EPA - Ireland's Environment, An Integrated Assessment - 2020

Ireland’s Environment – An Integrated Assessment 2020 4. Global Issues – Local Challenges Ireland is not alone in working on developing solutions for some of the most significant environmental, health and wellbeing challenges it currently faces. Antimicrobial resistance, air pollution, climate change and urbanisation pose considerable threats to Irish society and the global population. While global action is often key to enabling a coordinated and accelerated response across nations, it is essential that national solutions and individual actions are developed in tandem to address issues at a local level. Antimicrobial Resistance The issue of antimicrobial resistance is now one of the most serious global concerns affecting human health. The environmental dimension of antimicrobial resistance is now receiving more attention. Widespread and excessive use, overuse and misuse of antimicrobial agents, particularly antibiotics, has significantly contributed to the development, spread and evolution of antimicrobial resistance (AMR) worldwide. AMR occurs when microorganisms such as bacteria, viruses and fungi develop the ability to resist the action of the drugs (antimicrobials such as antibiotics, antivirals and antifungals) designed to combat them and are capable of multiplying in their presence. Antibiotics enter the environment through discharges from human sewage treatment plants and septic tanks, as well as through farm animal excreta. It is unfortunately commonplace that antimicrobials that were relied on and effective 20 years ago now fail. The report on the O’Neill review of AMR (UK Government and Wellcome Trust, 2016) estimated that, by 2050, AMR infections may become the leading cause of deaths globally. ‘A post-antibiotic era means, in effect, an end to modern medicine as we know it . ’ – Dr Margaret Chan, Former WHO Director-General The environmental dimension of AMR, as reported by Gaze and Depledge (2017), is not well understood, in particular the complexity of interactions in the wider environment. Our water, soil and air are extremely vulnerable to discharge and release of antimicrobials and resistant microorganisms, as well as other resistance- promoting chemicals, such as biocides and heavy metals, through various routes. They also represent important potential routes of transmission of AMR to humans, animals and the food chain. The pivotal role that the environment plays in the persistence and dissemination of AMR is now being recognised; however, the extent of its role represents a significant knowledge gap. Insights are lacking on its attributional role in the selection and spread of AMR, its impact on human, animal and ecological health and on management and remediation strategies to curb its further evolution. AMR is of such concern at a national level that it has been identified as a strategic risk to Ireland’s future wellbeing in the Irish Government’s National Risk Assessment since it was first published in 2014. Ireland’s first National Action Plan on AMR (iNAP; Figure 14.10) was published in 2017 (Government of Ireland, 2017) and recognises that joint coordinated action is needed to deal with the threat of AMR to public health, animal health and the environment. The plan represents an ambitious 3-year multi-stakeholder effort to implement actions to prevent, monitor and combat AMR across the health, agricultural and environmental sectors in Ireland, which is consistent with the requirement of a One Health approach to tackling the issue of AMR. 374