Public health advocate

Abstract

With antimicrobial resistance mounting, an important public health goal is to preserve therapeutic effectiveness of remaining antimicrobials. To that end, fewer antimicrobials should be used in human medicine and in agriculture. Public health initiatives to reduce antimicrobial overuse could benefit from concurrent collection of agricultural usage data; they could aid scientific understanding of the resistance problem and confirm the efficacy of interventions. Data collection in this context should be a priority. However, usage data are nonessential to achieving the public health goal. U.S. regulation of agricultural antimicrobials today is very reliant on risk assessment. While more data can be useful for use in risk assessment, microbial risk assessment itself may not be well suited to the purpose of reducing antimicrobial overuse. Among other recognized shortcomings, current microbial risk assessment models typically fail to account for the essential ecological nature of antimicrobial resistance. This makes it inadequate for fully characterizing the human health or ecological risks of animal antimicrobials. European success at phasing out unnecessary antimicrobial usage in agriculture, on the other hand, has derived from decisions based on public health concerns and political will, and not on the collection of usage data or on the successful completion of a risk assessment.