Antimicrobial resistance (AMR) is often described as a “silent” or “hidden” threat, but its consequences are anything but quiet.
“AMR remains underreported, underappreciated, and dangerously misunderstood,” said Dr. Sophie Masika, the Global Health Policy Manager at the World Federation for Animals (WFA). “It also doesn’t have a clear ‘face’ – people don’t see obvious symptoms the way they do with diseases like HIV or malaria.”
For instance, Masika said, someone might die from pneumonia or sepsis, but the underlying cause, drug resistance, is rarely recorded.
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AMR is a growing public health concern that occurs when bacteria, viruses, fungi, and parasites stop responding to drugs designed to kill them. Infections may become harder to treat as a result of this resistance, increasing the threat of disease spread, severe illness, and even death. The toll of AMR already exceeds a million deaths a year, and it is expected to rise over the next few decades. Drug-resistant infections are increasing, yet awareness, investment, and action fall short.
One in six bacterial infections worldwide cannot be treated with existing antibiotics, according to the World Health Organization. This isn’t just a statistic, it’s a warning. Sub-Saharan Africa suffers one of the highest burdens of antimicrobial resistance, according to a study published in The Lancet in 2022.
The complexity of antimicrobial resistance (AMR) contributes to its “silent” nature. This threat is spreading across humans, animals, and the environment, impacting health systems, food security, trade, and the environment.
“AMR is not just a human health issue; it is also tightly linked to how we treat animals,” said Masika.
In the human sector, antimicrobials are immensely mishandled at the hospital, patient level, and pharmaceutical industrial levels. Similarly, in animal health, antimicrobials are often given to healthy animals simply to promote growth and/or to prevent infections because good husbandry practices, including space, hygiene, ventilation, and low-stress environments, are not consistently applied at this scale of mass production.
The threat of AMR is not distant; it is present and demands immediate, sustained action.
If current trends continue unchecked, Dr. Masika warns that the threat will eventually become impossible to ignore. “AMR will become visible only when the consequences are personal and unavoidable: when families lose loved ones to infections that used to be treatable, when governments face pressure as hospital stays get longer and care becomes more expensive, and when insurers raise premiums because routine procedures become far riskier,” she said. “Food systems will strain, environmental contamination will worsen, and communities already living in poverty will be the least able to absorb these shocks.”
“By the time this threat gets a voice, the damage will already be profound, if it isn’t already,” said Dr. Masika.
A major driver of this crisis lies far from hospitals.
A significant portion of the world’s antibiotics is consumed by farm animals, particularly in intensive systems where healthy animals are routinely given medication to prevent disease or speed up their growth. As a result of this constant exposure, resistant bacteria emerge and spread easily. Dr. Masika said that bacteria surviving routine antibiotic use in industrial farming do not remain on the farm.
She said that they move through the food chain, and resistant bacteria can persist on meat, milk, or eggs if hygiene practices or slaughter processes are inadequate. The bacteria may not cause illness immediately, but they can enter the gut microbiome and transfer resistance genes to disease-causing bacteria. The bacteria can also spread through water and soil if untreated manure from intensively raised animals is applied on fields or runs off into rivers, containing unmetabolized antibiotics. As a result, resistance genes spread throughout the environment, creating reservoirs that humans are constantly exposed to.
By 2040, antimicrobial use in animals could increase by 30%, further aggravated by current trends.
To reduce antibiotic use, livestock productivity must be improved.
The latest Food and Agriculture Organization of the United Nations (FAO) study speaks of the importance of improving livestock productivity to significantly reduce global antibiotic consumption. In the FAO study, it is projected that improving livestock productivity will cut antibiotic consumption by 57% by 2040, reaching around 62,000 tons. According to Dr. Masika, this reduction rests on the assumption that increased productivity means that fewer animals are farmed.
However, Dr. Masika cautions that productivity gains alone aren’t enough.
She said that increased livestock productivity can come at a steep animal welfare cost, and doesn’t automatically lead to reduced antibiotic use unless the animals are raised in healthy, low-stress environments. For instance, selective breeding for fast-growth, high-productivity chickens was linked to painful leg disorders. She said that healthy animals are less likely to fall ill, which reduces the need for routine antibiotics that drive antimicrobial resistance.
For example, she said, outdoor systems lowered antibiotic use for gut diseases in pig herds and lower densities reduced antimicrobial use (AMU) and mortality in poultry farms that would otherwise be treated prophylactically. Further, increased animal welfare can lead to increased productivity in its own right, for instance, by enhancing growth and fertility.
“By centering animal welfare and addressing the root causes of disease, farms can maintain high output while simultaneously slowing the emergence and spread of resistant bacteria,” she said.
AMR is a nuanced topic, she said, and policy must be applied appropriately depending on the context of the country being considered.
Dr. Masika said that in Europe, regulations introduced in 2022 banned the routine and preventive use of antibiotics in farm animals, including mass medication in feed or water, reflecting the advanced nature of intensive agriculture there. However, these regulations reflected the advanced nature of the intensive agriculture systems there. She said that many lower-income countries in the Global South have not yet developed intensive livestock systems at scale, with livestock remaining a key source of livelihoods, cultural value, and nutrition.
She strongly argued that the primary drivers of high antimicrobial use in animal agriculture remain concentrated in the Global North.
“However, for the Global South, policies must reflect local realities,” said Dr. Masika. “They should focus on preventing the exportation of highly intensive livestock systems from the Global North, systems that can destabilise communities’ household farming, disrupting local supply chains, and increasing pollution and deforestation. Local knowledge and farming practices already support higher-welfare, lower-antimicrobial-use systems. These should be protected. It is not only better for livelihoods, but also for AMR reduction.”
One Health – Protecting Animals, People, and the Planet Together
Dr. Masika said that the One Health approach recognizes the close interconnection between human, animal, and environmental health. “Animal welfare is already a central component of this strategy, as good welfare is a prerequisite for good animal health,” she said.
She highlighted that the recent draft of the WHO Pandemic Treaty, finalized in April, which broke ground in acknowledging that animals are not just carriers of disease, but are critical partners in health systems and prevention strategies.
Right now, she said, leaders are at COP30 in Brazil, exploring solutions to the climate crisis, and we know that animals can help us to mitigate climate change. Wild large herbivores disperse seeds, regenerate forests, and maintain grasslands that lock carbon in soils, helping to mitigate climate change. Marine species sustain blue-carbon ecosystems that buffer our coasts against storms and store carbon on a vast scale in rivers, mangroves and coastal wetlands.
Dr. Sophie emphasized that the health of our planet, and the people in it, is intrinsically linked to the health of animals, wild, domestic and farmed, and there is growing awareness and momentum that their welfare needs to be protected accordingly. “Animal welfare is a responsibility shared between governments, communities, the people who own, care for, use, or interact with animals, the general public, educational institutions, veterinarians, and scientists,” she added.
AMR is everyone’s issue and needs everyone’s action.
The 2025 World Antimicrobial Resistance Awareness Week (WAAW) is themed “Act Now: Protect Our Present, Secure Our Future.” The campaign highlights the urgent need for bold, coordinated, cross-sector action to tackle antimicrobial resistance (AMR), a growing global threat already impacting our health, food systems, environment, and economies. However, awareness alone is not enough.
The issue of antimicrobial resistance affects all of us, and consumers can play a crucial role in supporting sustainable farming and reducing the demand for intensively farmed products by making informed and responsible food choices. A consumer’s awareness of and preference for sustainably produced food can help drive market demand toward better antimicrobial stewardship and minimize the use of routine antibiotics to promote animal growth or prevent disease.
Dr. Masika said that consumer choices can play a powerful role in shaping markets, and they can do the same to reduce AMR from the food perspective. That said, not all consumers have the same options. Some are privileged enough to choose products based on animal welfare or antibiotic use, while many others are focused on affordability and putting food on the table, she said.
“For those who are privileged to make choices, it should be about ensuring that their food is safe and free from unnecessary antimicrobials because the animals’ health and welfare are protected. In addition, they can choose to support smallholders rather than animals intensively raised by large corporations,” she said. “In communities where animals are raised in households rather than at scale in intensive systems, farming underpins livelihoods, social structures, and cultural practices. The expansion of intensive farming systems carries a risk of destabilising these traditional systems, alongside the risk of increased reliance on antibiotics in farming.”
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Resisting AMR
To combat antimicrobial resistance and develop new drugs, global coordination is necessary. This involves taking a ‘one health’ approach to combat AMR, which recognizes the interconnectedness between people, animals, plants, and the environment. The main challenge is competition for public health funds. AMR is not the only public health crisis facing Africa. It is reassuring to know that AMR reduction goes hand in hand with infection reduction.
Global leaders approved a political declaration at the UN General Assembly in September 2024 that outlined concrete targets to reduce antimicrobial resistance (AMR), including meaningful reductions of antimicrobial use (AMU) in the agri-food system by 2030 and investment in animal health. She hopes countries will now translate these commitments into action by enforcing stricter regulations on AMU in agriculture as well as promoting high-welfare practices along with consistent animal health services to prevent animal infections, strengthen surveillance systems, and invest in sustainable farming research.
Agri-food industry practices and systems that rely on the use of AMU for growth promotion and for prophylactic purposes must be removed. At the same time, investors must ensure their funds don’t contribute to the proliferation of AMR, she said.
For Africa, Dr. Masika said that we need to understand AMR within our own contexts.
“This means funding research that examines antimicrobial use and resistance patterns across human health, livestock, and the environment; exploring locally relevant drivers of resistance; and evaluating interventions that work within our social, economic, and cultural realities,” she said. “Evidence generated through such research will allow the design of context-appropriate strategies, strengthen surveillance systems, and guide investment in our farming practices that center the well-being and livelihoods of communities and the health and welfare of animals, while also ensuring the preservation of antimicrobials.”
