Jeffrey LeJeune, head of the college's Food Animal Health Research Program, is in the midst of a three-month assignment in Rome to work with the United Nations Food and Agriculture Organization to combat antibiotic resistance.
The FAO recruited LeJeune to provide technical advice and to help launch and coordinate several of the initiatives outlined in a dire U.N. declaration on antibiotic resistance.
LeJeune participated in a U.N. gathering Sept. 21 when the entire assembly signed a political declaration requiring countries to create national plans to fight antibiotic resistance in medicine, agriculture and the environment. The plans will be based on a blueprint on antimicrobial resistance developed in 2015 by the FAO, the U.N.’s World Health Organization (WHO) and the World Organisation for Animal Health (OIE).
“It’s a big task, but it’s exciting. It happened really fast,” LeJeune said. “I know several people in FAO, and we follow each other’s work.
“It was almost a year ago when they mentioned they might be working on something on antimicrobial resistance, and I asked them to keep me posted. And I didn’t hear anything in a long time, and then they called and asked if I would be interested in coming over, and how soon could I be there?”
With the Sept. 21 commitment from the U.N., the FAO is ready to go from planning to implementation, and that’s where LeJeune will help.
LeJeune, a veterinarian and a microbiologist, has long been involved with an interdisciplinary group at Ohio State focusing on antibiotic resistance. Led by Tom Wittum, professor and chair of the Department of Veterinary Preventive Medicine, the antibiotic resistance working group takes a “One Health” approach to the problem, tackling it from the standpoints of human, animal and environmental health.
The team has representatives from colleges across campus at Ohio State: CFAES, the College of Veterinary Medicine, the College of Medicine, the College of Pharmacy, the College of Nursing and the College of Public Health.
“They are all intertwined,” LeJeune said. “You can’t just look at antimicrobial resistance as a medical problem or a veterinary problem. It’s all linked, and you have to understand all of the underlying causes of antibiotic resistance in order to get a handle on control strategies.”
The team is taking seriously the National Action Plan for Combating Antibiotic-Resistant Bacteria, developed by the Obama administration in 2015, LeJeune said. The plan calls for increases in research, surveillance and monitoring, among other action items.
The Ohio State team is working on developing new diagnostic tests and surveillance methods and is conducting some cutting-edge research, LeJeune said. The national action plan also calls for increases in international collaboration, he said.
“So this fits right into the national action plan,” LeJeune said. “This is a global problem. We’re not going to solve it independently.”
The One Health outlook is precisely the approach the U.N. is taking by bringing together the FAO, WHO and OIE.
While with the FAO, LeJeune anticipates working with nations that have developed plans to work on antimicrobial resistance to make sure their plans are aligned with their capabilities and there are systems for monitoring and evaluation in place.
“We need to be able to tell if we’re making any progress,” he said.
Different nations are at different levels of adopting programs to control antimicrobial use in agriculture, he said. He expects to begin working with nations that have the least control measures in place, particularly in sub-Saharan Africa and parts of Southeast Asia. He will provide technical support and input and serve as a liaison for those countries to the FAO.
“Through my work here at Ohio State, I have a good understanding of the One Health approach, and I’ve had the opportunity to travel quite a bit to some of these developing countries, so I have an idea of agricultural practices globally,” LeJeune said.
After two years, the U.N. secretary-general will gauge each country’s progress.
The Sept. 21 gathering was only the fourth time the U.N. has convened to address a health issue, following action on Ebola in 2014, noncommunicable diseases in 2011 and HIV/AIDS in 2001.
Antibiotics and similar drugs, collectively known as antimicrobial agents, have been around for 70 years. But because they’ve been used so extensively, organisms have built up resistance to the drugs, rendering them less effective – a problem considered by many to be the world’s most pressing public-health concern.
According to the Centers for Disease Control and Prevention, each year at least 2 million people in the U.S. become infected with bacteria that are resistant to antibiotics, and at least 23,000 people die as a direct result of these infections. Worldwide, the annual death toll attributed to antimicrobial resistance is estimated at 700,000, and by 2050 that number is projected to increase to 10 million if urgent steps aren’t taken.
Because of the complexity of the problem, the most effective response will include a coordinated effort across disciplines, LeJeune said, including in medicine, agriculture, veterinary medicine, public health and environmental health.
Ohio State takes part in education, outreach and research and has a multidisciplinary team of individuals who meet regularly and are actively involved in a number of complementary approaches.
LeJeune’s laboratory has been working on understanding the ecology and mechanisms of how antibiotic resistance is spread, from bacteria to bacteria, from farm to farm, and around the world. Researchers there also study how farm management practices affect disease transmission, including the tracking of wildlife such as birds, which are known to transmit antibiotic-resistant organisms, from one farm to another.
LeJeune’s lab has also explored how bacteriophages — viruses that infect bacteria — can transmit antibiotic resistance from one bacterium to another, and it is developing educational materials to help agricultural workers protect themselves.