Food, Water, Air, and Mind must Become Cleaner

Dear Editor:

We read with interest the article by Saleem and Haq suggesting how to address the important public health challenge of antimicrobial resistance (AMR) in Campylobacter in India [1]. The authors suggested strengthening measures to control foodborne pathogens in the poultry sector and implementing a comprehensive national policy [1]. In particular, they suggested banning the non-therapeutic use of antibiotics as growth promoters in poultry production, setting limits for Campylobacter in poultry products, developing and implementing a comprehensive Campylobacter risk management strategy, promoting alternative methods to replace antibiotics on poultry farms, supporting the development of vaccines against Campylobacter, and establishing robust surveillance and monitoring systems to track the prevalence of AMR Campylobacter [1]. The comments are excellent, but some points should be discussed.

The first point is that Campylobacter can cause not only diarrhea in humans, but also more severe diseases such as Guillain-Barre syndrome (GBS) [1]. GBS is a ubiquitous immune-mediated neuropathy that manifests as muscle weakness, affects all age groups and has a wide range of outcomes, from full recovery to death. Among the microbial pathogens that can cause GBS, C. jejuni is the most prevalent [2]. Therefore, it would be interesting to know whether workers in the poultry industry are more likely to contract GBS than workers in other occupations. In addition, AMR Campylobacter is potentially dangerous not only for poultry workers but also for consumers of poultry. Has the overall prevalence of GBS increased in India, especially among consumers of poultry products?

The second point relates to the high AMR prevalence of Campylobacter in India [1]. Monocultures are known to increase the AMR of various microbial pathogens [3]. Several strategies can be used to counteract this trend. Firstly, new antibiotics could be invented that are no longer resistant to Campylobacter. Secondly, the poultry industry could change its production methods from monocultures to polycultures. Thirdly, a vaccine against Campylobacter could be developed. Fourthly, people could be persuaded to stop eating poultry and switch to a vegetarian diet.

The third point is that the supply of clean water, food, and air generally requires a change in thinking from profit orientation and profit maximization to sustainable production of essential goods, which does not accept damage to the environment and the people living in it to satisfy particular interests, but is committed to sustainable, environmentally friendly, and health-oriented action.

Overall, it is not only the production conditions that need to be changed, but above all the attitudes of consumers and producers. The manipulation by the food industry to accept unhealthy conditions and consume unhealthy food must be curbed.