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The substances we consume can either nourish us or cause sickness. Recently, I explored how dietary habits influences the likelihood of colorectal cancer. But what about food production?

Worldwide, we are observing the expansion of low-cost animal protein, largely driven by demand from a growing affluent population that now has the means to purchase beef, pork and chicken, items that were once out of reach. Roughly 45% of increased worldwide demand is occurring in upper-middle-income countries such as China, India, Brazil, Indonesia and the Philippines. Poultry is expected to capture an increasingly large share of that expansion, estimated to increase by 21% by 2034, since it is more affordable, widely acceptable and needs fewer resources per kilogram than red meat. By 2034, it is estimated that chicken will provide 45% of the protein eaten from animal-based foods.

But this comes with consequences. With scarce acreage and intense time pressure, the approach in many countries has been to use antibiotics at scale. This is not only to treat illness but also as a prophylactic to avoid sickness in crowded conditions. And, giving antibiotics causes farm animals to grow faster, although scientists aren’t sure exactly why. This situation means that, in contrast to their application in people—where antimicrobials are almost always prescribed to combat infection—their application in agriculture is much more widespread and indiscriminate. Research monitoring their consumption estimate that 73% of all antimicrobials distributed worldwide are used in animals raised for food.

This enormous overuse is causing a rise in antibiotic-resistant pathogens. As an illustration, resistance to colistin, a final-line treatment, initially emerged in E coli bacteria that subsequently contaminated pigs. The bacteria was afterwards detected in swine handlers. Only required are aeroplanes and international transport for these pathogens to circulate worldwide. Currently, colistin-resistant bacteria have been identified not only in medical facilities in China but around the globe.

What does this mean for someone sitting in a GP clinic or a medical center in the UK? It means that bacterial illnesses that were once easily treatable—such as ear infections, UTIs or surgical site infections—become untreatable even after a dose of antibiotics. It implies that operations such as caesarean sections, hip replacements and oncology treatments that depend on immunosuppression all become more dangerous. Although new antibiotics are feasible to develop, the development process is slow and expensive. We must conserve the tools we currently possess.

The remedies to this issue can only come from changing global food production. Admittedly, the UK has achieved notable reductions in curtailing antimicrobial use in livestock. Distribution of veterinary antimicrobials destined for consumption has declined by 59% over the past decade. The use of colistin is now virtually nonexistent. The employment of highest-priority antimicrobials has fallen to less than 0.5% of all animal antibiotic sales. And, research by European agencies indicated that after antibiotic use in farming was cut by nearly half between 2014 and 2021, antimicrobial resistance in E coli across the bloc also began to decline.

However just concentrating on the United Kingdom or Europe is a minor effort. Unless the large middle-income countries are part of the conversation on how animal protein is produced, we continue to be just as vulnerable to drug-resistant infections. The difficulty is that adopting alternative farming methods takes additional land and time: increasing the cost of animal protein in countries with large populations can rapidly cause public protests, political backlash and discontent. The health imperative is evident, but this must be weighed with concerns over nutritional access, economics and public demand.

Climate scientists have repeatedly cautioned about the environmental costs of the current global food system, whether it’s greenhouse gases, biodiversity loss, or forest clearing. But these consequences often feel distant and theoretical, particularly for people struggling with financial strain or concerned with short-term medical services.

Antimicrobial resistance is tangible. Almost everyone has taken antibiotics at one time or another, and we can imagine what would happen if their curative power was abruptly lost. Agriculture, medicine and the environment are all interlinked. How pig meat is farmed in China influences whether your offspring’s medication are effective in Scotland. Whether a woman in Lagos recovers from a caesarean is linked to how poultry are farmed in South America.

Unless we confront these pervasive, world-spanning challenges, such as how our food is produced and how we use our current medications, we endanger something precious: the capacity to cure bacterial diseases that we take for granted now.