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Reducing the unnecessary use of antibiotics in agriculture globally is one of the main conclusions in the O’Neill Review on Antimicrobial Resistance published last week.
The report lays down 10 specific steps to be taken to reduce demand for antibiotics.
However, for the agriculture sector the report says that surveillance needs to be improved in many parts of the world, so the extent of antibiotic use in agriculture is known.
Then targets need to be set by individual countries for this use, enabling governments to have the flexibility to decide how they will reach lower levels and much quicker progress needs to be made on banning or restricting antibiotics that are vital for human health from being used in animals.
The report says that there are circumstances where antibiotics are required in agriculture and aquaculture – to maintain animal welfare and food security.
However, much of their global use is not for treating sick animals, but rather to prevent infections or simply to promote growth.
The quantity of antibiotics used in livestock is vast. In the US, for example, of the antibiotics defined as medically important for humans by the US Food and Drug Administration (FDA), more than 70 per cent (by weight) are sold for use in animals.
Many countries are also likely to use more antibiotics in agriculture than in humans but they do not even hold or publish the information.
“The majority of scientists see this as a threat to human health, given that wide-scale use of antibiotics encourages the development of resistance, which can spread to affect humans and animals alike,” the O’Neill review says.
“We propose three steps to improve this situation.
“First, 10-year targets to reduce unnecessary antibiotic use in agriculture, introduced in 2018 with milestones to support progress consistent with countries’ economic development.
“For this to succeed, governments must support and speed up current efforts, including those of the World Organisation for Animal Health (OIE) and others, to measure antibiotic use and farming practices.
“Second, restrictions on certain types of highly critical antibiotics. Too many antibiotics that are now last-line drugs for humans are being used in agriculture; action should be taken on this urgently by an international panel.
“Third, we must improve transparency from food producers on the antibiotics used to raise the meat that we eat, to enable consumers to make more informed purchase decisions”
The report adds that antibiotics can reach the environment in many ways such as through sewage systems (including from hospitals) and run-off from food-producing units such as farms, and can then pose potential problems for AMR.
One area that has not received enough focus so far is the way that the active ingredients for antibiotics are manufactured, and particularly the impact of effluent from factories on AMR in nearby water systems.
To tackle this O’Neill calls for regulators to set minimum standards for the treatment and release of manufacturing waste and for manufacturers to drive higher standards through their supply chains.
“Both must take responsibility and correct this unnecessary environmental pollution immediately,” O’Neill says.
In the US, campaigning congresswoman, Louise Slaughter said: “This report is the culmination of years of work studying the effects of antibiotic use in humans, agriculture, and our environment.
“This is a global problem that requires a global response because, as this report outlines, antibiotic resistant bacteria could kill 10 million people a year by 2050 if we fail to act.
“We cannot fix this issue if we continue to misuse new antibiotics in the same old ways. That’s why I’ve introduced the Preservation of Antibiotics for Medical Treatment Act to target where most of our antibiotics go in the US – to agriculture.
“This single industry consumes 80 per cent of all antibiotics, which is why we must finally end the overuse and abuse of antibiotics in agriculture for nontherapeutic uses.
“I commend the work that Lord Jim O’Neill and the AMR Review have accomplished, and will continue working to address this urgent issue.”
In the UK, the National Office for Animal Health, Chief Executive Dawn Howard said: “We endorse the proposal for incentives to develop innovative new treatments and better diagnostics: these must include the veterinary sector, so that animal medicines are available to treat the diseases that vets and farmers encounter.
“Improving the availability and uptake of vaccines, which is also proposed, can reduce the need for antibiotics. Veterinary surgeons need access to a range of medicines, including antibiotics, in order to treat the conditions and species under their care and support the high standards of animal welfare our society expects.
“The Report’s call for improved surveillance will build on work already being undertaken within the different livestock sectors, for example in the UK poultry and pig sectors. Targets to reduce antibiotic use must be based on an understanding of why and where antibiotics are currently used, and we welcome the Report’s suggestion that careful consideration must be given to how any target setting will be done. Once the facts have been established, resources can then be focussed on areas where change is most needed to reduce any unnecessary use.
“It is important to remember that in the UK – and indeed throughout the EU, veterinary antibiotics are only available on veterinary prescription and have been banned as growth promoters since 2006,” she added.
The Report recommends restrictions on certain antibiotics for veterinary use.
“NOAH believes that any such decisions must be based on independent regulatory officials’ expert opinions and must follow the agreed regulatory process – such as the recent EMA (European Medicines Agency) re-evaluation of the veterinary use of colistin,” Dawn Howard said.
“Any changes need to be given a realistic timeframe in order that animal welfare is not compromised – something the report itself acknowledges,” she added.
“We also fully support the Report’s call for a global public awareness campaign of this ‘One Health’ issue involving both human and animal health to improve understanding and compliance. This is a global report for a global problem, with practical recommendations and calls to action, both on the international stage and here in the UK.”
British Veterinary Association President Sean Wensley said: “Antimicrobial resistance is a global issue, which the veterinary profession is deeply concerned about as it threatens our ability to treat animals and protect human health.
“We welcome Lord O’Neill’s report, which recognises the importance of using a whole range of measures in both human and animal health to tackle AMR, and the fact that action must be taken globally.
“BVA has opposed the introduction of arbitrary, non-evidence based target setting; such targets, to reduce antibiotic use, risk restricting vets’ ability to treat animal diseases, which could have serious public health and animal welfare implications. However, we accept that evidence-based targets to reduce usage in animal agriculture are likely to form part of the solution to address AMR on a global scale.
“Therefore we are pleased that the report recognises the need for targets to be evidence-based and country-specific, acknowledging that the UK and Europe have already taken action such as banning the use of antibiotics as growth promoters.
“The UK poultry meat sector has also done excellent work to achieve a 96 per cent reduction in the use of fluoroquinolones last year and the UK pig sector has recently introduced an online medicines book to record antimicrobial usage which may subsequently inform future target setting.
“We welcome the call for an expert group to develop proposals on setting targets so that they do not restrict vets’ ability to treat animal disease outbreaks that could threaten public health and animal welfare.
“The reduced use of antibiotics in animal agriculture is just one piece of the jigsaw when tackling AMR and we need to foster increased collaboration between health sectors – with the veterinary profession committed to playing its part – to ensure positive steps are taken to preserve these essential drugs for future generations.
“The current EU legislation on vets’ prescribing of antibiotics for all animals, including those farmed for food, is robust and we would like to see equivalent legislation adopted at international level.”