Special report: Many treatments in modern medicine would be impossible without antibiotics but increased resistance to these drugs means there needs to be a shift in the focus of research and closer collaboration between different scientific disciplines
On a global scale many pathogens with animals as natural reservoirs can, via a particular series of events, cross species borders and infect humans, resulting in limited cases but sometimes causing pandemics. From a biological point of view, humans are just another animal species. Some infections, such as measles, have changed from primarily infecting animals to instead having humans as their only host.
The arena for infections is different today: we are seven billion humans – the second most common mammalian species – while there are approximately 75 billion domestic animals linked to human consumption of meat, where broilers dominate. The expansion of these monocultures has devastating effects on biodiversity. Unexpected things such as the introduction of emerging diseases can and will happen at the intersection of these ecological systems.
Infectious disease is a rapidly increasing problem for society and the whole medical profession. Old as well as new emerging micro-organisms cause suffering and induce costs for humans and animals. In order to put a stop to the spread and effects of infections, Uppsala University invests in One Health: One World, One Medicine. The concept is based on the fact that animals – wild and domestic – as well as humans are to a large extent exposed to the same pathogens, including those resistant to antibiotics, and that all of these therefore need to be studied with a wide ecological perspective.
In order to meet these challenges and fight infection there is a need for close collaboration between different disciplines. In Uppsala, world-leading expertise within human and veterinary medicine, ecology and microbiology is in place to fight infection and antibiotic resistance. Uppsala University has a solid long-standing research tradition of drug development in close cooperation with industry which is a prerequisite for the development of new drugs, such as antibiotics.
What is a human? The number of bacteria in our bodies is tenfold the number of own cells. We have even incorporated virus genes into our genome – we are surrounded by micro-organisms. A substantial proportion of humans would not have been even alive if it was not for antibiotics. Many treatments used in modern medicine would not be possible without antibiotics, for example organ transplants, cancer treatment and neonatal care, but increased antibiotic resistance means that the focus will have to shift.
In Sweden this is still a relatively small problem, but not on a global scale. In Europe 25,000 people are dying from infections with resistant bacteria every year. In developing countries the number is running out of control. Antibiotics are used for treatment and prevention in humans, treatment and prevention in companion animals, and –more of a problem – in many countries for growth promoting purposes in farm animals, which is horrendous and unethical.
Swedish veterinarians have been in the forefront when it comes to banning antibiotics for growth promoting purposes, and a restricted use for therapeutic purposes. In many other countries antibiotics are still used in animal production in a way that threatens human health. Outsourcing the production of antibiotics to poor countries with little control has led to gigantic problems with antibiotic substances spread into the environment. It is time to realise that we are ambassadors for the coming generations, but we must do it now.
In our new cooperative constellation several research disciplines – together with networks such as Infection Ecology & Epidemiology Network, a university project initiated in 2010; ReAct, a global network initiated in 2006 to fight antibiotic resistance; and RAPID, a centre for development of new antibiotics – we presently make a huge joint effort for One Health, One Medicine through research and development. We strive to find new optimal ways for society, to prevent, fight and cure infection under the banner One Health Sweden.
To communicate with a wide scientific and public audience we have created an open access journal, infectionecologyandepidemiology.net
, which is Pubmed indexed. There is no publication fee during 2013 so scientists within any discipline in the global field of One World One Health are welcome to send in contributions.
Björn Olsen is a senior physician and professor in infectious diseases at Sweden's Uppsala University