The World Health Organisation (WHO) considers antibiotic resistance to be one of the “biggest threats to global health, food security, and development”. Now, a report led by the Bureau of Investigative Journalism reveals that thousands of tonnes of colistin – what medics refer to as the “last hope antibiotic” – is being shipped to countries like India for use in livestock farming, which is bad news for everyone.
Colistin is one of the world’s strongest antibiotics, often prescribed by doctors as a last-ditch attempt at staving off infections in patients who are unresponsive to nearly all other medication. Yet, colistin and other drugs are frequently used in agriculture, not just to treat diseased animals but to keep livestock fat and healthy.
While the use of antibiotics as growth promoters is illegal in the EU (2006) and US (2017), the practice is widespread and unregulated in large parts of the world. In some countries, roughly 80 percent of medically important antibiotics are used in livestock farming, often as growth promoters in otherwise healthy animals. According to the report, more than 2,800 tonnes of colistin for use in farming was shipped to countries including India, Vietnam, Russia, South Korea, Nepal, Mexico, Guatemala, El Salvador, Columbia, and Bolivia in 2016. The Bureau estimates the real figure is higher than that.
“Colistin is the last line of defense,” Timothy Walsh from the University of Cardiff, an adviser to the UN on antimicrobial resistance, told The Bureau. “It is the only drug we have left to treat critically ill patients with a carbapenem-resistant infection. Giving it to chickens as feed is crazy.”
But if nothing is done, things could get much worse. Experts have predicted that agricultural use of antibiotics will be 53 percent higher in 2030, in comparison to 2010. In India, "the epicenter of the global drug resistance crisis", demand for antibiotics in chicken-rearing will increase fivefold within the same timeframe.
Antibiotic resistance occurs naturally – it's Darwinian – but misuse of antibiotics in medicine and farming is rapidly speeding up the process. What's worse, according to a 2017 WHO report, there is a "serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance".
Infections such as pneumonia, salmonellosis, and gonorrhea are increasingly hard to treat as the drugs are becoming less effective. Drug-resistant tuberculosis, for example, currently kills around 250,000 people every year. By 2050, we can expect some 10 million people a year (4.7 million in Asia) to die from diseases that should be curable if no action is taken to reverse the trend.
"The antibiotic pipeline is modest at best so we must act quickly to preserve our last-resort drugs," said Walsh. "If we don’t act now by 2030 colistin will be dead as a drug. We will have serious drug-resistant infections and nothing to use against them.”