title: An Integrated Systems Approach is Needed to Ensure the Sustainability of Antibiotic Effectiveness for Both Humans and Animals.
abstract: The growing demand for animal products and the widespread use of antibiotics in bringing food animals to market have heightened concerns over cross-species transmission of drug resistance. Both the biology and emerging epidemiology strongly support the need for global coordination in stemming the generation and propagation of resistance, and the patchwork of global and country-level regulations still leaves significant gaps. More importantly, discussing such a framework opens the door to taking modular steps towards solving these challenges - for example, beginning among targeted parties rather than all countries, tying accountability to financial and technical support, or taxing antibiotic use in animals to deter low-value usage of these drugs. An international agreement would allow integrating surveillance data collection, monitoring and enforcement, research into antibiotic alternatives and more sustainable approaches to agriculture, technical assistance and capacity building, and financing under the umbrella of a One Health approach.
authors.affiliation: Professor of the Practice of Public Policy and Global Health and Director of the Program on Global Health and Technology Access at the Sanford School of Public Policy at Duke University and Duke Global Health Institute in Durham, NC.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: So
authors.affiliation: Associate in Research at the Program on Global Health and Technology Access at the Sanford School of Public Policy at Duke University and Duke Global Health Institute in Durham, NC.
authors.forename: Tejen A
authors.initials: TA
authors.lastname: Shah
authors.affiliation: Food Safety Program Director at Food Animal Concerns Trust in Chicago, IL.
authors.forename: Steven
authors.initials: S
authors.lastname: Roach
authors.affiliation: Director of Programmes at the Third World Network in Penang, Malaysia.
authors.forename: Yoke
authors.initials: Y
authors.lastname: Ling Chee
authors.affiliation: Assistant Professor, Departments of Environmental Health Sciences and Health Policy and Management at Johns Hopkins Bloomberg School of Public Health, and a Program Director at the Johns Hopkins Center for a Livable Future at Johns Hopkins University in Baltimore, MD.
authors.forename: Keeve E
authors.initials: KE
authors.lastname: Nachman
mesh_terms: D000822:Animal Husbandry; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003299:Cooperative Behavior; D004352:Drug Resistance, Microbial; D019649:Food Industry; D014943:Global Health; D006291:Health Policy; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents