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What we consume can either sustain us or make us ill. Not long ago, I wrote about how food consumption impacts the risk of colon cancer. But what about food production?

Worldwide, we are observing the rise of low-cost animal protein, primarily fueled by demand from a expanding middle class that finally has the means to purchase poultry and red meat, which were previously out of reach. Roughly 45% of increased worldwide demand is occurring in upper-middle-income countries such as India, China, Brazil, the Philippines and Indonesia. Chicken is expected to capture an increasingly large share of that expansion, estimated to increase by 21% by 2034, because it is more affordable, widely acceptable and needs less input per kilogram than beef or pork. In the next decade, it is estimated that chicken will supply 45% of the dietary protein consumed from animal-based foods.

But this has costs. With limited land and intense time pressure, the approach in numerous nations has been to employ antimicrobials extensively. This isn’t just to address disease but also as a prophylactic to avoid sickness in crowded conditions. And, administering antimicrobials makes livestock to gain weight more rapidly, although scientists aren’t sure the precise reason. All of this means that, unlike their use for humans—where antibiotics are almost always prescribed to combat infection—their use in farming is far more common and uncontrolled. Studies monitoring their use estimate that 73% of all antibiotics distributed globally are used in animals raised for food.

This massive misuse is causing a increase in antibiotic-resistant pathogens. For example, colistin resistance, a final-line treatment, first developed in E coli bacteria that subsequently contaminated swine. E coli was later found in pig farmers. Only required are aeroplanes and global travel networks for these microbes to spread globally. And now, resistant strains have been discovered not only in medical facilities in China but around the globe.

What does this mean for someone waiting in a doctor’s office or a medical center in the UK? It means that bacterial illnesses that were once simple to cure—such as ear infections, UTIs or post-operative infections—become untreatable even after a dose of antibiotics. It implies that operations such as caesarean sections, hip replacements and cancer therapies that depend on immune suppression all become riskier. And while novel antimicrobials are feasible to create, the pipeline is slow and expensive. We must conserve the arsenal we currently possess.

The solutions to this issue can exclusively come from changing worldwide agriculture. Admittedly, the United Kingdom has made significant progress in curtailing antibiotics in farming. Sales of veterinary antimicrobials reared for food has dropped by 59% over the past decade. The use of colistin is now virtually nonexistent. The employment of critically important antibiotics has dropped to less than 0.5% of all animal antibiotic sales. Moreover, studies by several EU bodies suggested that after antimicrobial consumption in agriculture was reduced by almost 50% between 2014 and 2021, antibiotic resistance in E. coli bacteria across the bloc also began to decline.

But just concentrating on the United Kingdom or Europe is a drop in the bucket. If the large middle-income countries are included in discussions on how animal protein is farmed, we continue to be just as susceptible to antibiotic resistance. The difficulty is that moving towards different production practices requires additional land and time: increasing the cost of animal protein in countries with large populations can quickly trigger public protests, political backlash and discontent. The medical necessity is evident, but this must be weighed with considerations of nutritional access, financial factors and public demand.

Climate scientists have long warned about the ecological impacts of the current global food system, whether it’s greenhouse gases, species decline, or forest clearing. But these consequences often feel distant and abstract, particularly for individuals facing cost-of-living pressures or worried about short-term medical services.

Antibiotic resistance is tangible. Virtually all people has taken antibiotics at some point, and we can imagine what would happen if their curative power was suddenly switched off. Agriculture, health and the environment are all connected. How pig meat is farmed in China influences whether your offspring’s medication work in Edinburgh. Whether a female patient in Lagos survives a C-section is linked to how poultry are raised in Brazil.

If we confront these pervasive, world-spanning challenges, such as how our diet is sourced and how we use our existing drugs, we risk losing something precious: the ability to cure bacterial diseases that we take for granted today.