There are several things that many of us fear will be in a long list our grandchildren draw up of 'how could you possibly have let that happen'? Cooking the planet with fossil fuels and presiding over a massive extinction of our fellow creatures will, I am sure, be there. So will be our squandering an incredible class of life-saving medicines, antibiotics, unless we act fast to save them.
The first finding of MRSA in retail pork is a clarion call for more urgent action. New research commissioned by The Alliance to Save Our Antibiotics was carried out by scientists at Cambridge University led by Dr Mark Holmes, and found that two samples of pig meat out of 52 bought from English supermarkets were positive for MRSA. One sausage sample had two different MRSA strains, and a third strain was found in pork mince. Genetic analysis (whole-genome sequencing) of the bacteria showed that the three MRSA were of livestock-origin and of a type called ST398. This study indicates that consumers eating pork twice a week may be exposed to MRSA every three months. It is likely that MRSA will now spread throughout the English pig herd, posing a significant risk of human exposure to these resistant bacteria.
In addition, a recent Guardian investigation has revealed Livestock-associated MRSA CC398 in pork products sold in Sainsbury's, Asda, the Co-operative and Tesco. Out of 100 samples, nine samples (eight Danish and one Irish) - tested positive for CC398.
The emergence and spread in animals of antibiotic-resistant bacteria like MRSA is linked to overuse of antibiotic in farming. Animals are often given antibiotics routinely even when no disease has been diagnosed, creating favourable conditions for the survival of resistant bacteria which then can be passed to humans.
'Antibiotic Armageddon', 'a post-antibiotic era', 'the demise of modern medicine' - the terrifying prospect of a world without antibiotics is foreseen by experts from World Health Organisation's Director-General Dr Margaret Chan to the UK's Chief Medical Officer, Dame Sally Davies. All agree that we are hurtling towards a major human health crisis - on the brink of destroying one of the biggest achievements in human medicine: our ability to treat human infections.
90 years ago, three years before Alexander Fleming's ground-breaking discovery of penicillin, five women out of every 1,000 died in childbirth. Skin infections proved fatal for one out of nine people, and the death rate for pneumonia was 30%. Most of us have benefitted from using antibiotics, and some of us, me included, owe them our lives. When infection set in after a major operation I had over forty years ago, I had to be pumped (literally) full of first one and then another antibiotic for all of one night, until the drugs did their work, and the infection receded. What seems unthinkable to those of us alive today is that without effective antibiotics many major operations - like caesarean births at the start of life or hip replacements towards the end - would be either extremely risky or even impossible.
The saddest thing is that this is being brought about mainly by our own stupidity - we use and abuse these drugs with abandon and in doing so we systematically undermine the ability of antibiotics to do their job. Antibiotic resistance occurs when bacteria, extremely adaptable organisms, evolve to survive antibiotics, and the drugs stop working. Each dose of antibiotics provides an opportunity for resistant bacteria to thrive, while their susceptible companions are killed off.
In the public debate, the focus so far has been on antibiotic misuse in hospitals and GP surgeries. This is only part of the picture, accounting for around 55% of total antibiotic use in the UK. Coming in at a close second, with around 40%, is the staggeringly high use of antibiotics on farm animals, particularly intensively farmed pigs and poultry.
Immense quantities of antibiotics are used by the world's farmers, often unnecessarily and routinely. Mass medication is widely practiced, particularly in pig and poultry production, even when no disease has been diagnosed in any of the animals. This is in part due to the post-war growth of intensive livestock production. Here, antibiotics are needed to compensate for typically over-crowded conditions, where disease outbreaks are more commonplace and harder to control. Antibiotics are used as a pharmaceutical crutch - exemplified by the practice of routinely dosing animals through medicated feed or water, which accounts for 85% of farm use in the UK. Disease is anticipated, expected even, and antibiotics are used to allow animals to stave off disease in disease-inducing conditions. The justification is that consumers want meat, and lots of it, and as cheap as possible. Farmers need to turn a profit and maximise output.
But on-farm antibiotic use is coming at a huge cost. Increasing evidence shows that overuse in farming is contributing to resistance in life-threatening human infections. Resistant bacteria in livestock can be passed on through direct contact, consumption of animal products, or the environment. Farm use of antibiotics is now a major source of resistant human infections such as Campylobacter and Salmonella, E.coli and livestock-associated MRSA.
Farmers are even allowed to use emergency antibiotics, critically important in human medicine, the last resort when other antibiotics fail. While medical use of these drugs has declined in recent years in the UK, farm use has increased steadily since 2000.
Some EU countries have ambitious targets to cut antibiotic use on farms, but not the UK. Here antibiotic use in pigs and poultry is at least 3.5 times higher per unit of livestock than in the Netherlands. The UK Government's Five Year Antimicrobial Strategy states that routine use of antibiotics to treat animals is not acceptable, but doesn't set targets for reducing farm use, despite including tough targets for human use.
Routine, mass-medication in farming must be banned, except for where disease is diagnosed in some animals. Targets must be set to cut use of the crucial emergency antibiotics. The Government must gather data on the human health impacts of antibiotic resistance that originates in farm animals.
Livestock farmers, retailers and consumers all have a part to play. Antibiotics must not be used as an insurance policy for low-welfare, intensive farming practices. Farming must focus on disease prevention through good husbandry and hygiene. Organic farmers are only allowed to use antibiotics on animals that are sick. Food retailers must insist that the farmers that supply them drastically cut their use of antibiotics. More expensive ham, chicken or eggs is a small price to pay to keep these amazing drugs available to treat life-threatening infections in people, for us and future generations. We all need to take a good look at what we eat and what we buy.
Countries like the Netherlands - where farm use of the antibiotics most strongly associated with MRSA has been cut by 98% resulting in a fall in the number of human cases of livestock-associated MRSA - show that decisive action can reverse resistance. MPs of all parties agree on the need for action. Kerry McCarthy, Labour MP for Bristol East says: 'The recent findings of MRSA in British retail pork highlight the need for urgent action to address antibiotic use in farming. Routine prophylactic use of antibiotics to treat groups of animals - when no disease has been diagnosed - is a practice which cannot continue. Disease prevention should be achieved through a focus on good hygiene and husbandry.'
Zac Goldsmith, Conservative MP for Richmond Park, initiated the first debate in Parliament on the abuse of antibiotics in farming: 'The recent finding of MRSA in retail pork is a new and worrying development in the unfolding calamity of human antibiotic resistance. However, in the context of widespread, routine misuse of antibiotics in farming, it is not a surprising one. Ambitious targets must be set to tackle the misuse of these precious resources in farming, accompanied by a shift towards good husbandry, animal welfare and hygiene practices which reduce the need for drugs in the first place'.
The Alliance to Save our Antibiotics (formed by Compassion in World Farming, the Soil Association and Sustain, and funded by the Coller Foundation) is calling for restrictions on the use of the critically important, emergency antibiotics - no modern cephalosporins to be used in pig, poultry and dairy farming, and no fluoroquinolones used in poultry. Farmers must phase out routine prophylactic use of antibiotics, and mass medication of animals in their feed or drinking water where no disease has been diagnosed in any of the animals in the group being treated must be banned.
Follow our campaign on twitter, and call on retailers to address antibiotics in their supply chains: @ASOAntibiotics