(Refugees by Country of origin, Source: Office of the United Nations High Commissioner for Refugees, 2013)
We would like to express our sympathy and support to all the people displaced fleeing from war zones (Syria and others) and specially to those coming to the European area. The agreement reached by the EU with Turkey is not correct, it is a shame for all the EU citizens and a setback for people seeking refuge from terror.
The EU-Turkey statement, signed the 18 March 2016, determines that All new irregular migrants crossing from Turkey into Greek islands as from 20 March 2016 will be returned to Turkey. This will take place, according to the agreement, in full accordance with EU and international law, thus excluding any kind of collective expulsion. All migrants will be protected in accordance with the relevant international standards. Migrants arriving in the Greek islands will be duly registered and any application for asylum will be processed individually by the Greek authorities in accordance with the Asylum Procedures Directive, in cooperation with UNHCR. Migrants not applying for asylum or whose application has been found unfounded or inadmissible in accordance with the said directive will be returned to Turkey.
For every Syrian being returned to Turkey from Greek islands, another Syrian will be resettled from Turkey to the EU taking into account the UN Vulnerability Criteria. However there is a limit of 72000 persons to be resettled into EU.
The EU, in close cooperation with Turkey, will further speed up the disbursement of the initially allocated 3 billion euros under the Facility for Refugees in Turkey and ensure funding of further projects for persons under temporary protection identified with swift input from Turkey before the end of March. Once these resources are about to be used to the full, and provided the above commitments are met, the EU will mobilise additional funding for the Facility of an additional 3 billion euro up to the end of 2018.
(see full text at http://www.consilium.europa.eu/en/press/press-releases/2016/03/18-eu-turkey-statement/ )
In summary, EU sends back people fleeing from the Middle East and beyond to Turkey, and compensates for the trouble with the amount of 6 billion Euro. EU agrees to re-settle a maximum of 72.000 people from Syria. There is no mention to re-settlement of other nationalities. The figures for resettlement are ridiculously low, if you realise that the amount of displaced people in the world is closed to 15 million (2014, UNHCR data), with about 5 million from the Middle East area.
The reasons argued by the EU is that Turkey is a safe Country, capable of hosting people and capable providing them with work, health attention, education and respect for human rights.
That argument is in clear contradiction with the EU Commission staff working document published at the end of 2015 with regard to the possible integration of Turkey in the EU:
http://ec.europa.eu/enlargement/pdf/key_documents/2015/20151110_report_turkey.pdf
The report states the following:
- The independence of the judiciary and respect of the principle of separation of powers have been undermined I Turkey and judges and prosecutors have been under strong political pressure.
- Corruption remains widespread in Turkey. The undue influence by the executive in the investigation and prosecution of high-profile corruption cases continues to constitute a major concern.
- The enforcement of rights stemming from the European Convention on Human Rights (ECHR) and the case law of the European Court of Human Rights (ECtHR) is not fully ensured.
- Turkey needs to effectively guarantee the rights of women, children, and lesbian, gay, bisexual, transgender and intersex (LGBTI) individuals and ensure sufficient attention to the social inclusion of vulnerable groups such as the Roma.
- There are ongoing and new criminal cases against journalists, writers or social media users. Changes to the internet law, which are a significant setback from European standards, increased the government’s powers to block content without a court order on an unduly wide range of grounds.
- Freedom of expression is frequently challenged, in particular through arbitrary and restrictive interpretation of the legislation, political pressure, dismissals and frequent court cases against journalists which also lead to self-censorship.
- Freedom of assembly is overly restricted, in law and practice, in particular through disproportionate use of force in policing demonstrations and a lack of sanctions for law enforcement officers.
- Non-discrimination is not sufficiently enforced, in law and in practice, and the rights of the most vulnerable groups and of persons belonging to minorities are not sufficiently upheld. Gender-based violence, discrimination and hate speech against minorities, and respect for the rights of lesbian, gay, bisexual, transgender and intersex (LGBTI) persons are major areas of concern.
- Criminal and anti-terror legislation is not yet in line with the ECtHR case law and the proportionality principle needs to be observed in practice.
- Turkey is the country hosting the largest refugee population in the world, with about 2.2 million, of which close to 2 million from Syria. Sheltering and integrating such a large population of refugees is a major challenge for the country which has already spent about EUR 6.7 billion in this endeavour. However Turkey should still adopt legislation giving Syrians under temporary protection access to the labour market. This involves in particular drawing up detailed rules and procedures for labour market access, including a list of sectors and provinces where Syrians under temporary protection can be employed.
- On fundamental rights, some developments were at odds with the action plan for the prevention of violations of the European Convention on Human Rights (ECHR), in particular the legislation adopted on internal security. Freedom of expression is of particular concern, with arrests, hearings, detentions, judicial prosecutions, censorship cases and layoffs of journalists increasing as the authorities maintained their pressure on the media and free speech.
- Since September 2014, the European Court of Human Rights (ECtHR) has found that the country violated the European Convention on Human Rights (ECHR) in 92 cases relating mainly to the right to life, prohibition of torture, right to a fair trial, right to respect for family life, freedom of expression, freedom of thought, conscience and religion and right to liberty and security.
- The National Human Rights Institution (NHRI) released several reports. The one on the Gezi protests includes recommendations on torture and ill-treatment, freedom of expression, freedom of assembly, right to life, effective investigation and recommendations for security forces.
- There is no comprehensive approach to missing persons or the exhumation of mass graves. Independent investigation of all alleged cases of extrajudicial killing by security and law- enforcement officers is also lacking.
- Turkey still fails to implement ECtHR case law on mistreatment, conditions in prisons and protection of the right to life. This also includes violation of the right to vote.
- Child labour persisted, including in its worst forms, and needs to be tackled as a matter of priority. The 2014 national employment strategy committed to prevent the phenomenon but its implementation is very limited. Child workers continued to be victims of fatal accidents. Despite existence of social protection measures, including cash transfers, around 30 % of children (7.4 million) live in relative poverty, compared with 23 % of adults. Infant and child mortality continued to fall. No national strategy is in place to prevent violence against children. Nor is there an effective system of monitoring rehabilitation centres and institutions. Research on sexual abuse and ill-treatment of children is insufficient. The average marrying age continued to rise but child and forced marriage persists, mainly in the eastern provinces.
- around 500 000 refugee children have no access to education. Refugees living outside the camps still face difficult living conditions and considerable challenges in accessing essential services. Some 80 satellite cities across Turkey are part of the national hosting system for non-Syrian refugees. Their reception capacity to provide decent living conditions and access to basic services differs from city to city but is generally limited. This has put local capacity and resources under significant strain in many places.
Therefore the conclusion after this devastating report is that Turkey is not up to the standards to join the EU. For the same reasons the conclusion should have been that Turkey is not a safe Country to receive refugees back from the EU zone. Lack of human rights, lack of independent judiciary, child abuse and force child labour, lack of education for refugee children, discrimination, torture.
We only hope that the EU and all its citizens reflect on the fact that human beings fleeing from conflict zones where human rights are lacking, where there is no medical attention, no education for the youth and where only death and misery are present, have all the right to settle elsewhere beyond border restrictions. Sending refugees away is an outrageous cynical act.
Many Europeans feel ashamed of this decision and will continue striving to help and fight to reverse the situation. Refugees are welcome among us.
All4oneworld, April 2016.
Business as usual: post COP-21 reality is cruder than oil.....
Energy Summit, Brussels, Egmont Palace, 23rd February 2016.
The summit was an interesting overview about the EU policy for the following 5-15 years after COP21. According to the COP agreement in Paris (yet to be ratified but considered to be a real success of the international diplomacy), each country has to deliver every 5 years specific plans for reductions in anthropogenic emissions. Those are the so called “Intended national determined contributions (INDCs). The agreement is binding after ratification, but not the INDCs. After this process, where each country or zone (e.g. EU) makes concrete steps and plans to reduce the anthropogenic emissions, the world is supposed to manage the increase in temperature to no more than 2 degrees and optimally no more than 1.5 degrees.
However when reading the concrete plans and the arguments of politicians and representatives of the larger corporations it is immediately evident that what we are talking about is simply “business as usual”. That is probably not only truth for the EU, but also US and many other countries.
It is not that the world has come to realise that mankind is in an extremely difficult situation where wildlife, environment, health and sustainable growth are at stake, and that therefore a radical change in the economic paradigm prevailing is needed - nothing of the kind - nobody challenges today’s mantra. The world must continue to be efficient and productive. We all must consume to activate the economy. The more we consume the more vigorous and healthier the economy is. This is the “business as usual” mantra: Continue producing commodities with more efficient processes which hopefully will produce fewer emissions. Continue producing and consuming heavily. Use energy more efficiently, reduce the carbon footprint of transport, render households and cities less polluting and efficient, make hybrid and electrical cars. Improve the chemical industry, use more renewables and dream that all that would be enough to make the world become emission neutral in the future and stop the catastrophic unpredictable warming up of the atmosphere.
Do you think the world is planning to stop the burning of carbon fuels and replace them by renewables? You are wrong. At the most, EU and others are intending to convert the coal power plants into gas-power stations. The new mantra for the coming years is to replace the coal and petrol with a mix of renewables and gas. Gas is very abundant. There is enough gas to be burnt for the next hundreds of years. And is less polluting, it does not litter so much carbon into the atmosphere. And renewables.....yes of course, as far as possible. Bear in mind that the sun does not always shine and the wind does not always blow....and bear in mind that whatever the plans are, the efficiency and sustainability of the industry is the most important factor to consider. So, gas and liquefied gas (LPG) will be with us until the North Pole melts down.
EU is discussing about the electricity network and the amount of resources needed to achieve some success in reducing emissions before 2030. New directives will regulate and redesign the energy market. Energy efficiency and regional agreements are seen as the magic formula. Competitiveness of the EU industry is essential, no matter at which cost.
Reality is cruder than oil. In 2013 26.7 % of electricity was generated in the EU by coal fired power plants and 16.6 % by gas (Eurostat data). In addition, 19 new coal power plants are in various stages of approval, planning or construction in Bulgaria, Czech Republic, Greece, Germany, Poland, Romania and Slovenia. Greenpeace figures show these new projects alone would emit almost 120m tonnes of CO2 every year – equivalent to three-quarters of the annual carbon output of the UK’s energy sector. The average lifespan for a coal power station is about 40 years, meaning the plants could release nearly 5bn tonnes of CO2 into the atmosphere (the Gurdian, 27.08.2014).
The consumer is regarded simply as a poor human being unable to think. The thought is that a consumer will never buy a new and more efficient boiler if it is at the cost of giving up the week of holidays in Ibiza. The consumer has no ideals, no thoughts on his or her own, is always seeking some kind of material benefit. There are no much thoughts about education, about campaigning to convince the public to consume LESS, to become vegetarian, to use public transport, to stop buying cars... etc. It just goes against the prevailing mantra.
Agriculture is never mentioned or discussed. The 7 Gigatons of anthropogenic emissions produced by the livestock and agricultural industry (Nature Climate Change Vol 4 2014, pages 2-4, W.J. Ripple et al) is never questioned nor there are plans to cut it down.
Nobody really believes that the trend of global warming and the level anthropogenic emissions will ever be neutral in the future with the present plans. COP21 has been indeed a diplomatic success. However the world needs more than diplomacy. To be emission neutral in the future and prevent the raise of see levels and temperatures much above the 2 degrees the world needs much more than “business as usual”. This is once more a global problem that requires global solutions and governance.
All4oneworld, March 2016
Humans have used antibiotics since the early civilizations. Egyptians used mouldy bread to apply them to infected wounds, without knowing about the existence of antibiotics. According to the Cambridge dictionary, an antibiotic is a “medicine or a chemical that can destroy harmful bacteria in the body or limit their growth” .
It was only at the beginning of the 20th century that a German scientist, Paul Ehrlich, discovered one of the first antibiotics against syphilis, arsphenamine. The accidental discovery of penicillin gave the nobel price to Fleming, when some penicillium fungus contaminated the culture plate of a bacterium Fleming was studying, Staphylococcus, and inhibited its growth.
Penicillin was in mass production by the second world war and applied successfully to the troops during the D-day invasion of the German occupied territory in Europe. Penicillin was considered a wonder drug and many post-war children and adults were treated with it and and saved their lives.
Antibiotics work either by preventing the reproduction of bacteria, or by impairing the formation and building of the cell wall structures.
The surfaces of the human body such the skin, mouth, intestines, vagina...etc are covered in millions of individual micro-organisms that don’t do any harm. In fact they help to protect us from becoming infected with harmful microbes. They are known as the normal body flora. Bacteria which are harmful are called pathogens. The number of normal bacterial cells hosting our bodies is of about 100 million.
Bacteria are incredibly small, about 0,2 micrometer in diameter (a micrometer is 1000 times smaller than a millimetre). They reproduce very quickly, usually by division. In this process the bacterium, divides into two identical daughter cells. The DNA of the bacterium (genetic material) divides into two (replicates). The bacterial cell splits into two daughter cells each with identical DNA to the parent cell.
With the right conditions (temperature, nutrients) some bacteria like Escherichia coli can divide every 20 minutes. In 7 hours one bacterium can generate more than 2,000,000 bacteria. After one more hour the number of bacteria will have increased to about 16,000,000 (http://www.microbiologyonline.org.uk/about-microbiology/introducing-microbes/bacteria) . That’s the reason why we can quickly become ill when pathogenic microbes infect our bodies, like an army that self-reproduces at an incredible speed. That capacity to divide and multiply is also the key to antibiotic resistance. In every division there are errors when the DNA of the bacterium is copied. These errors are called mutations. A bacterium like Staphylococcus aureus can accumulate 300 mutations in about 10 hours (Nature Education 1(1):30, 2008). The mutation rate is so high that a bacterial colony is hardly ever the same. When we touch a tap in the toilet we come in contact with a population of rapidly changing bacteria, so changeable that is already different from the person that left the toilet and the bacteria before us. That sounds scary, but it is the principle of antibiotic resistance. Some of these aleatory mutations will confer resistance to the bacteria when they are in the presence of an antibiotic.
Antibiotic resistance has become a major public health issue. The problem exists not only due to the rapid bacterial mutation rates, but also because of the “selective pressures that antibiotics impose”. If a drug-resistant phenotype were to evolve and there were no antibiotic present, then that phenotype would fare no better than any other bacterial phenotype. In other words, it wouldn't flourish, and it might even die out. It is only when antibiotics are used that drug-resistant phenotypes have a selective advantage and survive.” (Nature Education 1(1):30, 2008).
Why antibiotic abuse? on the one hand there is over-prescription of antibiotics, even when they are not necessary; on the other hand antibiotics are over-used in the farming meat industry, not only for treating infections in animals but also added in the animal feed as growth factors (AGP, Antimicrobial Growth Promoters).
It is well known that some people take antibiotics (and physicians prescribe then) when suffering from flue like symptoms or any other kind of viral infections. However antibiotics are ineffective against viruses. Sad is, that while over-prescription occurs in some countries, in other places of the world children and adults have no access to antibiotics to treat real life-threatening conditions. While some die from pathogenic bacteria because no antibiotics are available, others take antibiotics for no reason and provoke bacterial resistance which is becoming a global health problem.
Antibiotic consumption in humans is increasing worldwide, driven by rising incomes, health insurance, and a large remaining burden of infectious disease. Between 2000 and 2010, antibiotic consumption in 71 countries increased by 36%, with Brazil, Russia, India, China, and South Africa (BRICS) accounting for three-quarters of this increase. (The Lancet, 2016, 387: 168-175)
According to the UK’s National Institute for Health and Care Excellence, almost a quarter of prescriptions for antibiotics won’t benefit those issued them. Why? Nine out of 10 doctors say they feel pressured to prescribe antibiotics; 97 per cent of patients who ask get them (New Scientist, 30.12.2015).
However, is the use of antibiotics as growth promoters in animal farming (swine and poultry overall, cattle in USA, Brazil and Argentina) which is very worrisome for the global health.
“Antibiotics have been used in livestock in sub-therapeutic concentrations (for growth promotion and disease prevention) and in therapeutic concentrations (to treat sick animals). Since many antibiotics commonly used in sub-therapeutic concentrations are the same as or similar to antibiotics used in human medicine, there is global concern that drug-resistant organisms may pass from animals to humans and present a serious threat to public health” “ Twenty-seven different antimicrobial classes are used in animals, most of which have human antimicrobial counterparts. Nine of these classes are exclusively used in animals (Page and Gautier, 2012). The top three antimicrobial classes by sales for animal use in 2009 were: macrolides (USD 0.6 billion), penicillins (USD 0.6 billion) and tetracyclines (USD 0.5 billion), three classes of antimicrobials considered as critically important in human medicine” (Global antimicrobial use in the livestock sector, 21-01-2015, OCDE, Working party on agricultural policies and markets)
The worst is that according to the OCDE report, “In spite of 50 years of AGP use, definitive conclusions on their effects on productivity are still lacking. There is considerable variability in the growth response to sub-therapeutic antibiotics, according to the species, the age of animals, their genetic potential, and the specific hygiene and management conditions”.
Last month, the US Food and Drug Administration reported that sales of antibiotics approved for use in livestock rose by 23 per cent between 2009 and 2014. Much of this use, linked to the growth of antibiotic resistance in humans, is not to treat infections but to promote growth of the animals
(New Scientist, 30.12.2015).
Antibiotics are an essential element of animal health, but the increasing use of antibiotics in sub-therapeutic concentrations for growth promotion and disease prevention (as a substitute for hygiene) is placing substantial selection pressure for resistance to evolve. Worldwide antimicrobial consumption in animals is projected to rise by 67% from 63 151 (±1560) tons in 2010 to 105 596 (±3605) tons in 2030 (The Lancet, 2016, 387: 168-175).
The regulatory situation worldwide is a mosaic of laws. Whereas EU Countries have completely forbidden the use of AGPs in 2006, USA and many other countries allows them, each with different exceptions and specificities.
According to WHO, the resistance to antibiotics is becoming critical:
“ In 2013, there were about 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB). MDR-TB requires treatment courses that are much longer and less effective than those for non-resistant TB.
There are high proportions of antibiotic resistance in bacteria that cause common infections (e.g. urinary tract infections, pneumonia, bloodstream infections) in all regions of the world. A high percentage of hospital-acquired infections are caused by highly resistant bacteria such as methicillin-resistant Staphylococcus aureus(MRSA) or multidrug-resistant Gram-negative bacteria.
Patients with infections caused by drug-resistant bacteria are generally at increased risk of worse clinical outcomes and death, and consume more health-care resources than patients infected with the same bacteria that are not resistant.
As an example, the death rate for patients with serious infections caused by common bacteria treated in hospitals can be about twice that of patients with infections caused by the same non-resistant bacteria.
Re Treatment failure to the drug of last resort for gonorrhoea – third-generation cephalosporins – has been confirmed in several countries.
Resistance to one of the most widely used antibacterial drugs for the oral treatment of urinary tract infections caused by E. coli– fluoroquinolones – is very widespread.
Resistance to the treatment of last resort for life-threatening infections caused by common intestinal bacteria – carbapenem antibiotics – has spread to all regions of the world. Key tools to tackle antibiotic resistance – such as basic systems to track and monitor the problem – reveal considerable gaps. In many countries, they do not even seem to exist”. ( http://www.who.int/mediacentre/factsheets/fs194/en/ )
The over-prescription of antibiotics and the use of antibiotics as AGPs for use in livestock is an example of the lack of consistency and the lack of a global regulation and governance in a matter (antibiotic resistance) which is of worldwide interest. A question of importance for the global health which cannot be left to the discretion of the meat industry, the private interest and/or the countries which support both. (see Global antimicrobial use in the livestock sector, 21-01-2015, OCDE, Working party on agricultural policies and markets, table 1for the regulatory landscape).
The expansion of appropriate access to antibiotics where they are needed while restricting the inappropriate access, in particular to the last generation, last-resort antibiotics requires a delicate balance where an overall worldwide governance is necessary. Reality is that no access to antibiotics kill more people (e.g. pneumonia in children) than antibiotic resistance does (The Lancet, 2016, 387: 168-175). Therefore restricting the abuse and providing what is needed is the way ahead.
World Health Organization is clear about it: Without urgent, coordinated action, the world is heading towards a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill.
All for one world, January 2016
It was only at the beginning of the 20th century that a German scientist, Paul Ehrlich, discovered one of the first antibiotics against syphilis, arsphenamine. The accidental discovery of penicillin gave the nobel price to Fleming, when some penicillium fungus contaminated the culture plate of a bacterium Fleming was studying, Staphylococcus, and inhibited its growth.
Penicillin was in mass production by the second world war and applied successfully to the troops during the D-day invasion of the German occupied territory in Europe. Penicillin was considered a wonder drug and many post-war children and adults were treated with it and and saved their lives.
Antibiotics work either by preventing the reproduction of bacteria, or by impairing the formation and building of the cell wall structures.
The surfaces of the human body such the skin, mouth, intestines, vagina...etc are covered in millions of individual micro-organisms that don’t do any harm. In fact they help to protect us from becoming infected with harmful microbes. They are known as the normal body flora. Bacteria which are harmful are called pathogens. The number of normal bacterial cells hosting our bodies is of about 100 million.
Bacteria are incredibly small, about 0,2 micrometer in diameter (a micrometer is 1000 times smaller than a millimetre). They reproduce very quickly, usually by division. In this process the bacterium, divides into two identical daughter cells. The DNA of the bacterium (genetic material) divides into two (replicates). The bacterial cell splits into two daughter cells each with identical DNA to the parent cell.
With the right conditions (temperature, nutrients) some bacteria like Escherichia coli can divide every 20 minutes. In 7 hours one bacterium can generate more than 2,000,000 bacteria. After one more hour the number of bacteria will have increased to about 16,000,000 (http://www.microbiologyonline.org.uk/about-microbiology/introducing-microbes/bacteria) . That’s the reason why we can quickly become ill when pathogenic microbes infect our bodies, like an army that self-reproduces at an incredible speed. That capacity to divide and multiply is also the key to antibiotic resistance. In every division there are errors when the DNA of the bacterium is copied. These errors are called mutations. A bacterium like Staphylococcus aureus can accumulate 300 mutations in about 10 hours (Nature Education 1(1):30, 2008). The mutation rate is so high that a bacterial colony is hardly ever the same. When we touch a tap in the toilet we come in contact with a population of rapidly changing bacteria, so changeable that is already different from the person that left the toilet and the bacteria before us. That sounds scary, but it is the principle of antibiotic resistance. Some of these aleatory mutations will confer resistance to the bacteria when they are in the presence of an antibiotic.
Antibiotic resistance has become a major public health issue. The problem exists not only due to the rapid bacterial mutation rates, but also because of the “selective pressures that antibiotics impose”. If a drug-resistant phenotype were to evolve and there were no antibiotic present, then that phenotype would fare no better than any other bacterial phenotype. In other words, it wouldn't flourish, and it might even die out. It is only when antibiotics are used that drug-resistant phenotypes have a selective advantage and survive.” (Nature Education 1(1):30, 2008).
Why antibiotic abuse? on the one hand there is over-prescription of antibiotics, even when they are not necessary; on the other hand antibiotics are over-used in the farming meat industry, not only for treating infections in animals but also added in the animal feed as growth factors (AGP, Antimicrobial Growth Promoters).
It is well known that some people take antibiotics (and physicians prescribe then) when suffering from flue like symptoms or any other kind of viral infections. However antibiotics are ineffective against viruses. Sad is, that while over-prescription occurs in some countries, in other places of the world children and adults have no access to antibiotics to treat real life-threatening conditions. While some die from pathogenic bacteria because no antibiotics are available, others take antibiotics for no reason and provoke bacterial resistance which is becoming a global health problem.
Antibiotic consumption in humans is increasing worldwide, driven by rising incomes, health insurance, and a large remaining burden of infectious disease. Between 2000 and 2010, antibiotic consumption in 71 countries increased by 36%, with Brazil, Russia, India, China, and South Africa (BRICS) accounting for three-quarters of this increase. (The Lancet, 2016, 387: 168-175)
According to the UK’s National Institute for Health and Care Excellence, almost a quarter of prescriptions for antibiotics won’t benefit those issued them. Why? Nine out of 10 doctors say they feel pressured to prescribe antibiotics; 97 per cent of patients who ask get them (New Scientist, 30.12.2015).
However, is the use of antibiotics as growth promoters in animal farming (swine and poultry overall, cattle in USA, Brazil and Argentina) which is very worrisome for the global health.
“Antibiotics have been used in livestock in sub-therapeutic concentrations (for growth promotion and disease prevention) and in therapeutic concentrations (to treat sick animals). Since many antibiotics commonly used in sub-therapeutic concentrations are the same as or similar to antibiotics used in human medicine, there is global concern that drug-resistant organisms may pass from animals to humans and present a serious threat to public health” “ Twenty-seven different antimicrobial classes are used in animals, most of which have human antimicrobial counterparts. Nine of these classes are exclusively used in animals (Page and Gautier, 2012). The top three antimicrobial classes by sales for animal use in 2009 were: macrolides (USD 0.6 billion), penicillins (USD 0.6 billion) and tetracyclines (USD 0.5 billion), three classes of antimicrobials considered as critically important in human medicine” (Global antimicrobial use in the livestock sector, 21-01-2015, OCDE, Working party on agricultural policies and markets)
The worst is that according to the OCDE report, “In spite of 50 years of AGP use, definitive conclusions on their effects on productivity are still lacking. There is considerable variability in the growth response to sub-therapeutic antibiotics, according to the species, the age of animals, their genetic potential, and the specific hygiene and management conditions”.
Last month, the US Food and Drug Administration reported that sales of antibiotics approved for use in livestock rose by 23 per cent between 2009 and 2014. Much of this use, linked to the growth of antibiotic resistance in humans, is not to treat infections but to promote growth of the animals
(New Scientist, 30.12.2015).
Antibiotics are an essential element of animal health, but the increasing use of antibiotics in sub-therapeutic concentrations for growth promotion and disease prevention (as a substitute for hygiene) is placing substantial selection pressure for resistance to evolve. Worldwide antimicrobial consumption in animals is projected to rise by 67% from 63 151 (±1560) tons in 2010 to 105 596 (±3605) tons in 2030 (The Lancet, 2016, 387: 168-175).
The regulatory situation worldwide is a mosaic of laws. Whereas EU Countries have completely forbidden the use of AGPs in 2006, USA and many other countries allows them, each with different exceptions and specificities.
According to WHO, the resistance to antibiotics is becoming critical:
“ In 2013, there were about 480 000 new cases of multidrug-resistant tuberculosis (MDR-TB). MDR-TB requires treatment courses that are much longer and less effective than those for non-resistant TB.
There are high proportions of antibiotic resistance in bacteria that cause common infections (e.g. urinary tract infections, pneumonia, bloodstream infections) in all regions of the world. A high percentage of hospital-acquired infections are caused by highly resistant bacteria such as methicillin-resistant Staphylococcus aureus(MRSA) or multidrug-resistant Gram-negative bacteria.
Patients with infections caused by drug-resistant bacteria are generally at increased risk of worse clinical outcomes and death, and consume more health-care resources than patients infected with the same bacteria that are not resistant.
As an example, the death rate for patients with serious infections caused by common bacteria treated in hospitals can be about twice that of patients with infections caused by the same non-resistant bacteria.
Re Treatment failure to the drug of last resort for gonorrhoea – third-generation cephalosporins – has been confirmed in several countries.
Resistance to one of the most widely used antibacterial drugs for the oral treatment of urinary tract infections caused by E. coli– fluoroquinolones – is very widespread.
Resistance to the treatment of last resort for life-threatening infections caused by common intestinal bacteria – carbapenem antibiotics – has spread to all regions of the world. Key tools to tackle antibiotic resistance – such as basic systems to track and monitor the problem – reveal considerable gaps. In many countries, they do not even seem to exist”. ( http://www.who.int/mediacentre/factsheets/fs194/en/ )
The over-prescription of antibiotics and the use of antibiotics as AGPs for use in livestock is an example of the lack of consistency and the lack of a global regulation and governance in a matter (antibiotic resistance) which is of worldwide interest. A question of importance for the global health which cannot be left to the discretion of the meat industry, the private interest and/or the countries which support both. (see Global antimicrobial use in the livestock sector, 21-01-2015, OCDE, Working party on agricultural policies and markets, table 1for the regulatory landscape).
The expansion of appropriate access to antibiotics where they are needed while restricting the inappropriate access, in particular to the last generation, last-resort antibiotics requires a delicate balance where an overall worldwide governance is necessary. Reality is that no access to antibiotics kill more people (e.g. pneumonia in children) than antibiotic resistance does (The Lancet, 2016, 387: 168-175). Therefore restricting the abuse and providing what is needed is the way ahead.
World Health Organization is clear about it: Without urgent, coordinated action, the world is heading towards a post-antibiotic era, in which common infections and minor injuries, which have been treatable for decades, can once again kill.
All for one world, January 2016