Is the public health aim of antibiotic reduction overriding AB usage in China? Exploring the moral considerations of antibiotic usage and restriction in China

Abstract

Worldwide humans are threatened by the growing antibiotic microbial resistance problem. Recently the WHO, global infectious diseases researchers and AMR experts have gathered together to set global targets to reduce AB usage for fighting AMR worldwide. This thesis explores whether the global antibiotic reduction policy aim overrides antibiotic usage now in China. The main research question entails whether the global public health aim of antibiotic reduction overrides AB usage in China? The study’s direct relevance is the global antimicrobial resistance problem. China is of particular interest because of it’s huge total consumption of Abs in combination with it’s massive amount of citizen’s.

In fact, recent statistics from the Academy of Sciences of China showed that China consumes 162 thousand tons of ABs, which is more than half of the world’s total consumption. 52% of these ABs are used in their farming, and 48% are used by people.2 More than 50 thousand tons of ABs flow to the soil and water, affecting the ecosystem. These amounts are worrisome as, according to the World Economic Forum, antimicrobial resistance constitutes one of the main risks to human health.3 AMR is threatening the health of both present and future humans. To reduce the harm and damage from AMR, world renowned experts and global governments have recently announced a global public health AB reduction aim. Interestingly although there is a shared interest of inducing an AB reduction aim, no common agreed public health ethics framework excists to guide and justify actions. Until now ethicists have mostly ignored the AMR problem. Only a few ethicists have provided an ethical assessment of the AMR-related threats, which only entail clinical medicine practices. Within this case, the underlying ethical question is whether this public health aim of reducing AB usage overrides current AB usage in China. Because of the lack of in-depth conceptual ethical analyses and public health ethics framework to weight arguments and guide policy decisions, more attention to this topic is needed.