In May 2022, the Minister of Agriculture issued a decision banning the import of colistin into the veterinary sector in Lebanon. This decision came following 6 years of struggle and efforts to approve it, and following the widespread and frightening increase in antibiotic resistance in Lebanon, and it may be a salvation from this health danger and negative effects. resulting from it. The challenge today is to monitor and implement this law, otherwise it will be just like any other ink on paper.
Who can forget the scandal of the outbreak of colistin-resistant bacteria in the food chain, at sea and even among children in Lebanon. The indiscriminate use of this drug has led to the spread of the mcr-1 gene that is resistant to antibiotics, this disaster has cast its shadows in recent years, as one study showed an increase in the use of colistin on humans five times between 2012 and 2017. Will the law save the health of citizens, animals and the environment in a country Suffering from a lack of medicines, difficulty in hospitalization, and poor food safety control?
Professor at the Center for Food Safety at the University of Georgia in the United States, Ismat Kassem, who led the campaign to ban colistin in Lebanon, explains that “the issue of the use of colistin is still interacting in the country, it is true that the law to prevent its use will definitely help reduce its effects, but we need to know Some things to be aware of.
The study of some farms in the South, conducted and published in the journal Microbial Drug Resistance, is perhaps the best example of the reality we live in. This study focused on home farms that have different types of animals, including cows, sheep, chickens, pigeons…
Qassem talks regarding the part published in the magazine, where the examination revealed the presence of antibiotic-resistant bacteria in all samples, but what was remarkable was the presence of bacteria that were resistant to colistin that was mobile in the bathroom, which means that this resistance is transmitted from one place to another and from one bacteria to another. This gene called the MCR gene makes bacteria mobile, and the irony is that the number of pigeons on this farm is regarding 250, and this requires us to stop and think carefully regarding what this means for antibiotic resistance and environmental pollution.
The legitimate and obvious question following these results, especially since we are talking regarding a small farm, how did these bacteria reach the bathroom with the colistin resistance gene? In Qassem’s opinion, “It is likely that the reason is due to environmental pollution in Lebanon, and since pigeons fly from one place to another, it is likely that they transmitted these bacteria with them, which will lead to the transfer of resistant bacteria to other animals, which in turn may transmit them to humans. It will lead to the pollution of other places that the pigeons go to as a result of its permanent movement, which means that it transfers pollution with it wherever it goes, whether in the river, irrigation canals, lakes, agricultural crops or cars…
So, this study summarizes in a small sample the extent of the problem of environmental pollution and antibiotic resistance in Lebanon, especially that the E-Coli bacterium carrying colistin-resistant bacteria is a bacterium that is genetically linked to the food chain, as it belongs to strains that affect food, that is, it can be transmitted through the food.
Qassem in this study depends on the MCR-1.26 gene, which was detected in samples and is the first time it was reported in Lebanon, and usually we observed the presence of the MCR-1 gene. According to international reports, the MCR-1.26 gene is found in an isolated sample of a patient in Europe. what does that mean? That bacteria with this gene can affect the food strain and humans.
Returning to the decision to ban colistin in Lebanon, Qassem asserts that, “Since 2017, and following our research, we have discovered the presence of resistance to colistin on a large scale in some Lebanese farms, even in fish farms, children and Syrian refugee camps, knowing that the MCR gene should not be extensive. Since then, we have raised our voice to prevent the indiscriminate use of colistin on Lebanese farms.
Also, research showed that the use of colistin in humans increased regarding 5 times between 2012 and 2017. This increase, according to Qassem, means, “These diseases need colistin, and in the event of colistin failure, there will be no other treatment for these patients, whose estimated number reached 6,000 patients in 2017. As it has become known, colistin is the last chance or last resort in treating incurable diseases for some The patients.
The drug colistin, which is used to treat some patients, we use in animal farms in Lebanon, and this is what prompted Kassem to raise his voice to prevent the indiscriminate use of colistin since 2018. The intensive meetings and efforts exerted over recent years have resulted in a decision to ban the use of colistin in the veterinary sector in Lebanon in May 15, 2022.
Qassem describes this decision “as a win for Lebanon, because we are not only talking regarding preserving and using it for humans, but also regarding animal health, environmental pollution and the food chain. Accordingly, Law 1/221 is the result of wide and long efforts between the Ministry of Agriculture in cooperation with the University of Georgia and the American University In Beirut, in addition to those responsible for animal husbandry.
After 6 years of struggle, this law was approved, which is considered a positive start in light of the crises afflicting the country, but the lesson remains in the application, especially following reviewing cases of antibiotic resistance. Therefore, we need steps to monitor and implement this law, and this is not impossible. In 2016, China implemented a similar law, and two years following its implementation, the rate of antibiotic resistance in the food chain, agricultural animals and the environment decreased.
Qassem concludes by saying, “Colistin is an urgent need for some diseases, and we documented in a previous paper published a month ago an increase in E-Coli bacteria that needs colistin intervention. Therefore, it is imperative to maintain the effectiveness of this drug, which is considered a last resort. All we ask today is to focus on applying This law is because people’s health is a priority and time is not on our side in these matters.”
