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What we introduce into our bodies can either sustain us or make us ill. Recently, I wrote about how food consumption influences the risk of colorectal cancer. But what about food production?

Across the planet, we are observing the rise of cheap meat, primarily fueled by consumer desire from a expanding middle class that finally has the means to purchase beef, pork and chicken, which were previously unaffordable. Approximately 45% of increased worldwide demand is occurring in nations with rising economies such as China, India, Brazil, Indonesia and the Philippines. Chicken is set to take an greater portion of that expansion, projected to increase by 21% by 2034, since it is relatively cheap, culturally popular and needs less input per kilogram compared with red meat. In the next decade, it is projected that poultry will provide 45% of the protein eaten from animal-based foods.

But this has consequences. With limited land and tight schedules, the approach in many countries has been to employ antimicrobials extensively. This is not only to treat illness but additionally as a prophylactic to avoid sickness in crowded conditions. And, administering antimicrobials makes farm animals to grow faster, even though scientists do not know exactly why. All of this means that, in contrast to their application in people—where antimicrobials are almost always given to combat infection—their use in farming is far more common and indiscriminate. Studies tracking their use estimate that 73% of all antimicrobials sold worldwide are used in animals raised for food.

This massive misuse is causing a increase in drug-resistant bacteria. As an illustration, resistance to colistin, a final-line treatment, first developed in E. coli microorganisms that subsequently contaminated pigs. The bacteria was later detected in pig farmers. Only required are aeroplanes and global travel networks for these microbes to circulate worldwide. Currently, colistin-resistant bacteria have been identified not only in hospitals in China but across the world.

How does this impact for someone sitting in a GP clinic or a medical center in England or Scotland? It signifies that infections that were previously easily treatable—such as ear infections, UTIs or post-operative infections—become untreatable even after a course of antimicrobials. It means that operations such as caesarean sections, hip replacements and cancer therapies that rely on immunosuppression all become more dangerous. Although novel antimicrobials are feasible to develop, the development process is lengthy and expensive. We have to conserve the tools we have.

The remedies to this issue can only come from transforming worldwide agriculture. To be fair, the UK has made significant progress in reducing antibiotics in farming. Sales of antibiotics for animals destined for consumption has dropped by 59% over the past decade. The use of colistin is now effectively zero. The employment of critically important antibiotics has fallen to under 0.5% of all veterinary antimicrobial distribution. Moreover, research by European agencies indicated that after antibiotic use in farming was reduced by almost 50% between 2014 and 2021, antimicrobial resistance in E coli throughout Europe also began to decline.

But just focusing on the United Kingdom or Europe is a minor effort. Unless the large middle-income countries are included in discussions on how meat is produced, we continue to be just as susceptible to drug-resistant infections. The difficulty is that moving towards different production practices requires additional land and duration: increasing the cost of animal protein in highly populated nations can quickly trigger public protests, political backlash and discontent. The medical necessity is clear, but this needs to be balanced with concerns over nutritional access, economics and public demand.

Environmental researchers have repeatedly cautioned about the environmental costs of the current global food system, whether it’s greenhouse gases, species decline, or deforestation. But these effects often feel long-term and abstract, especially for individuals struggling with cost-of-living pressures or worried about short-term medical services.

Antibiotic resistance is concrete. Almost everyone has used antimicrobials at one time or another, and we can envision what would occur if their curative power was abruptly lost. Food production, health and climate are all connected. How pork is farmed in China influences whether your child’s antibiotics are effective in Edinburgh. Whether a female patient in Lagos recovers from a caesarean is tied to how chickens are farmed in South America.

Unless we confront these widespread, global issues, such as how our diet is sourced and how we utilize our existing drugs, we risk losing something invaluable: the ability to treat infections that we assume will always work today.