HomeAboutSoftwarePublicationsPostsMicroBinfie Podcast

One Health as it pertains to antimicrobial resistance as it pertains to microbial genomics

Posted on March 13, 2023
an AI generated picture (Midjourney) with prompt; 'one health and antropogenic selection'. You can share and adapt this image following a CC BY-SA 4.0 licence.

After reading too many publications and proposals I do not understand the relationship between one health, and antimicrobial resistance and microbial genomics. I write this as an exercise for myself, hoping to clarify these concepts and their interdependence. This may be of interest to you too.

What is One Health?

One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent. From https://doi.org/10.1371/journal.ppat.1010537

"One Health" is based on a few observations. Firstly, human health, from the perspective of population scale public health, is influenced by plants, other animals and the wider environment [1]. Secondly, many potential problems in public health, such as some emerging pathogens, are caused by anthropogenic forces [1]. There is a close interdependence between humans and nature, and to understand this to the extent where we can make meaningful public health inventions we need to encourage interdisciplinary collaboration [2]. There are many definitions of One Health, but this focus on interdisciplinary collaboration is always mentioned. Initiatives that subscribed to One Health seem to focus on developing platforms and networks to foster interdisciplinary collaboration and interoperability (e.g. improvement of data sharing) [3,4]. One Health activities do not seem to extend to directly commenting on science (i.e. specifically researching the important mechanisms in natural sciences) [5]. Many topics fall under the One Health banner, as the scope is quite broad, however, in all cases these topics are couched as they apply to human/public health. For instance, understanding zoonoses, which are diseases of animals that can infect humans, requires veterinarians, physicians, and public health officials to understand and combat such disease [6]. Yet, some issues may have a wider scope, such as changes in climate or land use that then provides new opportunities for disease [1].

I stress, again, that descriptions of One Health do not strictly specify particular issues, but there are some topics that are naturally in this space [1, 2], such as:

  • Contamination of water and the impact on human health.
  • Urbanisation, land use and the effect on the ecological systems, which then in turn changes opportunities for disease.
  • The ease of global travel and how that affects disease transmission.
  • Farming and food production practices and how it promotes (or demotes) food-borne pathogens.
  • Changing climate and the effect on vector-borne diseases
  • Human use of antimicrobials and how that impacts antimicrobial resistance in microbes.
  • Some sources (e.g. [7]) extend One Health to food security as well. This may be true, but I argue that with such a loose definition One Health basically encompasses all the life sciences.

What is antimicrobial resistance?

Antimicrobial resistance is the capacity of microbes to tolerate antimicrobials. Microbes can use a number of different mechanisms. The WHO specifically specifies antimicrobial resistance occurs “..when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines ...” [8].This definition is framed in regards to medicines and drugs (made by humans). This is a point of confusion, as microbes also develop resistance to antimicrobials produced by other (non-human) organisms. As an obvious example, Penicillins were originally obtained from Penicillium moulds (P. chrysogenum and P. rubens). We have also “borrowed” a number of antibiotics from Streptomyces [9]. Indeed, antimicrobials have been around for a very long time [10] and antimicrobial resistance in turn is ancient [11]. Research into antibiotic resistance is broad and may include:

  • Understanding the mechanics of bacteria and how they resistant antimicrobials in their environments.
  • The development of new antimicrobials to target resistant microbes.
  • Understanding the relationship between microbes and humans - how anthropogenic forces around antimicrobial use shapes adaptation in microbes.

Based on the definition of One Health above, it is only the last topic where studies in antimicrobial resistance intersect with One Health.

Tying it together with microbial genomics

Microbial genomics is the study of the molecular organisation of microbial genomes, their information content, and the gene products they encode. This is a broad topic and not constrained to human pathogens, antimicrobial resistance or One Health. It is important to keep these distinctions clear. I feel in a rush to be relevant (for grant funding) we conflate our projects with vogue ideas like One Health. This limits the scope of our research – and external parties may observe our movements and make hasty decisions. For instance, they may conclude that non-pathogenic antimicrobial sensitive bacteria are not important. Understanding antimicrobial resistance in of itself, and understanding microbes and their systems (such as plasmids) are both important as understanding the fundamentals of life. It is only through first understanding can we then manipulate to our advantage.

For example (and my apologies to my comrades in plasmid biology for picking on them), a project using long read sequencing to understand the fundamental mechanics of plasmids and how they mobilise is only tangential to antimicrobial resistance, as plasmids are sometimes a vector for antimicrobial resistance genes. And such a project is certainly not related to One Health as the mechanisms at play are likely much older than modern humans. If we accept the narrow focus presented to us, future projects will be deemed out of scope. Ironically, this contradicts the spirit of One Health in the first place – which is encouraging a holistic interdisciplinary view of the world. The trap with a One Health approach is that it is ultimately anthropocentric, which I have expressed as "the One Health Bechdel test":

A research project does not take a One Health approach if the phenomenon under investigation would still exist if humans did not.

References

Questions or comments? @ me on Twitter @happy_khan

The banner image is an AI generated picture (Midjourney) with prompt; 'one health and antropogenic selection'. You can share and adapt this image following a CC BY-SA 4.0 licence.