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There was a time
when simple infections were deadly,

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but now, thanks to the wide
availability of antibiotics,

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this is merely a relic of the past.

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But actually, I should say "was,"

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because nowadays,
we're using antibiotics so much

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that the bacteria
that cause these infections

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are becoming resistant.

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And that should really scare
the hell out of all of us.

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If we do not change our behavior
and wean ourselves off antibiotics,

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the UN predicts that by 2050,

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antimicrobial resistance
will become our single biggest killer.

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So we must start to act.

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But "where to begin"
is an interesting question,

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because we humans are not
the only ones using antibiotics.

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Worldwide, 50 to 80 percent
of all antibiotics are used by animals.

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Not all of these are critical
for human health,

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but if we do not get it
under control right now,

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we're looking at a very scary future
for humans and animals alike.

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To begin, let's talk
about how we ended up here.

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The first large-scale use of antibiotics
was in the early '50s of the last century.

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In the Western world,
prosperity was increasing

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and people wanted to eat
more animal protein.

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When animals were sick,
you could now treat them with antibiotics

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so they did not die and kept growing.

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But soon, it was discovered

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that adding small and regular amounts
of antibiotics to the feed

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kept the animals healthy,

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made them grow faster

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and caused them to need less feed.

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So these antibiotics worked well --

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really well, actually.

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And with increasing animal production,

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also antibiotic use skyrocketed worldwide.

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Unfortunately,
so did antibiotic resistance.

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The reason your doctor tells you
to finish the entire bottle of antibiotics

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is if you shorten your dose,
you will not kill all of the bugs.

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And the ones that stick around
build up the antibiotic resistance.

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It's the same problem with giving animals
small and regular doses of antibiotics:

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some bad bugs die but not all of them.

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Spread that across an entire industry,

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and you can understand
that we accidentally build up

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a large reservoir
of antibiotic-resistant bacteria.

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But I hate to break it to you --

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the problem doesn't stop there.

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You know who else takes antibiotics?

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Fluffy, your cat, and Rover, your dog.

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(Laughter)

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Pets rank even amongst
the heaviest users of all,

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and they use antibiotics

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that are much more critical
for human health.

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Combine this with how close
we live with our companion animals

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and you understand the risk

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of you picking up antibiotic-resistant
bacteria from your own pet.

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But how do these
antibiotic-resistant bacteria

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in farm animals affect you?

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Let me give you an example
we have, actually, data on.

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The levels of antibiotic-resistant
salmonella in pigs in Europe

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against different types of antibiotics

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range from less than a percent
to as high [as] 60 percent.

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Which means that in most cases,

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this antibiotic will not work anymore
to kill this salmonella.

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And there was a high correlation

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between antibiotic-resistant
salmonella in the pig

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and in the final product.

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Whether that is pork chop,

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spare ribs or minced meat.

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Now, luckily, typically
less than one percent

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of all raw meat, fish or eggs

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will contain salmonella.

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And this only poses a risk
when not treated well.

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Still, there are over 100,000
human salmonella cases in the EU

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and more than a million cases in the US.

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In the US, leading
to 23,000 hospitalizations

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and 450 people dead each year.

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With antibiotic-resistant
salmonella on the rise,

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this death toll is likely to increase.

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But it's not only
about consuming yourself.

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This year, more
than 100 people got infected

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with a multidrug-resistant salmonella

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after feeding pig ears,
as a treat, to their dog.

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So we really must cut back
on antibiotic use in animal production.

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And luckily, this is starting to happen.

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The EU was the first region to ban

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putting antibiotics
in low doses in the feed.

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From '99 on, in several steps,

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the amount of different types
of antibiotics allowed was reduced,

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and in 2006, a complete ban
went into place.

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Antibiotics were only allowed

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when a veterinarian determined
the animal was sick.

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Sounds great, right?

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Problem solved.

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No, wait, not so fast.

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As soon as the reduction program started,

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it was very quickly discovered

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that antibiotics had been
the perfect blanket

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to cover up a lot of bad farm practices.

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More and more animals became sick

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and needed to be
cured with ... antibiotics.

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So instead of the total amount going down,

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it actually increased.

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Surely, that was not the way to go.

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But luckily, that was not
the end of the story.

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The whole European agricultural sector
started on a journey,

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and I think it's a journey
anybody can learn from.

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This is also the time
I personally entered the scene.

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I joined a large European feed compounder.

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A feed compounder makes a total diet
for a farmer to feed to his animals

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and often also provides the advice

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on how to raise the animals
in the best way.

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I was really motivated
to work together with my colleagues,

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veterinarians and, of course, the farmers

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to figure out how to keep the animals
healthy and antibiotic-free.

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Now there are three major things
that need to happen

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for antibiotic-free production.

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Let me walk you through the playbook.

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To start -- and it sounds very obvious --

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that our hygiene is the place to start.

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Better cleaning of the stable
and the drinking-water lines

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making it harder for the disease
to come in and spread across the stable.

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That's all very important,

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but the part I was personally
most interested in

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was better feeding for the animals,

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better nutrition.

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Feeding a well-balanced diet is important.

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Think about it this way:

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when you yourself do not eat
enough fiber, you do not feel well.

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Part of the food you consume
is not digested by yourself

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but fermented in your large
intestine by bacteria.

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So you're feeding those microbes
with part of your diet.

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Initially, most young animals
were fed low-fiber,

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high-starch and protein,

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very finely ground
and highly digestible diets.

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Like being yourself on a diet
of hamburger buns,

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rice, waffles and protein bars.

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We changed this to a lower-protein,

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higher-fiber, coarser type of diet.

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Like being on a diet of whole grains,
salad with meat or beans.

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This shifted the bacterial flora
in the animals' guts

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to the more beneficial ones

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and reduced the chance
that pathogens would flourish.

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You might be surprised

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but not only diet composition,
also diet structure plays a role.

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Simply the fact
that the same diet is coarser

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will lead to a better-developed
digestive tract,

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and thus, a healthier animal.

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But the best part was that farmers
started to buy this actually, too.

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Unlike some other parts of the world,

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Western European farmers mainly still make
their independent buying decisions:

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who to buy the feed from
and sell their animals to.

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So what you're actually selling in the end

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reflects the actual local need
of these farmers.

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For example,

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the protein content in piglet diets

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in countries that are much more vigilant
in reducing antibiotics,

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like, for example,
Germany and the Netherlands,

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were already 10 to 15 percent lower

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than in a country like the UK,
which was slower to pick this up.

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But, like with better hygiene,
better nutrition helps

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but will not totally prevent you
from becoming sick.

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So more is needed.

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And that's why we turned
to the microbiome.

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Making the water with the feed more acidic

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helps to create an environment

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that benefits the more beneficial bacteria

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and inhibits the pathogens.

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Like fermented food,

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whether it's yogurt, sauerkraut or salami,

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they'll all spoil less quickly, too.

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Now, with modern techniques,

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like the ones based on DNA testing,

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we can see that there are many more
different microorganisms present.

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And this ecosystem,
which we call the microbiome,

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is much more complex.

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Turns out there are about eight times
more microorganisms in your gut

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as tissue cells in your body.

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And for animals, the impact is no less.

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So if we want to work
without antibiotics in animal production,

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we have to make the animals
much more robust.

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So that when a disease strikes,

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the animals are much more resilient.

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And this three-pronged
nutribiosis approach

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involving the host, nutrition
and the microbiome

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is the way to do it.

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Now the practice of raising animals
on an antibiotic-containing

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or antibiotic-use-provoking diet
is a bit cheaper at farm level.

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But in the end, we are talking about
a few percent at the consumer level.

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That's actually quite affordable

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for the middle- and high-income
part of the world population.

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And a very small price to pay

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when our own health
or our loved ones' health is at stake.

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So what do you think,
what direction do we take?

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Do we allow antimicrobial resistance
to become our biggest killer,

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at huge financial
and a special personal cost?

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Or do we, besides reducing
human antibiotic consumption,

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truly start embracing
antibiotic-free animal production?

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For me, the choice is very obvious.

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But to make this happen,

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we have to set reduction targets

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and make sure that they're followed
all around the world.

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Because farmers compete with each other.

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And at a country level,

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trading block or the global market,

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costs are very important.

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And also, we have to be realistic.

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Farmers need to have the possibilities

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to invest more in better
management and better feed

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in order to achieve this reduction.

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And besides legal limits,
the market can play a role,

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by offering antibiotic-reduced
or antibiotic-free products.

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And with growing consumer awareness,

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these market forces
will increase in power.

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Now everything I've been talking about
seems to be great for us.

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But what about the animals?

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Now, guess what,
their lives get better, too.

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Better health, less stress, happier life.

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So now you know.

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We have the knowledge
how to produce meat, eggs and milk

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without or with very low
amounts of antibiotics,

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and I'll argue it's a small price to pay

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to avoid a future
in which bacterial infections

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again become our biggest killer.

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Thank you.

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(Applause)