Resistant pathogens cause infections that cannot be treated by common antibiotics but require the use of so-called ‘reserve’ or ‘last-resort’ antibiotics. The use of these last-resort antibiotics has been increasing, resulting in multi-drug-resistant strains that cannot be treated. The root cause of the development of AMR is its overuse in agriculture, veterinary and human medicine. Despite increasingly strict regulation (i.e. bans on antibiotic supplemented feed or on preventive antibiotic use), the livestock sector remains the chief user of antibiotics. The types of antibiotics used are similar across animals and humans and it has been well established that resistant pathogens can transfer their resistance gene to other microorganisms.

The food chain represents the traditional rural-urban linkage, where food items produced in rural areas are transported to urban markets and consumed by the urban population, whilst the inputs of production flow from urban to rural areas. Along this rural-urban linkage resistance genes can spread either directly or indirectly.