The concern and confusion that exist among the general public and policymakers about antibiotic use on farms represent a threat not only to the future of poultry and livestock production but to the health of humans and food-producing animals globally.

The message from the November 13–15 symposium, “A one health approach to antimicrobial use and resistance: A dialogue for a common purpose,” is that poultry and livestock producers have a lot to lose and need to take the initiative in resetting the dialogue about the issue.

Keynote speaker Dr. Lonnie King, who is the dean of Ohio State University College of Veterinary Medicine, told symposium attendees that the scale and complexity of animal and human medical problems embedded in a changing environment demand that scientists move beyond the confines of their own disciplines and explore new organizational models for teamwork.

Currently, there’s a divide between the human health community and the animal health community over who’s to blame for the problem of antimicrobial resistance and what action should be taken.

King said this impasse is an example of a wicked problem, a concept documented in business circles. “Wicked problems often occur as organizations face constant change and unparalleled challenges; they often occur in a social context with diverse opinions from numerous stakeholders,” he explained. This can lead to indecision and stalemate.

A white paper produced by the symposium’s sponsor, the National Institute of Animal Agriculture, explains the challenge as follows: “The issue of antimicrobial resistance is not strictly an issue of science-based decision-making. Like many other aspects of food production, the issue of antimicrobial resistance invokes differing opinions, and given the intricacies and size of the modern food production system, it’s a foregone conclusion that any policy issue will invoke many different perspectives.”

King and the NIAA advocate a “one health” approach that would involve the collaborative effort of multiple disciplines – working locally, nationally and globally – to attain optimum health of humans, animals and the environment. “This is not a new concept,” he said, “but had greater acceptance prior to the specialization of medicine.”

The need for action is acute, King said, due to many reasons including the accelerated human-animal interface, which is a global phenomenon.

“Antimicrobial resistance is caught up in a network of other societal issues evoking emotions and anger,” he said. It is incumbent on animal agriculture to search for common ground – ideas to break the impasse.

King provided a list of actions for the animal agriculture industry to consider:

• Consider specific classes of antibiotics reserved for animals

• Determine incentives for pharmaceutical companies – discovery and products to market

• Develop, implement and adopt international standards for usage

• Improve data collection and sharing to ensure early detection of resistance in order to make adjustments – integrated surveillance strategies

• Incorporate use and plans for new vaccines – leverage the “decade of vaccines”

• Stimulate and emphasize disease control, prevention and sanitation to reduce the need for usage

• Mandate training for all health professionals in the judicious use of antimicrobials and all health science students

• Adopt strategies and drugs for targeted use

• Adopt a "one health" mindset across all domains and involve all interests and concerns

• Place agreements and solutions clearly in front of decision-makers, national organizations and agencies; a political will is necessary

• Create and implement a new educational campaign

• Develop a new economic model – sponsor and hold a national forum on the topic

• Decide on leadership and followership roles

“The greatest power is to change the game, turning adversaries into partners; shift the focus from one of an intractable issue to new perspectives and options,” King said. “Even though this is a wicked problem, it can be successfully ameliorated, although not necessarily completely resolved.”