Archive for the ‘RUMA News’ Category

RUMA issues wide ranging position paper on antibiotic resistance and antibiotic use in livestock

RUMA has published a wide ranging position paper on antibiotic resistance and antibiotic use in livestock.

Announcing the publication, RUMA Secretary General, John FitzGerald, said that understandably there is much debate at present on antibiotic resistance in human medicine and antibiotic use in human and veterinary medicine. The Prime Minister has raised the issue and two Parliamentary Committees have considered it with various groups, including RUMA, making submissions. This paper clarifies RUMA’s position on antibiotic resistance and how antibiotics can be responsibly used in UK livestock. It also addresses some of the inaccurate assertions about the use of antibiotics in livestock in the recent Alliance to Save Our Antibiotics (ASOA) paper.

Key points in the RUMA paper include

  • Recognising antibiotic resistance as an important One Health issue. RUMA feels it is vital that all parties should work together to ensure that antibiotics remain an effective tool in the treatment of humans and animals so that they continue to be available and effective when needed.
  • The key driver for any controls on the use of antibiotics in animals is to reduce the risk of resistance in humans.
  • Scientific evidence increasingly recognises that the problem of antibiotic resistance in humans comes largely from the over-use and mis-use of antibiotics in human rather than animal medicine
  • Antibiotics must be used responsibly in agriculture to stop the possibility of their use leading to problems in animal or human medicine.
  • RUMA supports the call from various quarters for the collection of better data on the usage of antibiotics in animals.
  • RUMA agrees with the general premise that prevention is better than cure and believes that antibiotics can be used responsibly in both human and animal medicine to prevent disease and suffering. RUMA does not, however, support the routine preventive use of antibiotics where such disease challenge can be prevented by better husbandry and farm management.
  • RUMA believes that the responsible use of antibiotics, and other veterinary medicines, is an important component of the care of livestock and RUMA calls on the Soil Association, and others licensing organic production, to allow antibiotics, and all other authorised medicines, to be used responsibly in the interests of animal welfare.
  • Critically important antibiotics for human medicine should be used sparingly and not routinely as first choice antibiotics in animals.
  • Removing any antibiotic from animal use will put more pressure on the antibiotic classes used in its place thus increasing the likelihood of resistance developing.

NOTES FOR EDITORS

  1. RUMA is an alliance of 23 organisations representing every stage of the “farm to fork” process which aims to promote a co-ordinated and integrated approach to best practice in the use of medicines on farm. For further information contact RUMA Secretary General John FitzGerald (rumasec@btinternet.com) or see the RUMA website www.ruma.org.uk
  2. The RUMA Position Paper on antibiotic resistance and antibiotic use in livestock is available from this link.
  3. The Alliance to Save Our Antibiotics involves the Soil Association, Sustain and Compassion in World Farming.

AMR Strategy Action Plan

The Responsible Use of Medicines in Agriculture Alliance (RUMA) fully supports the UK Government’s Five Year Antimicrobial Resistance (AMR) Strategy that was launched on 10 September 2013 and has produced an action plan for the livestock sector.

RUMA Secretary General, John FitzGerald, said the Alliance had discussed the actions that will be required to implement the Strategy and had developed the action plan that has been published on the RUMA website. The plan is based on the detailed actions in Annex B of the Strategy and sets out the actions that RUMA and/or its individual member organisations will take. Inevitably, the plan is still at an early stage. RUMA members have agreed to review and record progress against the plan at RUMA’s quarterly meetings and to publish the plan and its subsequent revisions to provide an open report on how this work is developing. During these reviews new actions will be added to the plan including any identified by the high level steering group made up of DARC, ARHAI and ACMSF members set out in the Strategy as being responsible for agreeing the overall plan for its implementation.

In response to the action to improve public engagement, RUMA has published an information note on antibiotic resistance. Written in Plain English, the information note aims to:

  1. Explain antibiotic resistance and why it matters to human and animal health
  2. Set out why and how antibiotics are used in UK farms
  3. Identify the risks to public health from use of antibiotics in farming
  4. Explain the responsible use of antibiotics in farming
  5. Identify the changes in legislative controls (for antibiotic use in veterinary medicines and feed additives) that RUMA believes are appropriate and proportionate to manage the limited risk of antibiotic use in farm animals leading to clinical treatment problems in humans.
  6. RUMA Secretary General, John FitzGerald, said that the Alliance had published the information note to help all interested parties from consumers to regulators to understand the complex topic of antibiotic resistance and the use of antibiotics in livestock.

NOTES FOR EDITORS

  1. RUMA is an alliance of 23 organisations representing every stage of the “farm to fork” process which aims to promote a co-ordinated and integrated approach to best practice in the use of medicines on farm. For further information contact RUMA Secretary General John FitzGerald (rumasec@btinternet.com) or see the RUMA website www.ruma.org.uk
  2. The UK’s Five Year AMR Strategy can be found at https://www.gov.uk/government/publications/uk-5-year-antimicrobial-resistance-strategy-2013-to-2018
  3. The RUMA Action Plan can be found here
  4. The RUMA Antibiotic Resistance Information Note can be found here
  5. DARC is the DEFRA Antimicrobial Resistance Co-ordination Committee; ARHAI is the Advisory Committee on Antimicrobial Resistance (a Department of Health Advisory Committee) and Healthcare Associated Infections; ACMSF is the Advisory Committee on Microbiological Safety of Food (a Food Standards Agency Advisory Committee)

RUMA launches new farmer Poultry and Game guidelines

The Responsible Use of Medicines in Agriculture Alliance (RUMA) is delighted to launch its revised guidelines for farmers on the Responsible Use of Antimicrobials in Poultry and Game Production.

RUMA Secretary General, John FitzGerald, said the revised guidelines were prepared as part of RUMA’s programme of regularly updating its guidelines. He said that the new revision had been extended to include game production and he was delighted that the Game Famers’ Association had decided to send the revised guideline to all their members as a supplement to their Game Farming Guide.

Mr FitzGerald said that the new version of the Poultry and Game Antimicrobial Guidelines for farmers stressed the need to manage farms to reduce disease challenge and minimise antimicrobial use. They include practical advice for poultry and game farmers and highlight the Four Golden Rules on Disease Control i.e.

  • biosecurity to limit disease spread
  • avoid stress
  • good hygiene
  • good nutrition.

RUMA Guidelines were first introduced in 2000 and are intended as working documents. They are updated periodically to continually provide best advice.

Now in their 3rd editions, the short version provides quick and easy guiding principles that can be used as a working document by farmers, while the longer version is aimed primarily at veterinary surgeons and other advisers, to provide more detail. Work has already begun on updating the longer poultry guideline which will be launched later in 2014.

The holistic approach to minimising disease set out by the Four Golden Rules helps reduce the need to use antimicrobials, including antibiotics, without adversely affecting animal welfare. It is important to reduce the risk of antibiotic resistance without reducing the availability of necessary antibiotics.

NOTES FOR EDITORS

  1. RUMA is an alliance of 23 organisations representing every stage of the “farm to fork” process which aims to promote a co-ordinated and integrated approach to best practice in the use of medicines on farm. For further information contact RUMA Secretary General John FitzGerald (rumasec@btinternet.com) or see the RUMA website www.ruma.org.uk
  2. The Game Farmers’ Association (GFA) is a trade organisation dedicated to the production of quality game birds for the UK shooting industry. The Association was founded over 80 years ago and now has in excess of 200 game farming members. Most game farmers in Britain are members of the GFA and the Association represents their interests, as well as encouraging everyone who rears game to follow high standards which include the responsible use of medicines.
  3. RUMA Guidelines are regularly reviewed in consultation with RUMA members and specialist groups working in the relevant sector.
  4. The Four Golden Rules on Disease Control are explained in the table which is included in the Guidelines Disease Control:

Four golden rules

RUMA Surprise and Disappointment at CMO’s Unprecedented Proposal to Kill Animals rather than Treat Them with Antibiotics

The Daily Mail reported yesterday that Professor Dame Sally Davies, the UK’s Chief Medical Officer, has proposed that badly infected animals should be slaughtered rather than treated with antibiotics.

The Mail article is focused on human antibiotic prescribing with just a small section on animal use. But this section also reports the CMO as claiming that antibiotic use in animals is a substantial source of antibiotic resistance in humans which is a dramatic change from her previous position and UK Government policy. Scientific evidence shows that the main source of resistant infections in people is the use of antibiotics in people.

RUMA Secretary General, John FitzGerald, said his members had expressed considerable surprise and grave disappointment at the CMO’s reported comments and RUMA is seeking a meeting with Dame Sally. The purpose of the meeting would be to review any scientific evidence she has to support her reported comment that animal use is a substantial source of resistance in humans and to seek clarification of her unprecedented proposal that sick animals should be slaughtered rather than treated. In particular, RUMA will ask how many animals the CMO thinks it is acceptable to slaughter rather than treat and whether her comments apply also to family pets. RUMA will also make it clear that treating sick animals is an essential way for farmers to ensure that they comply with animal welfare legislation.

NOTES FOR EDITORS

  1. The Daily Mail article can be found at http://www.dailymail.co.uk/health/article-2588475/Family-doctors-told-stop-doling-antibiotics-Chief-medical-officer-accuses-GPs-prescribing-drugs-patients-suffering-minor-illnesses.html
  2. The section on animal use in the article says

    She also called for a cut in the use of antibiotics in farm animals, one of the biggest causes of resistance to the drugs.

    Controversially, she urged vets to slaughter sick animals rather than give them antibiotics to help them recover. She said: ‘I had a bit of a problem with some vets recently because I said, “Why don’t you just slaughter animals when they’re badly infected?” It seems to me much better because then they can’t transmit them [antibiotics].

    At the moment, if you eat a farmed salmon in America it has probably eaten its own weight in antibiotics.

  3. RUMA is an alliance of 23 organisations representing every stage of the “farm to fork” process which aims to promote a co-ordinated and integrated approach to best practice in the use of medicines on farm. For further information please contact RUMA Secretary General John FitzGerald (rumasec@btinternet.com)

Carbapenems not used in Livestock

The recently announced increase in carbapenem resistance in humans led to an Alliance to Save Our Antibiotics inspired article in The Independent on 12 March 2014 calling for a ban on carbapenem use in agriculture.

The Responsible Use of Medicines in Agriculture Alliance (RUMA) would like to point out that

  • there are no carbapenem antibiotic products authorised for use in animals and
  • there is no evidence of carbapenem use in livestock under the prescribing cascade (often referred to as off-label use).

With no carbapenem use in livestock, this means that the resistance reported in humans has come from the use of carbapenems in human medicine.

RUMA Secretary General, John FitzGerald, said antibiotics are key medicines in both human and animal health and they should be used responsibly. The carbapenem resistance reported in the UK and recent research which shows that resistant bacteria from humans and animals are genetically different strengthen the UK Government’s and RUMA’s view that human use of antibiotics is the prime source of antibiotic resistance in humans.

Once again, RUMA is disappointed that the Alliance to Save Our Antibiotics continues to use an important one-health issue like antibiotic resistance to attack conventional farming. Indeed, this misinformation and unnecessary scaremongering only serves to confuse the issue. It is essential that antibiotics that are necessary to maintain animal health and welfare remain available for veterinary use. The best way to tackle antibiotic resistance is for all involved in the use of antibiotics in humans and animals to work together.

NOTES FOR EDITORS

  1. The Independent article can be found at http://www.independent.co.uk/life-style/health-and-families/health-news/ban-vets-from-using-last-resort-antibiotics-to-beat-drugresistant-bacteria-say-campaigners-9185088.html
  2. Carbapenems are a class of antibiotics where only medicines for human use have been authorised. There are no antibiotic products for animal use that contain carbapenems.
  3. The prescribing cascade is a decision tree set out in EC legislation to allow veterinary surgeons to use other medicines where there is no product authorised for the species and/or disease that is being treated. The cascade recognises the lack of authorised veterinary medicines available to treat the wide range of animal species and disease. There is no evidence of any use of carbapenems in livestock under the cascade.
  4. The following research has shown that antibiotic resistant bacteria from humans and animals are genetically different.
    • Mather AE et al (2013) Distinguishable Epidemics of Multidrug Resistant Salmonella Typhimurium DT104 in different hosts. Science express published on line 12 September 2013
    • Wu G, Day MJ, Mafura MT, Nunez-Garcia J, Fenner JJ, et al. (2013) Comparative Analysis of ESBL-Positive Escherichia coli Isolates from Animals and Humans from the UK, The Netherlands and Germany. PLoS ONE 8(9): e75392. doi:10.1371/journal.pone.0075392
    • M de Been et al. ECMID 2013 Whole genome sequence-based epidemiological analysis of ESBL-producing Escherichia Coli’ .
  5. The Department of Health’s 5 year Strategy on Antimicrobial Resistance said ‘Increasing scientific evidence suggests that the clinical issues with antimicrobial resistance that we face in human medicine are primarily the result of antibiotic use in people, rather than antibiotics in animals’. (Point 2.1, page 8, Department of Health UK 5 Year Antimicrobial Resistance Strategy 2013 to 2018) https://www.gov.uk/government/publications/uk-5-year-antimicrobial-resistance-strategy-2013-to-2018
  6. RUMA is an alliance of 23 organisations representing every stage of the “farm to fork” process which aims to promote a co-ordinated and integrated approach to best practice in the use of medicines on farm. A full list of RUMA members is at paragraph 4 below. For further information contact RUMA Secretary General John FitzGerald (rumasec@btinternet.com)
  7. RUMA’s members are:
    • Agricultural Industries Confederation
    • Animal Health Distributors Association
    • Animal Medicines Training Regulatory Authority
    • BPEX and EBLEX
    • British Egg Industry Council
    • British Poultry Council
    • British Retail Consortium
    • British Veterinary Association
    • City and Guilds
    • DairyCo
    • Dairy UK
    • Game Farmers’ Association
    • LEAF
    • National Beef Association
    • National Farmers’ Union
    • National Office of Animal Health
    • National Pig Association
    • National Sheep Association
    • NFU Scotland
    • Red Tractor Assurance
    • Royal Association of British Dairy Farmers
    • RSPCA
    • Royal Pharmaceutical Society

    Observers

    • Food Standards Agency
    • Veterinary Medicines Directorate

RUMA Business Plan 2014

Introduction

    1. RUMA is an alliance of farming, animal health industry, food retailing and associated groups (see annex A for current RUMA membership and officers) with the aim of promoting a co-ordinated and integrated approach to best practice in the use of medicines on farm.

How

    1. RUMA operates by providing best practice advice on the use of medicine to farmers and veterinary surgeons by publishing free guidelines aimed at each of these groups and providing advice/comment on specific issues on its website ruma.org.uk. RUMA guidelines stress good farm management and health planning to reduce disease challenge and, therefore, the need to use medicines. RUMA does not support the use of medicines as a substitute for good farm management and animal husbandry.

RUMA’s existing commitments

    1. It is important for RUMA to maintain a high profile amongst farmers and vets, so that they can avail themselves of the advice on best practice use of medicines, and policy makers (e.g. Defra and the Food Standards Agency), so that they are aware of this advice. This will continue to be done by
      • helping the livestock industry to implement the UK Government’s 5 year AMR Strategy published in 2013.
      • keeping the RUMA website up to date by populating it with position statements, factsheets and all the sort of information users would expect of an organisation speaking for the industry.
      • exploring opportunities to increase awareness of the RUMA website and familiarity with its contents.
      • modernising and launching a new RUMA website by the end of 2014.
      • updating and publishing the various guidelines by using internal RUMA expertise and good will where at all possible to reduce costs.
      • RUMA members regularly referring to the work of RUMA where appropriate. auditing the reach of the guidelines, as far as that is possible.
      • helping to support veterinary surgeons and educate farmers and others involved in the responsible use of medicines. In particular, RUMA will work with others to increase and improve the training in responsible use available to farmers.
      • RUMA’s officers attending meetings and writing articles to publicise RUMA’s work.
      • possibly arranging a conference on responsible use.

Future work programme

    1. The European Commission plans to announce proposals to amend the EU’s veterinary medicines legislation in the first quarter of 2014. Their key aims are to improve the availability of veterinary medicines and reduce the risk of antimicrobial resistance. RUMA has been working since 1998 to ensure the responsible use of antimicrobials and reduce the risk of antimicrobial resistance and fully supports the Commission’s aims. So, in addition to the routine work set out above, RUMA will work to influence and prepare for the Commission’s announcement and to help the UK negotiators in their response to it. RUMA will:
      • closely monitor EU discussions, proposals etc in relation to the antimicrobial issue.
      • work with EPRUMA to influence the Commission’s developing proposals.
      • brief/meet UK and European Parliamentarians as appropriate.
      • produce appropriate briefing material.
      • keep RUMA members up to date on developments via email and on the website.
      • as necessary, call special meetings of the Board/AMR group to assess action.
      • organise RUMA press briefings or participate in RUMA members’ press briefings.
      • organise an event in conjunction with the Science Media Centre on antibiotic resistance
      • RUMA’s officers attending meetings and writing articles to publicise the work of the Alliance on the Commission’s proposals.
      • access specialist external veterinary/public health advice.
      • consider organising a conference to discuss the implications of the Commission’s proposals to amend the Veterinary Medicines Directive.

Budget

  1. RUMA is financed through fees paid by its members. These normally generate an annual income of some £20,000 which is used to meet the costs of drafting and issuing the guidelines, maintaining the website, holding meetings and general administration by the Secretary General.
  2. The one-off additional costs of the extra work outlined above are estimated to be up to £16,000 for
    • briefing all relevant bodies in the UK – paid from regular income
    • three visits (6 nights stay) to Brussels to meet EPRUMA and/or Commission officials and to attend any relevant conferences – £2,500.
    • briefing/meeting MEPs may be partly achieved under the first bullet but an allowance of £1,000 is needed to cover additional trips.
    • keeping RUMA members up to date on developments via email and on the website. This is part of RUMA’s routine work and would be met from the normal annual income.
    • possibly calling special meetings of the Board/AMR group to assess action – room hire/refreshments – up to £1,000 which hopefully members will be able to cover.
    • organise or participate in RUMA members’ press briefings. This is part of RUMA’s routine work and would be met from the normal annual income.
    • arrange individual meetings with member organisations as necessary to let them know what RUMA is doing. These meetings would be more specific to the organisation in question than the general email/website circulation – £1,000 for travel, overnight stays.
    • access to specialist external veterinary/public health advice – £2,500.
    • additional secretariat support preparing papers, liaising with UK and EU officials, EPRUMA and other advisers, arranging meetings etc – £8,000.
  3. The additional income may be required for 2014/15 and RUMA will seek this from its reserves and external sources e.g. Defra, the Commission etc. Alternatively, the additional funding could be achieved by increasing RUMA members’ fees for one year or a one-off special payment. The RUMA Board will assess the need for additional income in subsequent years taking into account the proposals eventually made by the Commission and the need for RUMA to seek any changes to them.

To see the full version of the RUMA Business Plan 2014 click here

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