Experts agree that a holistic approach encompassing human, animal, plant and environmental health is the only way to effectively fight antimicrobial resistance. Dr Anthony Huszar sees infrastructure as another key battleground.
A communique from the health ministers of the Group of Seven (G7) advanced economies on 4 June 2021 reaffirmed their war on ‘superbugs’ – microbes responsible for common illnesses which have become resistant to conventional treatments. Antimicrobial resistance (AMR) is a growing global threat that, if left unaddressed, will cause 10M additional deaths per year, globally, by 2050, with a cumulative global economic cost of US$100trn. The communique underlined the importance of a holistic ‘One Health’ approach which views human, animal, plant and environmental health as interlinked.
“We encourage close coordination and collaboration including full integration of environmental and ecosystem work,” the G7 health ministers said. “This is crucial in order to improve the international system’s ability to prevent, detect, report and respond to current and future health threats, including by promoting transparency and facilitating the rapid sharing of data, samples and information.”
The United Nations Environment Programme (UNEP), the Food & Agriculture Organization (FAO), the World Organisation for Animal Health (OIE) and the World Health Organization (WHO) have joined forces to make a One Health approach central to their work. Most in the field of infectious disease control and prevention are rightly delighted by the commitment, collaboration, and hope provided for the future.
But in addition to human, animal, plant and environmental health, One Health should also encompass the built environment and infrastructure. From the poorest nations to the richest, pollution and degradation of the natural environment cuts lives short and contributes to a wide swathe of illnesses. Much of that pollution and degradation arises from building, operating and using infrastructure.
Infrastructure also plays a part in harbouring germs and spreading infection, as illustrated by the COVID-19 pandemic, which was spread via everything from escalator handles, the buttons of ATM cash dispensers and grab rails on public transport to heating, ventilation and air conditioning (HVAC) systems. Transport systems circulated the coronavirus around the world in a matter of weeks. While COVID-19 is caused by a virus, similar transmission pathways should be considered for bacterial infections and in particular antimicrobial resistant bacteria.
One Health: three levels
A One Health approach to tackling AMR can be divided into three operational levels, affecting the infrastructure industry in different ways: