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Using ‘One Health’ to tackle AMR

by Guest Author on 26 Jun 2019

Antimicrobial resistance (AMR) is one of the greatest threats to human health. That’s why, today in the House of Commons, the UKRI Cross Council AMR Initiative is speaking face to face with MPs and decision makers about their ‘One Health’ approach to the problem. But what is this approach? And what does it mean for researchers? Ruth Zadoks, Professor in Molecular Epidemiology at the University of Glasgow, tells us about this important interdisciplinary area of research.

SNAP-AMR team photo

Ruth (middle, front row) with the interdisciplinary team of UK and Tanzanian investigators working to support the national action plan on AMR in Tanzania.

Ever since Alexander Fleming discovered penicillin, there have been concerns about the over-reliance on antibiotics to treat diseases. Even Fleming himself cautioned against their over-use.  Training as a vet in the Netherlands in the late 80s and early 90s, I was taught that a lack of indication is a contraindication – in other words, if you don’t have a specific reason to use antibiotics, then don’t use them. But veterinarians and medics didn’t necessarily practice what they preached.

Since those days, there’s been a tangible and widespread shift in attitudes towards the use of antibiotics in both human and veterinary medicine. We’ve seen a growing understanding that antibiotic resistance, the bacterial component of antimicrobial resistance (AMR), jeopardizes animals and humans alike, is present in different medical, environmental and societal contexts across the globe, and crosses borders by land, water and air. Recognition of this complexity is what has underpinned the ‘One Health’ approach to tackling AMR.

Tailoring the approach

Tanzanian drug store sign.

Tanzanian drug store sign.

Since AMR is found in bacteria from animals and humans, it’s a problem that can’t be solved by looking at either in isolation.  And since AMR exists in a wide variety of countries and different cultures, we need to find solutions that fit best in any given environment. We won’t solve the AMR problem by imposing actions that aren’t relevant, practical or acceptable in a particular situation, even if the same interventions may be successful in a different country.

For example, in a low-income country, like Tanzania, there is little to be gained from promoting better use of antibiotics among doctors, when the availability of doctors and access to them is the overriding challenge for many people living there.

Logo of the SNAP-AMR team’s project in Tanzania.

As natural scientists, we must work with social scientists, including behavioural and health economists, media experts, anthropologists and others, to really understand the complexity and drivers of AMR. Only then can we appreciate the countries’ cultural diversity and translate our biomedical understanding of AMR into societally appropriate approaches to tackling it. This is what we try to do in our MRC-funded project on Supporting the National Action Plan on AMR in Tanzania, or SNAP AMR: develop solutions that are relevant and practical in Tanzania.

We all have a role to play

Not one discipline, be that natural science, social science or business, has the magic bullet for solving the AMR problem. That’s why funding of interdisciplinary research and approaches is so critical. Interdisciplinary working is complex and time-consuming, and it doesn’t necessarily lead to the sort of technological solutions that western society tends to value, but it’s essential.

In addition, we as individuals can all play our part in addressing AMR.  There’s been a growing public understanding of antibiotic use and an increasing acceptance that we need to use them “as much as needed, as little as possible”.  So too, we need to see a growing sense that by taking care of our health, for example by getting vaccinated and through lifestyle choices, we can be part of the solution. In low- or middle-income countries, we need to invest in not just AMR control, but also in basic health care and sanitation to prevent disease.

The AMR challenge facing us is large and complex, and will require fresh and innovative thinking about disease, mortality and society. But by using this holistic ‘One Health’ approach, we can meet the challenge head on and improve the lives of people across the world.

The SNAP-AMR project is funded by the MRC through the Global Challenges Research Fund (grant number MR/S004815/1). Read more about AMR on the blog:
From deep-sea sponges to dragonfly wings: superbug research from unexpected places
Antimicrobial resistance in Thailand: taking a holistic approach
Superbugs vs Superheroes: getting creative with antimicrobial resistance

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