Antibiotic resistance is a complex public health issue that requires a One Health approach. The overuse and misuse of antibiotics in human medicine, agriculture, and the environment has contributed to the emergence and spread of antibiotic-resistant bacteria. A holistic, multisectoral response is needed that promotes prudent antibiotic use and prevents infection across human, animal, agricultural, and environmental domains.

1. “ANTIBIOTIC RESISTANCE
IN THE ENVIRONMENT
THROUGH ONE HEALTH
PERSPECTIVE”
PREPARED BY:
DEEPIKA JAIN
M.V.Sc. (Ist Year)
Vety. Public Health

2. ONE HEALTH
 The One Health concept recognizes that the health of people is
connected to the health of animals and the environment.
 One Health is defined as a collaborative, multisectoral and
transdisciplinary approach — working at the local, regional,
national and global levels — with the goal of achieving optimal
health outcomes recognizing the interconnection between
people, animals, plants and their shared environment.

4. BACKGROUND
 One Health is a new phrase, but the concept extends back to
ancient times.
 The recognition that environmental factors can impact human
health can be traced as far back as to
the Greek physician Hippocrates in his text "On Airs, Waters,
and Places".
 He promoted the concept that public health depended on a clean
environment.

5. ANTIMICROBIAL
RESISTANCE
 Antimicrobial resistance (AMR or AR) is the ability of a microbe
to resist the effects of medication that once could successfully
treat the microbe.
 The term antibiotic resistance (AR or ABR) is a subset of AMR,
as it applies only to bacteria becoming resistant to antibiotics.

7. CONT…
 Addressing the rising threat of antimicrobial resistance (AMR)
requires a holistic and multisectoral approach – referred to as
One Health – because antimicrobials used to treat various
infectious diseases in animals may be the same or similar to
those used for humans.
 Resistant bacteria arising in humans, animals or the environment
may spread from one to the other, and from one country to
another.
 AMR does not recognize geographic or human–animal borders.

8. CONT…
 WHO, the Food and Agriculture Organization of the United
Nations (FAO) and the World Organisation for Animal Health
(OIE) speak with one voice and take collective action to minimize
the emergence and spread of AMR.
 Their aim is to:
• Ensure that antimicrobial agents continue to be effective and
useful for curing diseases in humans and animals.
• Promote prudent and responsible use of antimicrobial agents.
• Ensure global access to medicines of good quality.

9. CONT…
 Antimicrobial resistance (AMR) is a complex public
health concern.
 National, regional and global policies should address the
complex factors driving AMR, and be based on public
health principles such as surveillance, prevention,
containment and research.

10. CONT…
 The Global action plan sets out 5 strategic objectives:
• To improve awareness and understanding of AMR.
• To strengthen knowledge through surveillance and research.
• To reduce the incidence of infection.
• To optimize the use of antimicrobial agents.
• To develop the economic case for sustainable investment that
takes account of the needs of all countries and to increase
investment in new medicines, diagnostic tools, vaccines and other
interventions.

11. CONT…
 The World Health Assembly also urged all Member States to develop and have
in place by 2017 a national action plan on AMR that is aligned with the
objectives of the Global action plan.
 In collaboration with the Food and Agriculture Organization of the United
Nations (FAO) and the World Organization for Animal Health (OIE), WHO
developed a manual to assist countries in preparing or refining their national
action plans.
 WHO compiled a library of existing, publicly available national action plans on
AMR which countries can consult. This library will be updated regularly as new
information becomes available on national action plans and as new plans are
published. WHO welcomes any additional information of relevance to existing
and newly developed national action plans.

12. CONT…
 Surveillance provides a basis for taking action to control
antimicrobial resistance (AMR).
 Consistent and high-quality data on the incidence,
prevalence, range across pathogens and geographical
patterns related to AMR are needed to guide the treatment
of patients; to inform local, national and regional actions;
and to monitor the effectiveness of interventions.

13. WORLD ANTIBIOTIC AWARENESS
WEEK
 World Antibiotic Awareness Week (WAAW) aims to increase
awareness of global antibiotic resistance and to encourage best
practices among the general public, health workers and policy-
makers to avoid the further emergence and spread of antibiotic
resistance.
 The overall theme of the campaign, Antibiotics: Handle
with Care, reflects the overarching message that antibiotics
are a precious resource and should be preserved.

14. CONT…
 WORLD ANTIBIOTIC AWARENESS WEEK 2019 WILL BE
CELEBRATED FRON 18TH TO 24TH NOVEMBER.

15. ANTIMICROBIAL RESISTANCE: A ONE
HEALTH PERSPECTIVE
 One Health is the collaborative effort of multiple health science professions to
attain optimal health for people, domestic animals, wildlife, plants, and our
environment.
 The drivers of antimicrobial resistance include antimicrobial use and abuse in
human, animal, and environmental sectors and the spread of resistant bacteria
and resistance determinants within and between these sectors and around the
globe.
 Most of the classes of antimicrobials used to treat bacterial infections in
humans are also used in animals. Given the important and interdependent
human, animal, and environmental dimensions of antimicrobial resistance, it is
logical to take a One Health approach when addressing this problem.

16. CONT…
 Major concerns in the animal health and agriculture sectors are
mass medication of animals with antimicrobials that are critically
important for humans, such as third-generation cephalosporins and
fluoroquinolones, and the long-term, in-feed use of medically
important antimicrobials, such as colistin, tetracyclines, and
macrolides for growth promotion.
 In the human sector it is essential to prevent infections, reduce
over-prescribing of antimicrobials, improve sanitation, and
improve hygiene and infection control.
 Pollution from inadequate treatment of industrial, residential, and
farm waste is expanding the resistome in the environment.

17. ANTIMICROBIAL RESISTANCE IN THE
ENVIRONMENT
 The spread and contamination of the environment, mainly though
the so called “hot spots” like hospital wastewaters or un-
completely treated urban wastewaters is considered a serious
public health problem.
 The untreated effluents from livestock farms, or aquaculture can
be enriched for enteric bacteria resistant to one or more
antibiotics.

18. CONT…
 Sewage sludge recycled onto agricultural land can contain
significant amounts of various antibiotics, and antibiotic resistant
bacteria.
 Animal manures from pig farms contain various veterinary
antibiotics.
 Selection of antibiotic resistant bacteria following exposure to
antibiotic residues, and horizontal transfer of antibiotic-resistance
genes from resistant bacteria selected for in the gastrointestinal
tract, represent mechanisms by which antibiotic resistance could be
enhanced in environmental bacterial populations.