If you do not appreciate the significance of the link between antimicrobial resistance and antibiotic use in livestock, this book will leave you in no doubt as to the extremely close, complicated and politically fraught nature of the relationship.
‘One health and the politics of antimicrobial resistance’ describes the history of antibiotic use in animal agriculture, from its beginnings to the current day. It explains how antimicrobial resistance and new infectious diseases developed in animals can be passed around the world, to humans, and between other species. Yet while most, but not all, of the science is clear, the politics is complicated.
Author, physician and research scholar Laura Kahn suggests ten action points in her conclusion to help resolve the issues, but her presentation of all sides of the argument appears fair and unbiased.
All the facts are here, with 18 pages of appendices listing Congressional and US Food and Drug Administration activities relating to subtherapeutic antibiotic use in livestock and antibiotic resistance. A further 50 pages of notes and references (out of a total of 193 pages) make this a comprehensive reference source.
The bulk of the text compares the experience and learnings from five geopolitical points of view: the United States, the UK, Sweden, Denmark, and the EU. The differences in political arguments and scientific approaches are significant, but the solutions remain unclear. In the United States, for example, almost 80% of all antibiotics sold are used in livestock, while the use of antibiotics as growth promoters was banned in the EU in 2003. Neither approach has satisfied all the vested interests.
The main points of this book are of interest to anyone in pharmacy, but the each page of the main text must be read closely to find and understand them. There are no illustrations, diagrams or summaries. Few except those with a specialist interest are likely to be interested in, for example, the minutiae of 30 years of veterinary and agricultural science practice and legislation in Sweden.
But there are some absolute gems of wisdom for the UK pharmacy profession. Take the first of Kahn’s ten recommendations: “Veterinarians, farmers, and the pharmaceutical industry must be partners, not adversaries, in addressing antibiotic resistance”.
For such a comprehensive book on a fundamentally important topic, £22.00 for a paperback version represents good value for money.
Steve Bremer
References
‘One health and the politics of antimicrobial resistance’, by Laura Kahn. Pp 193. Price £22. Baltimore: John Hopkins University Press; 2016. ISBN 978 1 421420 04 2
