Antibiotic resistance is a growing threat to global health. As a result of infection with drug-resistant bacteria an estimated 700 000 people die each year worldwide. A total of around 33 000 die annually in the European Union and European Economic Area, and this number is increasing all the time.

Many of the same microbes (e.g. bacteria, viruses, fungi, parasites) affect both animals and humans via the environment they share and 60% of all human diseases originate in animals. This means that when microbes develop drug resistance in animals, they can easily go on to affect humans, making it difficult to treat diseases and infections.

“Human, animal and environment health are all equally responsible for the correct use of antimicrobials and to avert the threat of antimicrobial resistance,” said Dr Zsuzsanna Jakab, WHO Regional Director for Europe. “As we strive to ensure that antibiotics are rightly used in the community and in health-care settings, one sector alone will not solve the problem. A ‘One Health’ approach brings together professionals in human, animal, food and environment health as one force, and as such is the only way to keep antibiotics working. I call on all European countries to secure the highest commitment to this approach from the whole of society and the whole of government.”

“With 33 000 deaths each year as a consequence of an infection due to bacteria resistant to antibiotics and €1 billion in annual health-care expenditure, we need to ensure that antibiotics are used prudently and that infection prevention measures are in place in all settings across Europe,” stated Andrea Ammon, Director of the European Centre for Disease Prevention and Control (ECDC). She added, “Since the rates of antibiotic resistance and the rates of antibiotic consumption as well as infection prevention practices vary from country to country, it is essential to tailor strategies to address specific needs. ECDC calls for continued action at all levels”.

This year, the WHO European Region will mark the 4th annual World Antibiotic Awareness Week on 12–18 November, by committing to closer collaboration across sectors to protect human, animal and environment health, in the spirit of One Health.

One voice for One Health

For World Antibiotic Awareness Week 2018, WHO/Europe is joining forces with the Food and Agriculture Organization of the United Nations (FAO) Regional Office for Europe and Central Asia and the World Organisation for Animal Health (OIE) Sub-Regional Representation for Central Asia to urge governments to adopt or strengthen their use of the One Health approach.

The situation is urgent for a number of reasons:

Antimicrobials are widely used in livestock production, sometimes to promote growth and sometimes to prevent infection, rather than treating the animal. This overuse of antimicrobials can lead to more drug resistance among microbes.

The same classes of antimicrobials are often used in both humans and food-producing animals.

The food chain is an important route for transmission of disease and requires close monitoring and coordination to prevent its spread.

All this indicates that no single sector has the capacity to solve the growing problem of antimicrobial resistance alone, but collective action can help the world make progress. The One Health approach means coordinating action across sectors – such as public health, veterinary and environment health – to achieve the best possible health outcomes for all species. It means recognizing that resistant microbes know no borders – they can easily cross from humans to animals and spread from one geographic location to another.

One effective way of protecting human health is by reducing the chances of resistance developing among microbes in animals. Many governments are phasing out the use of antibiotics as a growth promoter and preventive measure in livestock, and now only use antimicrobials in healthy animals in very exceptional circumstances. Countries that have not already done so are urged to take steps to ensure that the drugs on the reserved lists of essential antibiotics, those which are of the greatest importance to human and veterinary health, are used only when absolutely necessary. This helps prevent antimicrobial resistance from forming and keeps antibiotics working, for humans and animals alike.