Archive for September, 2016

Response to new report from the Food Standards Agency released 21 September 2016

In response to the release of a new report from the Food Standards Agency (FSA) outlining test results for resistant bacteria in food, Gwyn Jones, Chair of RUMA, says:

Test results such as these build a better picture of the challenges we all face across human and veterinary medicine.

Good kitchen hygiene, washing hands after handling raw meat and thorough cooking, as advised by the FSA, remain the most reliable ways of preventing the spread of any harmful bacteria.

This is important as these test results underline the complexity of the problem we face. Bacteria naturally ‘dodge’ antibiotics – it’s why we find resistant bacteria millions of years old in the ice caps and in frozen remains of woolly mammoths.

Here, some campylobacter and E.coli have developed resistance to antibiotics rarely used in broiler (chicken) production, in this case fluoroquinolones, as confirmed by sales and use data.

We saw this phenomenon in a study earlier this month from University of Cambridge where the greatest level of resistance was to cephalosporins, which the poultry industry has itself banned since 2012.

So as the focus on recording and reducing use in agriculture without impacting welfare continues with the whole industry’s engagement, we hope testing and research will start to throw light on how to overcome this complex challenge for humans as well as animals.

While a number of studies suggest the risk of resistant bacteria passing from animal to man is exceptionally low, a robust review of the science would also help us understand any links.

Government response to O’Neill findings welcomed amid calls for joined-up leadership and capital investment

The headline requirements for farming set out in the Government response to the O’Neill Review on Antimicrobial Resistance, published today (16 September 2016), have been welcomed by the Responsible Use of Medicines in Agriculture (RUMA) Alliance.

But concerns have been expressed over how the multi-agency approach will work, and whether the industry can access the capital investment needed to create a greater step-change in antibiotic use.

RUMA, which works independently with organisations involved in all stages of the animal food chain from ‘farm to fork’, said it recognised the need for the ambitious target for farming set out in the report, alongside the goals for human medicine stewardship.

“The UK farming industry is being asked to play its part, in reducing antibiotic use by around 19% by 2018 based on sales recorded by the Veterinary Medicines Directorate in 2014,” explained John FitzGerald, RUMA’s secretary general.

“This will be testing, but we are confident and determined that the industry can rise to the challenge. While the O’Neill report suggested achieving this level of use within 10 years, we understand the need for the UK to take a lead, and believe we can deliver this reduction by 2018.

“We also appreciate the faith the Government has placed in the industry to work with the regulator in developing its own sector-specific objectives to reduce, refine and replace use of antibiotics,” he added.

“Included in this is use of antibiotics of critical medical importance, which we have been given an opportunity to steward effectively and potentially preserve as a last resort to protect animal welfare. Again, we accept this challenge, and are currently setting up a ‘Targets Task Force’ to help identify these objectives by 2017, alongside timescales for their delivery.”

However, Mr FitzGerald said RUMA was disappointed that in the response, the Food Standards Agency (FSA) had not acknowledged the industry guidelines for use of antibiotics that were already in place through RUMA.

“The FSA outlines a commitment to encourage the food chain to develop standards for responsible use of antibiotics. We would hope that rather than recreating standards, the RUMA guidelines, written by specialist vets and updated periodically, will be reviewed and augmented as deemed necessary.

“It’s important that existing resources and initiatives such as these don’t get overlooked as the various Government departments and agencies come together to tackle this issue. We need clear leadership from one Government department to help pull this together, and suggest it comes from Defra through the VMD, with the FSA and Environment Agency linking in through these bodies.”

Finally, said Mr FitzGerald, there was no recognition in the report of the huge role capital investment could play in reducing the need for antibiotics in farming, and where that investment could come from.

“Farmers have already identified housing and infrastructure as a major challenge. In pig farming, some aspects of poultry production and calf-rearing especially, modern housing with improved ventilation and hygiene could provide a step-change in the need for antibiotics to treat diseases linked to these factors.

“But with many sectors continuing to work off tiny margins and competing with European and global imports, the Government needs to take a serious look at how it can ‘prime the pump’ when the market is unlikely to provide sufficient returns to fund these changes itself,” explained Mr FitzGerald.

“Government investment or match funding in competitor countries like Germany, the Netherlands and Denmark has allowed significant improvements to facilities leading to a reduction in antibiotic use. Such an approach in the UK would address a similar failure in the market and accelerate positive change.”

RUMA urges G20 to recognise complexity of AMR

A paper challenging global business leaders to recognise the complexity of the antimicrobial resistance (AMR) challenge in humans and animals and role of agriculture, has been circulated at the G20 Summit, which took place at Hangzhou, Zhejiang in China on 4 and 5 September.

The paper, submitted by the Responsible Use of Medicines in Agriculture (RUMA) Alliance and published in the International Chamber of Commerce G20 CEO Advisory Group’s “Business and Leaders” magazine, also asks the G20 to work with regulators and vets to develop bespoke solutions for farmers in each country so they can reduce, refine and replace use of antibiotics.

RUMA chair Gwyn Jones says that through the publication’s readership of 80,000 business leaders, it is hoped the article will place some much-needed context around the role of medicines in livestock farming.

“Resistance is a naturally-occurring phenomenon that develops as bacteria defend themselves against attack, so any antibiotic use can lead to resistance. In fact, resistant bacteria that are millions of years old, pre-dating modern medicine, have been found in the ice caps,” he explains.

“With AMR is very much on the G20’s agenda, it’s very important that global political and business leaders understand this and other complexities around AMR in terms of the causes, the role of antibiotics in humans and animals, and the challenges of tackling resistance sustainably and effectively.”

He says antibiotics are used to treat or prevent disease in farmed livestock but in some countries outside Europe, are still used for growth promotion. “They remain a vital veterinary tool to protect animal health and animal welfare and help us to continue to produce safe, quality food.”

Mr Jones says the challenges to improving the responsibility with which antibiotics are used varies from country to country.

“In developed countries the barriers can revolve around supply chains, market pressure and communication. In developing countries, the focus is more on extended veterinary services to help farmers get the right medicine for treating their animals and to use those medicines at the right time and in the right way.”

He adds that responsible use also means using antibiotics ‘as little as possible and as much as necessary’. “In other words, managing farms to reduce the risk of infection by improving hygiene, using good quality feed, giving the animals access to fresh water, using vaccines and controlling the movement of animals and people into and around the farm through good biosecurity practises.”

The International Chamber of Commerce G20 CEO Advisory Group’s “Business and Leaders” magazine can be accessed at http://g20executivetalkseries.com/.

In its concluding communiqué, the G20 stated: “Antimicrobial resistance (AMR) poses a serious threat to public health, growth and global economic stability. We affirm the need to explore in an inclusive manner to fight antimicrobial resistance by developing evidence-based ways to prevent and mitigate resistance, and unlock research and development into new and existing antimicrobials from a G20 value-added perspective, and call on the WHO, FAO, OIE and OECD to collectively report back in 2017 on options to address this including the economic aspects.”

RUMA response to findings from Antibiotic Resistance Testing of Supermarket Meat

RUMA chairman Gwyn Jones says the farming industry fully recognises concerns about growing resistance to antibiotics, but resistance in humans remains largely attributed to human medical use with a recent study confirming farm animal use could be responsible for as few as one in every 370 clinical cases.

He says: “Good kitchen hygiene, washing hands after handling raw meat and thorough cooking of meat will almost completely prevent the transmission of antimicrobial resistance from meat to man.

“Despite this, the farming industry must also play its part to control spread of resistance. This is why RUMA announced in May it is setting up an industry task force to look at how meaningful targets can be developed to replace, reduce and refine antibiotic use in UK agriculture. That group is now being formed and a first meeting will be held shortly.”

Addressing some of the specific points raised, Mr Jones says UK farming is already focused on reducing use of antibiotics deemed critically important for human medicine (CIAs).

“Sales into farming of fluoroquinolones and 3rd and 4th generation cephalosporins,  which are CIAs, are already very low in the UK, representing just 0.9% of the total,” he explains.

“In 2012 the poultry meat industry introduced a voluntary ban on the use of 3rd and 4th generation cephalosporins, and a commitment to reduce the use of fluoroquinolones which has since led to an overall reduction. The 3rd and 4th generation cephalosporins authorised for use in pigs cannot be given in-feed or in-water and are only ever administered to individual animals.

“Furthermore, despite colistin making up less than 0.2% of UK antibiotic use in UK livestock, RUMA announced a voluntary restriction in December 2015 that it should only be used as the last effective antibiotic available for treating the sick animal,” adds Mr Jones.

“So while it’s very positive that no colistin and fluoroquinolone resistance was found in these samples, the discovery of bacteria resistant to modern cephalosporins when so few are being used only serves to underline the complexity of this issue, and the need to tread carefully – as interventions are not without consequence.”

He explains that bacterial infections and associated inflammation undoubtedly cause pain and discomfort to animals. The treatment of such infections is a requirement of both national and EU animal welfare legislation and all vets are under oath to protect the health and welfare of the animals in their care.

“Therefore, the benefits of any restrictions for public health need to be clear, and balanced against the impact of restricted antibiotic use on animal welfare, the economic viability of our farms and overall UK food security. Badly handled, there is a real risk we will end up importing produce which increases risk to human health if our own, highly-regulated industry is rendered unviable through arbitrary curbs.

Sources:
The European Medicines Agency Committee for Medicinal Products for Veterinary Use (CVMP): “It is recognized that the biggest driver of AMR in people is the use of antimicrobials in humans or human health.”
UK Department of Health 5 Year Strategy on Antimicrobial Resistance (2013) “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 the use of antibiotics in animals.”
Burch, D. 2015 – Use of antibiotics in animals and people. November 28, 2015, Veterinary Record, 549-550 doi:10.1136/vr.h6380
UK Veterinary Antibiotic Resistance and Sales Surveillance

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