make them resistant
to other bacteria in the human gut. And then those other bacteria may cause, say, a urinary tract infection.
So it's quite complicated to follow to actually prove was this down to the farming or was it down to human use?
Because bacteria are not telling us when they're transferring DNA. So sometimes it's very difficult to trace.
We do know that it happens.
Yeah, it's like a war on many fronts. That's how I feel about it.
It's like where those bacteria are waging war at us from our guts, from environmental factors, from the food that we eat.
Is that a good analogy?
Sorry, who's waging war? The bacteria?
Yeah, the resistant bacteria.
Well, yeah, I think it's not very helpful to think of bacteria as always being at war with humans,
because bacteria are actually carrying out lots of important, they're doing us a lot of benefit.
And we don't understand all the benefits that bacteria are doing to us as well, because we all have, you know,
maybe about two kilos of microorganisms on and in us.
There's a lot of them. We have far more bacterial cells in our gut than we have human cells in our bodies.
Okay, so they're very important and they do lots of different things and we don't understand all the things that we do.
And the problem is if we start trying to kill the bacteria all the time, we may end up with all sorts of health problems.
So just as antibiotics have been used in farming, well, I mean, maybe we can talk about that a bit later,
but there are many things that bacteria do for us.
And if you disrupt all your microflora, your bacterial flora, you may end up with various health problems.
There are scientists who think that the obesity crisis is partly caused by dysbiosis, the fact that our gut bacteria are not as healthy as they used to be.
There are people who are concerned that mental health problems are associated with bad gut bacteria.
There are many concerns about the fact that we overuse antibiotics or we eat unhealthy food, which is not feeding our important gut bacteria well enough.
So if you don't have enough fiber in your diet, that's not good for your gut bacteria. The beneficial bacteria in your gut need fiber and a lot of modern diets don't have enough fiber.
So yes, we have to make sure that we don't end up with too many resistant bacteria in our gut, but we also don't want to be thinking of getting rid of bacteria in our gut. That's not the way forward.
Okay, I think I know what follow-up questions will help me truly understand well this.
So I have a couple of them. The first one, are we always carrying a certain number of resistant bacteria in our body?
And the second question, what is an infection? When does the bacteria activate and decide to threaten my health?
Right, so I don't know exactly what the before the antibiotic era, how many resistant bacteria were there in our guts. I don't know.
I suspect that pretty much everybody now has got resistant bacteria to some extent in their gut, but obviously that will vary greatly from individual to individual and also from country to country.
What we do know is that resistant bacteria have been in the environment for millions of years and we know this because people have collected soil samples and preserved these from before the antibiotic era, the modern antibiotic era began in the 1940s and 1950s.
And they have been able to compare it with more modern soils. And we have seen big increases in the number of resistant bacteria in soils, but there were also resistant bacteria in soils before we began using them.
And this is because many of the antibiotics are actually produced, that we use, many of the antibiotics we use are actually produced originally by soil microorganisms.
So they've been, they've existed in soils for millions of years. And so some bacteria have evolved resistance.
So it may be, it may be that there were resistant bacteria in human guts before we began using antibiotics, but if there were, they would have been at the far, far lower level.
And what is an infection? An infection will tend to be when bacteria are in the wrong part of your body or when certain bacteria that shouldn't be in your body at all are able to establish themselves in your body.
So there are lots of bacteria in your gut, but that doesn't mean that you should be getting these bacteria into other parts of your body.
So they're probably not, you know, a lot of them are not doing you any harm when they're in your gut, but, but you know, don't get them into your bloodstream.
There should be no bacteria in your blood. It should be free of bacteria.
Also, it's important to realize that many infections, you need a certain number of bacteria to actually work to be able to develop into an infection, because otherwise your immune system will just clear out that, you know, a small number of bacteria,
they will often be able to just clear them out, you know, your immune system is always trying to make sure that the parts of your body, like your bloodstream are free of infectious agents like bacteria.
So the one that appears, it's just going to wipe it out very quickly.
But if there are lots of them that appear, then it's not so easy.
That's wonderful. That's frightening. But that's also wonderful. I'm learning so much about our human body from you.
How come my my doctor or any educator in the space of health, I've never heard that from any of them before, you know, the importance of bacteria in in our body.
And you did mention that we have the equivalent of three kilos of micro-archivants.
I think I think that I mean, there are different estimates and they have maybe changed recently. I'm not quite sure what the most recent estimate, but the estimate that I mentioned was two kilos.
But I'd have to check whether that's still the current.
And that there are more bacteria than human cells.
Yes.
Meaning we're composed more of bacteria than.
Yeah, I mean, bacterial cells are a lot smaller than human cells.
So, you know, there are there is less in total weight.
It's less, but in a number of cells and the point also about all of these, it's not just bacterial cells that are in our guts.
But the point is there are lots of different species of bacteria and they have they can do different things as well.
So and they they digest certain foods like like fiber, you know, in plants and whereas our human digestive system does not, you know, digest that fiber, the bacterial cells, these beneficial bacteria eat that fiber and then provide certain benefits to us.
In return, they produce certain molecules that are good for our health.
So they that's what also bacterial cells in our guts also help prevent the pathogenic bacteria, the ones that cause infections from establishing themselves in the gut.
So they provide this barrier to to infection.
So you may well eat some, you know, bad bacteria on your food.
And, you know, particularly when when we eat food raw, which, you know, we do like eating salads and and fruit and other things.
And some of this will have bacteria on it and it may well be that some of these are not good for you.
But as long as, you know, there aren't too many of them.
And, you know, you wash your fruit and vegetables and that sort of thing, it can be very difficult for those bacteria to establish themselves in your gut.
And having all these other microorganisms in your gut prevents them from establishing themselves because they don't allow the bad bacteria access to the food and that sort of thing.
Giving their importance and you have underlined some aspects of it.
How come it's not public policy to offer that education in science classrooms?
Like, maybe I had a bad education and I did not go to the right schools, but I never learned about this.
The importance of bacteria is.
Well, you know, the truth is it is very complicated as well.
I mean, I don't I'm not saying that that is complicated to explain. It's just that we know that a lot of this stuff is important.
We don't know exactly how important and we don't know exactly a lot of time what all of these bacteria are doing and what their their role is.
And we're, you know, some of it is things that we're only starting to really sort of understand.
But, you know, we know that, for example, you know, in in in mother's milk, you know, when an infant is is receiving mother's milk, there are bacteria in that milk.
And those bacteria are there for a reason and they are. This is how partly how this these bacteria then establish themselves in the in the infant's gut at the beginning.
And that's one reason why it's important to see if your mother's milk and that sort of thing. So so so yeah, bacteria are definitely.
You know, beneficial bacteria are definitely important. I mean, we do hear some some of this, you know, when when people sometimes talk about, you know, good bacteria in yogurt and this sort of thing.
And so there is some sort of, you know, public knowledge of this. But what is in what has been becoming sort of said by certain scientists in more recent years is that it's not it's not just about the role of these bacteria isn't just to resist infection from other bacteria.
It's playing a whole load of other roles as well, including in things, as I said, like mental health, which, you know, people would not have thought of before, but there are scientists who say now that that is the case.
And yeah.
I mean, I'm getting a bit further from the topic at hand, but I wonder all of those claims from yogurt companies. Is there any truth to that or is it just marketing?
Wow. Yeah, I mean, you're maybe I'm maybe not the best person to sort of, you know, answer that is kind of hard to say, but it's certainly the case that, you know, it may well be that there are some good bacteria in in in certain foods,
you know, particularly fermented foods are supposed to be good for your gut health. But sometimes it can be difficult for bacteria to establish themselves in your gut. So, so exactly how much of it actually then manages to establish itself in your gut is perhaps hard to say,
but it is generally my understanding is it's generally thought that, you know, fermented foods can be can provide some, you know, very good beneficial bacteria for your gut.
And what were you about to say?
Yeah, when it comes to, you know, yogurt, specifically, to be honest, I don't know. I mean, I do know that, you know, lack, you know, things like lactobacilli and bifidobacteria are certainly found in healthy humans in their guts.
Certainly, certainly the case, you know, these tend to be quite, quite good bacteria, but whether they establish themselves in your gut from eating yogurt is something else. I'm not really qualified to comment on that.
Well, it's not a resounding yes. And as an organism, those bacteria is, are they akin to plants? Viruses? Are they alive? They're certainly not sentient. What do we know about them as organisms?
Yeah, they're the simplest kind of alive organisms, they are alive and they eat food and they have their own metabolism, unlike viruses, which are not really alive and need to infect something else.
So yeah, bacteria are alive and they're not classified with plants. Essentially, there are single celled organisms without nucleus and there are things called bacteria and then there are things called archaic bacteria.
And then, then there are single cells that have evolved a nucleus. And those are called protists. And then everything, and then, so that's the biggest separation in nature is between single cell things that have no nucleus and cells that have a nucleus.
And then everything else has evolved from protists. So you have fungi, plants and animals are all multi cellular kind of above us at where they've all evolved from protists. So bacteria are kind of right at the beginning of life.
Yeah. Incredible. I have so much respect now for this organism. Let's now talk about the animals and the use of antibiotics in the agriculture industry.
You mentioned some concrete examples of how it can be threatening for our health. So for instance, eating meat and having antibiotic resistant bacteria in that food, in that meat.
What are the other threats that are posed by this intensive use of antibiotics in factory farming in just on livestock?
Yeah, so I mean, it can end up on meat, it can, the bacteria can also pass from direct contact with an animal. I mean, this can happen. So when a farmer is touching their animals or when a vet is touching the animals, it can also, of course, happen with pets.
You know, pets can also receive antibiotics. You can also pass into the environment.
So as I said, you know, the antibiotics can be excreted in the urine and that those antibiotics will then end up ultimately in the environment where they can select for more resistant bacteria.
But the bacteria can also end up in the air, particularly when you have kind of factory farms with thousands or in the case of chickens, tens of thousands of chickens in one shed.
Obviously, you know, a lot of their, the, there will end up being a lot of bacteria in the in the air. And so people who go into that shed will end up being kind of to some extent,
their clothes anyway, will end up with bacteria on it. The air that is released from those farms can contain bacteria. So in the local environment, some of the antibiotic residues that are excreted or the resistant bacteria that end up in the manure will end up on the land.
They can also end up in water supplies as well. Of course, so then it can also, as you said, be on the meat, but it can also end up, you know, when, you know,
the fruit or rather vegetables more likely are grown in the fields that, you know, there may be, you know, resistant bacteria or residues in those fields.
And so it can end up, you know, on vegetables as well.
So, so yes, there are various different ways in which you can spread, you can spread via eggs as well in theory, and certainly residues.
And one, one issue as well is so usually it's, it's more the resistant bacteria that people are concerned about on say meat or, or, you know, dairy.
There are concerns also about residues of the antibiotic ending up inside the meat or inside eggs or inside the milk.
Now, in, in sort of richer countries, you know, like European countries or North American countries, there tends to be testing for antibiotic residues and there's kind of legislation on you need to withdraw the use of the
antibiotic before a certain period of time before the, we say the animal goes to the abattoir and, and by withdrawing it early enough, the residue is reduced.
In many, you know, poorer countries, the regulations are weaker and very often, you know, there may be little or no residue testing and very often even the, the animal feed that contains antibiotic isn't even labeled as containing the antibiotic.
So the antibiotic may be used right up to the end of that animal's life, and in which case you end up with very significant residues inside the meat or inside the milk or inside the eggs.
So in those situations, actual residues of antibiotics are being consumed by, by people and this too may be having an effect in, in terms of selecting for resistant bacteria in, in the, in the person's gut.
I want to go back to the airborne bacterias. This is the first time I hear, I hear about bacteria is being in the air.
So what do we mean by that? Is that like mixed with water? And what's the altitude of, of, of, you know, can they mix with clouds?
Is it present in the rain?
I wouldn't, I wouldn't really know exactly that. I do know that you, you have to be relatively close, say, to a factory farm for there to be kind of the detectable number of bacteria, like in the air.
So I think it's, you know, kind of like, you know, within a few hundred meters or something like that.
And, and yeah, I don't know exactly, you know, presumably these bacteria are just kind of floating and eventually settle.
I don't know exactly, exactly how that works.
And what about the water? So I guess, bacteria is can thrive under water.
And, you know, you have slaughterhouses built as an example built by, you know, on the shores of a river, and they dump all of them in your and inside you have all of those bacteria is and then they will most likely trap.
They most likely travel to lakes, to other rivers, to even the ocean.
Is that a likely scenario?
Certainly in different parts of the world, yes, contamination of, you know, of rivers and that sort of thing with resistant bacteria, particularly in sort of lower and middle income countries.
And some of it is coming from livestock farming, some of it is coming from human sewage as well.
Human sewage is, you know, will be treated in many countries, but you know, but some of it nevertheless is going to release antibiotic residues.
And then some of it will also be coming from antibiotic manufacturing, which releases sometimes very high levels of antibiotics into the environment.
And so, yeah, there are manufacturing facilities in some countries like India, which are releasing very high levels of antibiotics into the environment.
But we do know that even in countries like the UK that there can be residues of antibiotics, you know, in water supplies and that can and these can sort of, you know, you can detect these on people who, you know, swim in that water, that sort of thing.
So, so yes, it is something that can be detectable and it may well depend on the time of year and rain and that sort of thing. And in the case of farming, it will depend on, you know, when manure is spread on the land.
And it will also depend on whether that manure has been properly composted before it's spread on the land, because if it's, if animal manure is mixed with crop residues and properly composted, then this will reduce the number of bacteria in there.
And it will also reduce antibiotic residues. But if it's not, and very often it isn't properly composted, then then you can get higher levels of these residues of antibiotics and of antibiotic resistant.
So when I read organic label, the supermarket, and I know that they have used, you know, natural manure to, I should think there is a risk of that, actually.
Yeah, I suppose it depends on the, on the, on the country and what the rules are and that sort of thing. Rules on antibiotics use in organic agriculture are much stricter than they are in intensive farming.
So in organic agriculture in Europe, routine antibiotic use has always been banned using antibiotics for group prevention. So group treatments just that are just purely preventative that's always been banned.
So there are much stricter rules and antibiotic use tends to be far lower in the United States. I think they even have banned antibiotic use in organic farming, which is probably not a good idea, because sometimes, you know, animals will, will require some treatment.
As an organization, we, we do not campaign against all use of antibiotics in farming, we are against the routine use of antibiotics in farming. So what do we mean by that? Well, we mean things like in some countries you can use antibiotics for
promotion, the growth of animals to make them grow faster. This is something that, you know, we're totally against that that has always been banned in organic farming, but in non organic farming in say in the United States that was only stopped in 2017.
And, you know, in Europe, it stopped in 2006. But there, there is also a lot of routine use for prophylaxis for prevention. So where it's just added to animal feed or to the drinking water.
In order to prevent the animals from falling sick. Very often, because of the conditions in which those animals are kept, you know, in these very intensive farms where it's much easier for disease to spread.
So this routine prophylaxis is still completely legal in the United States and is very much supported in many ways by, you know, the farming industry, the pharmaceutical industry very often and the US government.
In Europe, they've actually banned that in 2022. But, you know, whether the ban is being fully implemented, we're not quite sure it probably is in some countries, but not in others.
But this routine prophylaxis was never allowed in organic agriculture. And so yes, but there can of course be resistant bacteria in organic animals just as, you know, we've discussed it there are probably resistant bacteria in humans, you know, even those that have not received recently received antibiotics will probably have some so there is always
you know, that potential as well. Yeah.
I want to draw the comparison I want to make a comparison between this phenomenon phenomenon of antibiotic resistance and viruses.
So, we are now familiar with pandemic, what it is about. And because of the COVID pandemic, we know that big ag activities are a risk of zoonotic diseases.
But my question is, why is anti biotic resistance more virulent, so to speak, you know, to, to take some language from the side of viruses and their treatment, you know, why is it not more prevalent in in, you know, you talked about one million
deaths caused by this antibiotic resistance. Why is it not more actually.
What are those mitigating factors of.
Is it the antibiotics.
And, and also, is there, because we learn from the pandemic that it doesn't matter where you live in the on the planet. If there's an outbreak somewhere, you know, there will be everywhere, you know, the virus will travel the virus knows no frontier.
Is it the same with antibiotic resistance.
Yeah, so why are why is antibiotic resistance not not causing more deaths. It is, as I mentioned, it is associated in some way with four and three quarter million deaths.
So it is, you know, very significant, but it's only considered to be directly the cause of about 1.1 million deaths. And I suppose the reason why it's, it's not more than that is that we have had, we have discovered many different types of antibiotics.
So, we don't have just one type of antibiotics. So if one type of antibiotic is not working, you can try another one and if it's resistant to one type of antibiotic, it might not be resistant to another.
So usually, when people get these infections, you know, they don't die immediately, you have time to, you know, often to try different treatments until you find, you find the right one.
And so even though right from the beginning of the antibiotic era, we knew that if we overuse antibiotics, we will have antibiotic resistance and what people, you know, some scientists were concerned right at the beginning right in the 1940s people were concerned about this.
Alexander Fleming who discovered penicillin warned in his Nobel Prize acceptance speech in the 1940s that we should not misuse antibiotics, but he wasn't really listened to.
And the reason why is because once we had figured out how to produce antibiotics, or at least one type of antibiotic, we knew we could use the same mechanism just to discover more antibiotics.
And so we began looking and we started finding more antibiotics. And so we built up this arsenal of different types of antibiotics.
And so there was just a lot of confidence that where we could just, it doesn't matter if this penicillin no longer works, we can just use another one.
But gradually, we stopped finding more and more antibiotics. It took decades, but essentially by the 1980s, we were discovering very few new antibiotics.
Now, even then, we still had antibiotics in reserve. But the reason why there's so much more concern these days is because we have essentially discovered very, very few antibiotics in the last 40 years.
For some infections, we've discovered no new antibiotics for over 40 years.
And so we used to still have, we had discovered so many that we kept some in reserve.
But now we started using all of our reserve antibiotics for these infections as well. So we have nothing left to turn to.
So we just need to manage the antibiotics that we have.
Now, you can by reducing antibiotic use very often, not always, but very often the level of resistance will then reduce.
So there are things that can and should be done.
But I suppose it's a long, slow process. It's not like the outbreak of COVID where suddenly it went, it was suddenly everywhere.
It's because we have lots of different antibiotics.
And it's only gradually that the total number of deaths has really been increasing.
But certainly if suddenly we start to get infections that are resistant to all antibiotics, and that's one thing that people are concerned about, and that has happened, not very often, but it has happened,
then concerns will go even higher.
Sorry, you had a second question, which I've forgotten.
It's about the international aspect of this.
Oh, yes. Yes. So yes, yes, definitely the international aspect is important.
And we know that certain types of resistance have, for example, evolved in some countries and then people travel from country to country.
And also, we know that trade in food and international trade in food and sometimes also international trade in live animals will spread antibiotic resistance around.
And, you know, as the Alliance to Save Our Antibiotics, we work also internationally with other civil society organizations and NGOs,
and have helped co-found the Global Antibiotic Resistance Coalition working with these other civil society organizations.
And there are organizations in it from the United States, from South America, from Asia, Africa, Europe.
So yes, we do work internationally as well.
What do you say about, because my first instinct when I hear all of that is how can I protect myself as an individual?
And I get all sorts of weird thoughts like, I know that Vietnam has some of the worst cases, rates of antibiotic resistance.
And now I'm learning that it could be present in the food. Should I stop, you know, getting imported food from Vietnam?
But then I also draw from the lessons we learned from the COVID pandemic.
And I know that this is about public health and not just my, you know, what I can do as an individual, because it's very limited, you know, how I protect myself.
But if I invest in, you know, public health in efforts in changing policies, that's a better way to protect myself.
So what do you make of that decal to me in people?
Yeah, certainly. I mean, as an organization, so we were, the Alliance to Saber Antibiotics was founded by the Soil Association who certify organic farming in the UK, compassion in royal farming, and an organization called Sustain.
And we exist to campaign against the overuse of antibiotics in farming and for better regulation of antibiotics in farming, and also for improvements to animal health and animal husbandry.
Essentially, for a move away from many of the intensive farming methods that are causing animals to fall sick in order to try and reduce the need for antibiotics in the first place.
So that's kind of the approach that we have taken. But at the same time, we also think that many other actors as well can play a role.
So there's a role, obviously, in our view for farmers, there's a role for government and regulators to regulate antibiotics better, but also to regulate farming better so that certain practices are prohibited, you know, the highly intensive
factory farming methods which are causing disease. But also there's a role for supermarkets, for instance, we have campaigned for better supermarket antibiotic policies so that they take their responsibilities
into account because we know that that we've seen in the UK that improvements in supermarket antibiotic policies have helped reduce antibiotic use in UK farming quite substantially.
In fact, we know that campaigners in the United States have, you know, they focused on the chicken industry and they've managed there to reduce antibiotic use in US chicken, but it's still extremely high in US cattle and US pigs.
So there's a role for industry as well and there's also a role for the individual. So in particular, you know, obviously from a medical perspective, you know, the individual shouldn't be overusing antibiotics and they shouldn't be putting
pressure on doctors to prescribe antibiotics unless it's really needed. But also, you know, we really should be avoiding the consumption of, you know, intensively farmed meat and intensively farmed dairy and eggs,
and we should be, in our view, sort of reducing, you know, in rich countries we should be reducing the overall consumption of animal products and only consuming higher quality animal products.
Yes, and, you know, from the point of view of the vegans listening, you know, there is a very good argument here for, you know, encouraging people to reduce or stop their consumption of animal products and to abolish factory farming and those practices.
I realized from your explanation of the situations in Big Ag that there is an alliance with, let's say, Big Pharma, between Big Pharma and Big Ag and how the agriculture industry is actually
a client and an important client of Big Pharma, basically. How important of a client it is?
Yeah, I mean, I suspect that overall, you know, the pharmaceutical industry is making far more money, ultimately, from the human side than it is from the farm side. However, it is nevertheless concerned about, you know, the sales that it has on the farm side.
And it has, well, certainly certain pharmaceutical companies or trade bodies have played an important role in opposing the better regulation of antibiotics use in farming and in casting doubt on whether it is scientifically proven that the use of antibiotics in farming
in any way contributes to the antibiotic resistance problem in human medicine.
But that's very much been a characteristic for many years. You know, in the UK, there is an organization called RUMA, the Responsible Use of Medicines in Agriculture. It's an industry organization, which, although it has changed very much over the past sort of seven or eight years,
I would say like for the first 10 or 15 years of its existence, it really existed to campaign or to lobby against better regulation of farm antibiotics use and to, you know, oppose attempts to link intensive farming with the overuse of antibiotics
and suggesting that there was no resistance transfer from farming to human medicine. And RUMA is an organization that has farming groups as part of it, it has veterinary groups as part of it, and it has the pharmaceutical industry as part of it.
Now, in more recent years, it has to be said that RUMA has somewhat changed its position, although it continues to downplay the extent to which farm antibiotics use contributes to the resistance problem.
But it has in the UK actually set targets for reducing farm antibiotics use and has contributed to some reductions in farm antibiotics use in the UK, like over the last decade, it's gone down by 59% in the UK.
So that's quite a big reduction. But nevertheless, I would say that globally, it remains the case that there is resistance from the pharmaceutical industry in particular to reductions in farm antibiotics use.
So, just last month, there was a, the UN General Assembly met and there was a declaration, a high level declaration from the member countries on antibiotic resistance and this was being planned for a number of years.
And it was a proposal to set a target for reducing global farm antibiotics use by 30% by 2030, which is very, very achievable. It's not not particularly ambitious, but nevertheless, it was the first time that this was going to happen, a global target for reducing farm antibiotics use.
And, you know, certain industry bodies opposed this. And, and the United States and Canada, Australia and New Zealand all opposed it as well.
So it was dropped from the final declaration. And so there is no target for reducing farm antibiotics use was also a proposal for ending the use of antibiotics as growth promoters, it was setting a date for ending that that is all that was also dropped.
So, even in this day and age, there are, there are people who are actually saying we should continue to use antibiotics in animal feed for growth promotion, which is quite extraordinary.
And the United States Department of Agriculture claimed that there was no scientific basis for setting a target for reducing antibiotics use by 30%. Now, bear in mind that US animals, in terms of per essentially per kilo of livestock or per livestock unit are using about six times more antibiotics than UK animals.
And the UK is not even the lowest user in Europe, there are countries that are using, there are some countries that are using even less than the UK. So, the United States is a user of antibiotics in agriculture because it has a very intensive farming system and has weak regulations.
So the idea that 30% reduction that that is not justified is just absurd, they should be reducing it by a lot more than 30%.
So, so yeah, so that that is, that is the reality of the situation, but yes, the pharmaceutical industry has often campaigned against, you know, improvements and they've been very successful in delaying action.
Shocking, truly shocking. Colin, I have two final questions for you. The first one has to do with denial. You said that we are, we have this arsenal of antibiotics. But right now, you know, there are many infections in cases where we just don't have the right antibiotic, and we can't make them anymore.
And I've heard people say, Oh, let's delegate this task to AI. Artificial intelligence will build our next arsenal of antibiotics. How realistic is that?
To be honest, I don't really know. I do know that, you know, ever since I've been working on this topic, which is, you know, over 20 years that I've heard many, you know, supposed breakthroughs, you know, in terms of what the future would hold in terms of new antibiotics.
The reality is, most of the really good antibiotics that we've ever discovered are naturally occurring organisms and naturally occurring substances. And they were much easier to discover before.
You know, the first ever antibiotic was discovered by accident. And it's just not clear, you know, that we have a way of discovering new antibiotics for certain infections.
We may well discover some new ones, but I think it would be very irresponsible to think that that's definitely going to happen. As I said, like for approximately half of all of our infections, we've discovered effectively nothing for over 40 years.
And these are many of the types of bacteria that can come through the food chain, things like E. coli and Salmonella and Campylobacter. There's been nothing new for over 40 years.
So it's not very sensible to sort of think that we are necessarily going to discover, you know, a whole load of new antibiotics. We may well discover some.
There are always some in the pipeline, but they also need to actually not just kill the bacteria, but also not harm the human.
They also need to be able to get to the right part of the human body. So there are many different things that the antibiotic needs to be able to do.
There are always antibiotics in the pipeline, but most of them fail to actually make it. And when they do make it, very often they're no better than what we already have.
So that's the concern as well.
Yes. Thank you for the reminder. And my final question has to do with what would you say to someone who claims, you know, oh, before the discovery of antibiotics, humanity thrived, you know, we were prosperous and we lived for thousands of years.
So what's the big deal if we don't have antibiotics anymore? How does that change the prospects of humanity?
Well, our life expectancy was much lower. Our life expectancy was, I can't remember the exact figures, but something like 45 years or, you know, 50 years before the antibiotic year, the global life expectancy now it's over, you know,
70, 75 years. So life expectancy has gone up massively.
It's not all down to antibiotics, but antibiotics have definitely played a key role in that. And they have helped us revolutionize, you know, modern medicine without antibiotics or something else that can do what antibiotics can do.
A lot of modern medicine is completely undermined.
So I guess every time you need to have a, for instance, an open heart surgery or something akin to that, your chances of dying from that surgery increase dramatically.
Yes. So if you have a hip replacement, for example, with antibiotics, you've got maybe like a half a percent to 2% chance of it becoming infected.
If you get, you know, preventative antibiotics, then even if it is infected, then you can use some other antibiotics to treat it.
But if you don't, you're talking about more like 40 or 50% chance of infection.
And then once you have an infection, something like a 30% chance of dying. And that's just from something like a hip replacement.
So, so yeah, antibiotics really have helped, you know, transform modern medicine.
And every time you go outside, you will be thinking, oh, what if I get a cut because I heard stories of, you know, people who lived before antibiotics and they get a cut playing outside and they die from infection from that small cut.
So yes, I mean, my own uncle, who was two years old when he died from, you know, appendicitis, just having his appendix taken out.
And, you know, he was, he was born just before the antibiotic era.
A few years later, his life would have been saved.
But pretty much every family in the world has stories like that before the antibiotic era. You know, child mortality was much higher.
And this, this was quite common before the antibiotic era.
Wow. And it's right up there with the invention of the wheel.
Yeah.
And we're playing with that, you know, with such such a lack of mindfulness and for what, you know, for what?
Yes, this is, this is the issue.
And, and of course, the reason we use antibiotics so antibiotics have been, I suppose, one of my last thoughts will be antibiotics have been incredible for, for human health and for human welfare.
But broadly speaking, they've been really bad for animal health and animal welfare, because the main thing that we use them for is so that we can keep animals in worse conditions.
Though it hasn't, it hasn't improved their health and their welfare.
It's actually just enabled a lot of highly intensive farming practices, which lead to high levels of stress and poor health for the animals.
And so they probably, even though we've benefited massively from the antibiotics, the farmed animals, you know, most of them, some of them certainly have benefited from the antibiotics, but most of them have not.
With factory farming, would it have been possible without antibiotics?
At the time, probably not. Now they are developing, you know, chica intensive chicken farming can.
There are certain antibiotics that are not medically important. They're too toxic to be used in humans.
They can't be used in chicken farming. So that can help them control certain infections. I think highly intensive chicken farming can be possible with very low levels of antibiotics, but a lot of the other forms, particularly pig farming, factory farming, is not really possible without excessive antibiotic use.
I don't think intensive chicken farming would have developed in the same way either without antibiotics. At the time, it was key to the development of factory farming.
Wow.
Colin, thank you so much for your time. Thank you for all your wonderful insights and knowledge on this issue. I don't understand how you're so calm and I guess you're used to it, but this is such an urgent issue.
You just want to scream those facts to everyone. I hope our listeners will share this conversation with their family members and their community because it's really the issue of our time.
Thank you very much for having me on your program. That's been a very nice speaking.
Thank you everyone for listening. I kindly invite you to share this podcast with the vegans you know. Let's encourage more people to take action.
Again, thank you so much for caring and I will see you next Tuesday for a new episode.