Mapping the Invisible Enemy

A Map in the Making
Thomas Van Boeckel’s career is a rare example of scientific continuity. From his initial Branco Weiss Fellowship proposal to his current role as a tenured professor at the University of Zürich, his focus has never wavered: mapping antibiotic resistance globally. In fact, Van Boeckel’s application to the Fellowship included a sparsely populated map of resistance data in Africa. Five years later, at the close of his fellowship, he presented a fully global map published in Science. “My exit lecture disturbingly matched what I had proposed five years earlier,” he remarks, “which I think says something about the clarity and longevity of the research aim.”

The Branco Weiss Fellowship didn’t just fund a project – it enabled a vision. It gave Van Boeckel the flexibility to develop a labor-intensive, non-hypothesis-driven approach: mining thousands of published surveys on antibiotic resistance in farm animals. What began as a data challenge became a movement in global health surveillance.

Where the Superbugs Are
Antibiotic resistance is no longer an emerging threat – it is a global crisis. According to Van Boeckel, hotspots of resistance are now clearly identifiable, especially in India and China, where intensive livestock farming meets laxly enforced regulation, and comparatively poorer farm-hygiene standards. “Antibiotics are incredibly cheap and accessible in China,” he explains. “They’re used not only by veterinarians, but also by farmers, driven by the massive middle-class demand for meat.”

This has led to disturbing findings: super-resistant bacteria in pigs, particularly in Southeast Asia, that are virtually untreatable. These strains don’t just stay on the farm. “People from Southeast Asia admitted to Swiss hospitals are automatically screened for these bacteria,” says Van Boeckel. “They may not be sick, but they can carry resistant microbes.” In Switzerland and across Europe, awareness is growing – but much of the world remains poorly equipped to monitor or contain the problem.

The issue extends beyond agriculture. Companion animals, Van Boeckel argues, are a neglected factor in the transmission of resistance. In Europe, antibiotics are used heavily in pets – often without the stewardship standards found in human medicine. “There’s a cat in every third household in Switzerland, and many share their owner’s bed,” he says. “That’s a direct transmission route. We’re much more likely to have close contact with a dog than a cow.”

Beyond the Barnyard
Although the initial mapping project is largely complete and publicly available, Van Boeckel insists the work is far from finished. “We now need to update the maps regularly to track progress and failures,” he says. Future work also expands the scope of the original project: from farm animals to fruit, vegetables, and pets. The inclusion of food that is often eaten raw – and increasingly imported from regions with high resistance levels – adds another layer of complexity.

New research will also target veterinarians, particularly their prescribing habits. In Switzerland, prescriptions have dropped by 50 percent over the past decade, but a structural problem remains: veterinarians profit from the sale of antibiotics. “That’s a low-hanging fruit,” Van Boeckel notes. “Sweden removed this financial incentive, and it’s a change we should see elsewhere too.”

He emphasizes that the project’s goal is not to conduct lab experiments, but to pool and standardize existing data. “I try to occupy a space with our research – show what can be done,” he explains. Often, that means producing the first credible map or dataset so that larger organizations like the WHO can take over.

Turning Maps into Policy
From the outset, Van Boeckel’s research has had a clear audience: policymakers. Early in his fellowship, he spoke at the European Parliament. Since then, his data has informed strategies within international agencies. “We’re trying to equip decision-makers with global insights,” he says. One of his clearest messages is that antibiotic overuse must be tackled on two fronts. “We need to innovate – discover new antibiotics – and we need to conserve what we have,” he says. The latter involves hygiene, clean water, better veterinary standards, and global coordination. In wealthy countries, progress is measurable; in low-income regions, infrastructure and cost remain the main barriers.

Communication with policymakers is not always straightforward. When the experts proposed a 30 percent reduction in inappropriate antibiotic use in animals in a high-level meeting during the UN general assembly, the motion was rejected by heads of state. Still, Van Boeckel sees momentum building. “Europe is moving toward restrictions, like prohibiting preemptive antibiotic use in animals – a standard already in human medicine,” he says.

What Comes After the Map?
As the Branco Weiss Fellowship ended, Van Boeckel now finds himself at the One Health Institute in Zürich – a concept that recognizes the tight connections between human, animal, and environmental health. The Institute focuses on three main areas: antimicrobial resistance, zoonotic disease, and metabolic disorders. Van Boeckel is currently its sole professor but is working to expand the team.

The One Health approach is increasingly recognized by organizations like the WHO, particularly in the wake of the COVID-19 pandemic and outbreaks of avian flu. For Van Boeckel, it offers a long-term framework for confronting antibiotic resistance, not just as a medical issue, but as a systemic problem that spans agriculture, trade, and public behavior.

Reflecting on the Fellowship, Van Boeckel says it offered more than funding – it provided resilience. “At the beginning, it allowed the project to happen. In the middle, I had much success with additional grants. But near the end, I made a unfortunate career move that nearly derailed everything,” he recalls. “The Fellowship gave me a safety net. Without it, I might not have recovered.”

That recovery has paid off – not just for his career, but for global health. In mapping the invisible enemy of antibiotic resistance, Van Boeckel has helped make it visible – and actionable.