2.1 Ethical considerations of AMR in animal health and production

Ethical issues on AMR are not limited to human health care settings; ethical questions about AMU in animals must also be considered.

Consider this list of ethical questions related to AMR and AMU in animals:

• Should we stop giving food animals antimicrobials to promote their growth or to prevent disease when they are showing no clinical or subclinical signs of illness, if we think this action poses a threat to the future health and safety of people?
• Do we know if stopping or severely restricting AMU in food animals will reverse trends in emerging AMR in human health and in animal health?
• How can we moderate AMU in livestock production systems while meeting the needs of individuals, communities and nations who rely on agriculture to survive and thrive?
• How can we moderate AMU in food animals to protect their welfare and ensure they do not suffer debilitating or life-threatening infectious diseases, while also safeguarding the effectiveness of antimicrobials for human health?
• How can we modify the way in which antimicrobials are used in pet/companion animals and horses to reduce the risk of AMR that may spread from animals to their owners?
• Veterinarians have professional and societal expectations to treat animals who are sick and require antimicrobial agents. How can animals be treated whilst minimising the risk of AMR affecting the health of animals and of people?

These are some of the ethical questions we face as we look at ways to minimise the risk of AMR in animals and people who interact with pets, horses and food animals, and consume animal products.

Already in the European Union and some nations, bans have been introduced on the use of medically important antimicrobials in food animals. In 2017, the WHO published its Guidelines on the Use of Medically Important Antimicrobials in Food-producing Animals, which makes four recommendations, including the restriction of all classes of medically important antimicrobials for prevention of diseases that have not been clinically diagnosed (WHO, 2017a).

Widespread societal concerns about AMU practices in food animals, like growth promotion, are also driving these restrictions. However, some of the recommendations made in the WHO’s guidelines were controversial in the veterinary sector, given the WHO’s admission that there is sparse scientific evidence supporting their recommendations (Scott et al., 2019).

(If you are interested in learning more, The World Organisation for Animal Health publishes a regularly updated list of veterinary antimicrobials of importance to animals (OIE, 2021), and the Antimicrobial stewardship in animals module discusses AMU in animals in detail.)