by Chris Reinhardt, feedlot specialist
A very smart scientist once said, “Anyone who claims they fully understand antimicrobial resistance simply hasn’t studied it enough yet!” Development of antimicrobial resistance by bacteria is a very complex issue that even the brightest in the human health and animal health communities do not fully comprehend, let alone can unequivocally say it’s an issue for which they have identified definitive causes and solutions. So if a lay person, a talking head, or a blogger claims to have all the answers, we’re best off to take their opinion with a grain of salt and keep searching.
That said, there are few issues with so broad a gap between the potential future human and animal health ramifications and our collective impotence at devising truly effective control practices. We know that unchecked growth in resistance could be disastrous, yet none of the smart people who study this and who I trust can say with any degree of certainty that any of the proposed measures—including complete abolition of use—will have any significant impact on resistance.
In light of that uncertainty, some argue for a “stay the course” approach until science and understanding can provide some sure solutions. Others suggest a “precautionary principle”, choosing instead to err on the side of logic, even if that logic is unproven, hoping that some action is better than none at all.
So (1) we lack comprehensive understanding of the underlying science behind the issue, (2) we lack a consensus among reasonable and influential parties as to practical and useful solutions, and (3) we lack an even remote illusion that we can control what happens in other parts of the world in which there is less robust oversight of antimicrobial use in humans and animals and of food production practices in general, and oftentimes greater and more widespread prevalence of infectious diseases which encourages the use and often abuse of any available antimicrobials.
The point is that if use and abuse of antibiotics do in fact perpetuate growth in bacterial resistance to antimicrobials, there is concern regarding the current inability of some countries or regions of the world, due to insufficient funding and infrastructure, to police any future policy designed to limit use in order to control the growth of resistance.
H.L. Mencken, another smart person, said, “For every complex problem there is an answer that is clear, simple, and wrong.” I paraphrase and shorten this to, “Complex problems have no simple solutions.” We’ve got to do the seriously heavy lifting to get to meaningful outcomes. Einstein is credited for saying, “We cannot solve our problems with the same thinking we used when we created them.” I doubt Alexander Fleming in 1928 knew the next-level challenges that would arise nearly 100 years after his discovery of penicillin.
The good news is that the debate continues, and the smart, reasonable-thinking, people are at the table, here and abroad, trying to hammer out solutions which are not clear or simple but which hopefully will be right long-term for human health and for food production, which will be forever inextricably linked.