There was a time
when simple infections were deadly,

but now, thanks to the wide
availability of antibiotics,

this is merely a relic of the past.

But actually, I should say "was,"

because nowadays,
we're using antibiotics so much

that the bacteria
that cause these infections

are becoming resistant.

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

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

the UN predicts that by 2050,

antimicrobial resistance
will become our single biggest killer.

So we must start to act.

But "where to begin"
is an interesting question,

because we humans are not
the only ones using antibiotics.

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

Not all of these are critical
for human health,

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

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

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

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

In the Western world,
prosperity was increasing

and people wanted to eat
more animal protein.

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

so they did not die and kept growing.

But soon, it was discovered

that adding small and regular amounts
of antibiotics to the feed

kept the animals healthy,

made them grow faster

and caused them to need less feed.

So these antibiotics worked well --

really well, actually.

And with increasing animal production,

also antibiotic use skyrocketed worldwide.

Unfortunately,
so did antibiotic resistance.

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

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

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

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

some bad bugs die but not all of them.

Spread that across an entire industry,

and you can understand
that we accidentally build up

a large reservoir
of antibiotic-resistant bacteria.

But I hate to break it to you --

the problem doesn't stop there.

You know who else takes antibiotics?

Fluffy, your cat, and Rover, your dog.

(Laughter)

Pets rank even amongst
the heaviest users of all,

and they use antibiotics

that are much more critical
for human health.

Combine this with how close
we live with our companion animals

and you understand the risk

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

But how do these
antibiotic-resistant bacteria

in farm animals affect you?

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

The levels of antibiotic-resistant
salmonella in pigs in Europe

against different types of antibiotics

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

Which means that in most cases,

this antibiotic will not work anymore
to kill this salmonella.

And there was a high correlation

between antibiotic-resistant
salmonella in the pig

and in the final product.

Whether that is pork chop,

spare ribs or minced meat.

Now, luckily, typically
less than one percent

of all raw meat, fish or eggs

will contain salmonella.

And this only poses a risk
when not treated well.

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

and more than a million cases in the US.

In the US, leading
to 23,000 hospitalizations

and 450 people dead each year.

With antibiotic-resistant
salmonella on the rise,

this death toll is likely to increase.

But it's not only
about consuming yourself.

This year, more
than 100 people got infected

with a multidrug-resistant salmonella

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

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

And luckily, this is starting to happen.

The EU was the first region to ban

putting antibiotics
in low doses in the feed.

From '99 on, in several steps,

the amount of different types
of antibiotics allowed was reduced,

and in 2006, a complete ban
went into place.

Antibiotics were only allowed

when a veterinarian determined
the animal was sick.

Sounds great, right?

Problem solved.

No, wait, not so fast.

As soon as the reduction program started,

it was very quickly discovered

that antibiotics had been
the perfect blanket

to cover up a lot of bad farm practices.

More and more animals became sick

and needed to be
cured with ... antibiotics.

So instead of the total amount going down,

it actually increased.

Surely, that was not the way to go.

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

The whole European agricultural sector
started on a journey,

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

This is also the time
I personally entered the scene.

I joined a large European feed compounder.

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

and often also provides the advice

on how to raise the animals
in the best way.

I was really motivated
to work together with my colleagues,

veterinarians and, of course, the farmers

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

Now there are three major things
that need to happen

for antibiotic-free production.

Let me walk you through the playbook.

To start -- and it sounds very obvious --

that our hygiene is the place to start.

Better cleaning of the stable
and the drinking-water lines

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

That's all very important,

but the part I was personally
most interested in

was better feeding for the animals,

better nutrition.

Feeding a well-balanced diet is important.

Think about it this way:

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

Part of the food you consume
is not digested by yourself

but fermented in your large
intestine by bacteria.

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

Initially, most young animals
were fed low-fiber,

high-starch and protein,

very finely ground
and highly digestible diets.

Like being yourself on a diet
of hamburger buns,

rice, waffles and protein bars.

We changed this to a lower-protein,

higher-fiber, coarser type of diet.

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

This shifted the bacterial flora
in the animals' guts

to the more beneficial ones

and reduced the chance
that pathogens would flourish.

You might be surprised

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

Simply the fact
that the same diet is coarser

will lead to a better-developed
digestive tract,

and thus, a healthier animal.

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

Unlike some other parts of the world,

Western European farmers mainly still make
their independent buying decisions:

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

So what you're actually selling in the end

reflects the actual local need
of these farmers.

For example,

the protein content in piglet diets

in countries that are much more vigilant
in reducing antibiotics,

like, for example,
Germany and the Netherlands,

were already 10 to 15 percent lower

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

But, like with better hygiene,
better nutrition helps

but will not totally prevent you
from becoming sick.

So more is needed.

And that's why we turned
to the microbiome.

Making the water with the feed more acidic

helps to create an environment

that benefits the more beneficial bacteria

and inhibits the pathogens.

Like fermented food,

whether it's yogurt, sauerkraut or salami,

they'll all spoil less quickly, too.

Now, with modern techniques,

like the ones based on DNA testing,

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

And this ecosystem,
which we call the microbiome,

is much more complex.

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

as tissue cells in your body.

And for animals, the impact is no less.

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

we have to make the animals
much more robust.

So that when a disease strikes,

the animals are much more resilient.

And this three-pronged
nutribiosis approach

involving the host, nutrition
and the microbiome

is the way to do it.

Now the practice of raising animals
on an antibiotic-containing

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

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

That's actually quite affordable

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

And a very small price to pay

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

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

Do we allow antimicrobial resistance
to become our biggest killer,

at huge financial
and a special personal cost?

Or do we, besides reducing
human antibiotic consumption,

truly start embracing
antibiotic-free animal production?

For me, the choice is very obvious.

But to make this happen,

we have to set reduction targets

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

Because farmers compete with each other.

And at a country level,

trading block or the global market,

costs are very important.

And also, we have to be realistic.

Farmers need to have the possibilities

to invest more in better
management and better feed

in order to achieve this reduction.

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

by offering antibiotic-reduced
or antibiotic-free products.

And with growing consumer awareness,

these market forces
will increase in power.

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

But what about the animals?

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

Better health, less stress, happier life.

So now you know.

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

without or with very low
amounts of antibiotics,

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

to avoid a future
in which bacterial infections

again become our biggest killer.

Thank you.

(Applause)