The third biennial RUMA conference held at Sainsbury’s Conference Centre in central London celebrated success, but also examinined some weighty challenges ahead, including resistance to medicines, novel diseases, Brexit and reputation. Watch our two short conference videos and hear from pig vet Richard Pearson, dairy farmer Paul Tompkins and calf rearer Hannah Dyke, as well as RUMA chair Gwyn Jones, about the success that the UK farming industry now needs to build on.
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Two years after industry-led targets for antibiotic use were identified for all main farm livestock species in the UK, a second annual review of progress has been released, including details of where targets have been achieved early and where challenges remain.
The ‘Two Year On’ report, released by RUMA’s Targets Task Force to coincide with the RUMA conference (29 October), shows progress towards goals for data collection, use of antibiotics, and uptake of preventative measures such as vaccines and training.
The report follows up on the work of the task force in 2017 in which a leading farmer and veterinary surgeon from each sector identified different starting points and potential for reductions in antibiotic use in each species by 2020, then worked with their respective sectors to gain support for the plans . A progress report on the first year of activity was published in November 2018.
RUMA’s chairman Gwyn Jones says this latest review not only provides transparency and accountability, but collects information on progress into one place and explains what is underpinning the bigger picture.
“This report shows the granularity behind the very welcome reductions in antibiotics sales announced by the Veterinary Medicines Directorate at our conference ,” he says.
“Overall we have a positive story, with antibiotic sales having more than halved in five years, but each livestock sector is in a very different place. Even within a sector, there can be a wide range of results with some very progressive producers, and others yet to engage.”
He says that the poultry meat and laying hen sectors have maintained low antibiotic use and are below target. The gamebird sector has achieved its planned halving of antibiotic use early, but is looking at further cuts. Trout and salmon are near or below target, and with a 60% fall in antibiotic use over three years, the pig sector is on track to meet ambitious reductions by 2020.
“However, disease is proving a major challenge, some of which is being exacerbated by climate change. There is also awareness of how much tougher it will get each year to deliver the changes needed; next steps could require investment or some brave decision-making for some.
“Lack of data for the cattle and sheep sectors also continues to be a problem but we are seeing some very successful initiatives now making a difference, and concerted progress has been made towards resolving the data challenge.”
Mr Jones reiterated the importance of not compromising animal health and welfare or food safety while adjustments were being made.
“The approach has to be sustainable with an end-goal of optimal – not zero – use. Antibiotics play an important role in preventing pain and suffering in our farm livestock as well as ensuring food safety. This is why it’s important to judge progress against the whole range of qualitative and quantitative measures in the review.”
The ‘Targets Task Force: Two Years On’ report can be downloaded HERE.
Changes made to the Red Tractor assurance scheme standards for cattle and sheep last summer are driving further significant reductions in use of highest-priority critically important antibiotics (HP-CIAs) across the UK, suggests a new study released at the British Cattle Veterinary Association Congress this week (17-19 October).
Sales of fluoroquinolones and 3rd and 4th generation cephalosporins for UK farm livestock are already low, having fallen 57% and 38% respectively between 2013 and 2017. But analysis of veterinary records from 2,764 beef, sheep and dairy farms, carried out by Westpoint vet Tim Potter in association with Kingshay, found that following the introduction of the new standards, use of HP-CIAs on these farms fell by 92%.
Substituting HP-CIAs, which often require small amounts of active ingredient per treatment, with lower priority antibiotics requiring larger active ingredient dose rates, can push up overall antibiotic use; however, total sales of antibiotics to these farms also fell by 22% throughout the same period.
Red Tractor, which has a membership of over 35,000 beef, lamb and dairy producers across the UK, introduced the new requirements on antibiotic use to their ruminant standards in June 2018.
These include instructions that HP-CIAs are used only as a last resort under vet direction guided by sensitivity or diagnostic testing. Farms are also now required to collate their annual medicine usage and discuss use of HP-CIAs with their vet.
Tim Potter says the results of the study demonstrate the dramatic effect these new requirements have had.
“There was already an awareness of the importance of cutting back on prescriptions for the highest priority antibiotics,” he explains.
“Colistin, another HP-CIA, has almost no use in UK farm animals now. While use of fluoroquinolones and modern cephalosporins has also fallen, these are proving harder to replace and their rate of reduction has been slower.
“What this study shows is that the implementation of a formal hurdle to use of these more important antibiotics has driven behaviour change at farm level, by requiring the vet and farmer to have a conversation about their medicine regime.
“The result of these conversations appears to be reductions in HP-CIAs, helped by changes in management practices such as increased uptake of vaccination and disease eradication programmes,” adds Tim.
Richard Simpson of Kingshay, co-author in the study, says the other important element in the Red Tractor strategy has been the requirement for collation and review of antibiotic use by the vet.
“In our study, this increased the engagement of farmers on the topic of responsible use of antibiotics and ensured there was an overall reduction in use, not simply a substitution of alternative products for the HP-CIAs – as demonstrated by the fall in total sales.”
He says that in response to the increasing number of requests for medicines reviews and the integration of the reviews into the health planning process, Kingshay developed an antibiotic sales reporting service.
“The reports have proved a valuable tool for promoting farmer engagement,” explains Richard. “By providing a breakdown of the class of products used, vets have been able to provide tailored advice to farms on specific areas for improvement and the use of anonymised benchmarking has provided context to the data.”
Gwyn Jones, chairman of RUMA, says the success of the UK’s 48% overall reduction in on-farm antibiotic use between 2013 and 2017* has not just been about defining suitable targets, but also identifying ways to drive change – as illustrated in this study.
“Assurance schemes are a very good mechanism for this. With Red Tractor assurance accreditation covering 95% of dairy, 80% of finished beef and 60% of finished lamb production, it’s clear that following last year’s changes to their standards a lot more discussion is happening between farmer and vet.”
While the national effect of the changes to Red Tractor’s assurance standards won’t be fully known until the 2018 and even 2019 national antibiotic sales data are released, the results are extremely encouraging says Mr Jones.
“This is great news for the reputation of the UK industry – especially as we continue exploring future export opportunities for our meat and dairy.”
The analysis in the study found that in the six months leading up to June 2018 the average monthly volume of HP-CIAs sold was 1.8kg; from July 2018 to December 2018 the average monthly volume of CIAs sold was 0.15kg (147g) – a reduction of 92%. Total antimicrobial sales to those beef, sheep and dairy farms also fell over the same periods, from a mean of 110kg per month to 87kg per month. Looking at the individual months, the sales of HP-CIAs dropped from 1.4kg in May 2018 to 0.0004kg – just 0.4g – in December 2018, a decrease of over 99.9%.
The Veterinary Medicines Directorate will release the 2018 national antibiotic sales data on 29 October at the RUMA conference.
Vaccination of the UK’s calves and sheep against livestock diseases has risen to one of the highest levels in seven years.
The rise in agricultural use is being put down to a better understanding among farmers of the role good welfare and husbandry plays in helping reduce the risk of disease spread, and therefore the need for antibiotic treatments.
This is despite a 40% fall in sales of antibiotics for farm animals in the past five years, which has made the UK among the lowest users in Europe.
The data, contained in an upcoming report from the agricultural levy board AHDB, shows almost 10 million doses of vaccine were sold for use in cattle in 2018.
Derek Armstrong, lead vet from AHDB, says the big rise has been in vaccines to protect against pneumonia in calves, a condition many vets would otherwise have to treat with antibiotics.
“Sales for this have risen 35% since 2011, with two fifths of all calves protected in 2018. Vaccines for another lung condition, rhinotracheitis, have also gone up by 50% over the same period,” he explains.
“Other good news is that one in five breeding cows now gets vaccinated to reduce the risk of her calf contracting enteritis: protective antibodies are passed to the calf as it drinks its mother’s colostrum shortly after birth.”
The UK sheep sector also performed well in 2018, seeing the highest uptake of vaccines in over six years, with almost 39 million doses sold.
Dr Fiona Lovatt of the Sheep Antibiotic Guardian Group says that for the first time since 2012, over two-thirds of all sheep which should be vaccinated against a range of important ‘clostridial’ diseases, were vaccinated; half of sheep were also vaccinated against Pasteurella, bacteria which cause pneumonia and sudden death.
“This is good news as we try to shift behaviour away from treating disease, to planning ahead to prevent disease and protect the flock,” explains Dr Lovatt.
“Despite issues with vaccine supply, the number of ewes vaccinated against diseases that lead to miscarriages has also steadily increased since 2013 – although further uptake would increase the number of live lambs born significantly.”
She adds that although sales of foot rot vaccine had been steadily climbing since 2013, there was a small drop in uptake of the vaccine from 15% of breeding animals in 2017 to 13% in 2018.
“Foot rot vaccination is one of the important elements of the sheep sector’s strategy to control lameness, and a key target for antibiotic reductions. Vaccine use should be considered if there are more than 2% of the flock lame with foot rot at any one time.”
Professor Mark Fielder from Kingston University, also president of the Society for Applied Microbiology, says the news of the increase in vaccine sales in the cattle and sheep sectors is to be widely welcomed.
“This news is timely as it highlights the potentially positive steps being taken by the UK agricultural industry to further limit the use of antibiotics and so help protect the drugs we have left in use.
“Vaccines are established and effective medicines that have worked well in agriculture and human medicine in the past, with some diseases such as Rinderpest and Smallpox being eradicated globally.
“This report emerges at a time when our status in human medicine has slipped with regard to measles following a fall in vaccination uptake. Vaccines have undoubted positive effects and are efficient medicines that have helped to prevent diseases globally. Their use and this report should be celebrated,” he says.
A task force set up by the Responsible Use of Medicines in Agriculture (RUMA) Alliance in 2016 to identify targets for antibiotic use in UK farm livestock has been refreshed, and convened in a kick-off meeting to start defining new goals post-2020.
With each sector now on track to meet most of the targets set by the original Targets Task Force in time for the 2020 deadline, attention is turning to the aims for UK farmers and their veterinary surgeons beyond that point.
Chris Lloyd, secretary general of RUMA, says that many of the ‘easier battles’ on reducing antibiotic use have now been won, making the next phase of target-setting more complex but just as important.
“With some sectors now at, or fast approaching, lowest potential use without risking animal health and welfare or food safety, I think we will see far more focus on ways to demonstrate the quality of management, and the health and welfare of the animal,” says Mr Lloyd.
He adds that new iteration of the Targets Task Force has 10 livestock groups rather than the eight in the last initiative. “Calves have been introduced as a particular area of interest because of the way they span the dairy and beef sectors, and the fish sector has been split into salmon and trout species.”
The first meeting took place on 10 September, and the group is due to meet next in February 2020 to gauge progress. As before, the British Veterinary Association, Food Standards Agency, National Office for Animal Health, Red Tractor and Veterinary Medicines Directorate will be observers, with levy board AHDB also joining this time. The new post-2020 targets will be agreed and reported before the end of next year.
The new Targets Task Force comprises:
- Beef: Mark Jelley (producer), Elizabeth Berry (vet)
- Dairy: Paul Tompkins (producer), Elizabeth Berry (vet)
- Calves: Hannah Dyke (producer), Richard Cooper (vet)
- Pigs: Richard Lister (producer), Richard Pearson (vet)
- Sheep: Charles Sercombe (producer); Fiona Lovatt (vet)
- Salmon: Iain Berrill (representing producers), members of the Salmon Prescribing Group (vets)
- Trout: Oliver Robinson (producer), Peter Scott (vet)
- Gamebirds: Paul Jeavons (producer), Will Ingham & Isy Manning (vets)
- Poultry meat: Tom Wornham (producer), Daniel Parker (vet)
- Laying hens: Paul McMullin (vet)
- Observers: Clive Brown (AHDB), James Russell (BVA), Paul Cook (FSA), Donal Murphy (NOAH), Georgina Crayford (Red Tractor) and Fraser Broadfoot (VMD).
The original Targets Task Force was formed in 2016 in the wake of the Government-commissioned O’Neill Review on antimicrobial resistance, and went on to successfully define sector-specific targets which were announced at the end of 2017.
The wholesale industry engagement with these voluntary targets and the collaborative nature of the way Government and industry have worked together is unique globally, and has attracted interest from a number of other countries as well as from the European Commission’s Directorate-General for Health and Food Safety DG Sante.
The Targets Task Force initiative also won the hotly contested Prescribing and Stewardship category at Public Health England’s Antibiotic Guardian Awards in 2018.
With the final programme for RUMA’s third biennial conference on 29 October now published, it has been confirmed that early bird ticket sales at the discounted rate of £175 will close at midnight 30 September. From 1 October, tickets will revert to the full £200 price.
Using the theme ‘Building on Success’, the conference will examine whether recent progress in stewarding antibiotics can be maintained, and what needs to be done to better support global efforts to battle antimicrobial resistance (AMR). The role of media and public opinion in achieving positive change will also be discussed, and whether UK farming’s animal health and welfare and food safety are robust enough to take advantage of opportunities as well as address upcoming market challenges.
Headlining the event will be American journalist and author on public and global health and food policy Maryn McKenna, who will be dissecting the role of the public and media in driving change in medicine stewardship.
A senior fellow at the Center for the Study of Human Health at Emory University, Ms McKenna is the author of the books Big Chicken (published in the UK under the title Plucked), Superbug, and Beating Back the Devil. She is a columnist for WIRED and a journalist for magazines including National Geographic, The New Republic and the New York Times, and her work critically examines antibiotic use in agriculture.
The Food Standards Agency will be represented at a RUMA conference for the first time, with its chair Heather Hancock opening proceedings by outlining the regulator’s vision for safe, healthy food built on farm systems which are modern, productive and demonstrate responsible use of medicines.
As at the last conference, the latest antibiotic sales data for farm animals are expected to be released by the Veterinary Medicine Directorate’s (VMD) head of Antimicrobial Resistance Dr Kitty Healey; she will also provide recent surveillance findings for antibiotic-resistance genes within farm animals and their food products, and will discuss how the industry can maintain progress and lead the world in responsible use.
While antibiotic use and AMR remain key themes in the event, broader aspects of farm animal health and welfare, emerging resistance in other pathogens and wider challenges presented by disease will be debated. Behaviour change among farmers and their veterinary surgeons, and the economic and reputational opportunities of better health and food safety will be covered as part of this.
To provide insight in these areas, the following have also been confirmed as speakers:
- Stuart Roberts, NFU
- Dr Shabbir Simjee, RUMA Independent Scientific Group
- Duncan Sinclair, British Retail Consortium
- Aarti Ramachandran, FAIRR
- Professor Julie Fitzpatrick, Moredun Research Institute.
- Dr Simon Doherty, British Veterinary Association
Dr Christine Middlemiss, the chief veterinary officer, will be concluding the event with a summary of the learnings from the day and a call to action for the next two years.
RUMA has welcomed the publishing of 2018 antibiotic usage data collected through the British Poultry Stewardship programme. Despite increased disease challenges during 2018, the British poultry meat industry was able to maintain antibiotic use at low levels with just 12mg/kg required in the broiler meat sector, 47mg/kg used for turkeys and less than 2mg/kg for ducks.
Overall this meant that the amount of antibiotics used by the industry increased slightly from 14.4 tonnes to 16.2 tonnes, nonetheless representing an 80% reduction in total use since 2012, and an 83% reduction in use of highest-priority critically-important antibiotics.
Gwyn Jones, chairman of RUMA, said that the UK poultry meat industry was continuing to show leadership in antibiotics stewardship by maintaining low usage levels in a difficult year. “The challenge for all sectors will be as they reach their ‘terminal low’ in use. At this point, it is about responsibly maintaining low levels of use without compromising health and welfare or food safety in the face of emerging external challenges and disease.”
The report can be downloaded from the British Poultry Council website at https://www.britishpoultry.org.uk/bpc-antibiotics-report-2019/
Hybu Cig Cymru – Meat Promotion Wales (HCC) and Quality Meat Scotland (QMS) are the latest organisations to join the Responsible Use of Medicines in Agriculture (RUMA) Alliance, strengthening the farming industry’s ability to apply clear, consistent standards of farm medicine stewardship, and particularly of antibiotics, across the whole UK.
RUMA chairman Gwyn Jones says the involvement in RUMA of the two meat assurance organisations – alongside that of existing members the National Farmers Union of Scotland (NFUS) and the Ulster Farmers’ Union (UFU) – strengthens the UK’s cohesive and voluntary approach to antibiotic stewardship which has helped to deliver overall reductions of 40% in farm antibiotic sales so far.
Mr Jones explains: “While HCC, QMS, NFUS and UFU have been actively involved in welfare and antibiotic stewardship groups for some time, being part of RUMA will ensure greater future alignment.
“RUMA now has deep representation in all parts of the UK, at all stages of the supply chain and in every main livestock sector, which will be essential in delivering the RUMA Targets Task Force 2020 targets for antibiotic use. In turn, meeting these will help towards achieving the UK Government’s 5-year action plan on antimicrobial resistance (AMR) and the supporting measures already in place in Scotland and recently announced in both Wales and Northern Ireland.
“I can’t emphasise enough the benefits of UK farm and veterinary groups continuing to take ownership of their part of the challenge of antimicrobial resistance. That we can do it with clarity and mutual support makes our efforts all the more effective.”
The UK’s voluntary approach to stewardship, working in collaboration with the UK Governments, has attracted interest from other countries; the EU’s Directorate General for Animal Health DG Sante visited in 2018 on a fact-finding mission.
Mr Jones says: “The voluntary approach, which has led to the 40% reduction in farm antibiotic sales over the past five years without the need for legislative change, is making progress sustainable and cost-effective. We must stay focused to ensure that we deliver what has been promised and reduce any impact UK food and farming might have on the overall burden of antimicrobial resistance now and in the future.”
A new standardised way to measure the amount of antibiotics used on-farm have been announced by the Sheep Antibiotic Guardian Group (SAGG), a sub-group of the Sheep Health and Welfare Group (SHAWG). SAGG has worked closely with the Veterinary Medicines Directorate, academics and vets to identify these measures, and is now urging all those who work in the sheep sector to support farmers in capturing the information. The document outlining the measures and how they should be recorded sits alongside new guidelines on responsible use of antibiotics in the sheep sector. More information at www.shawg.org.uk.
The cattle sectors are also moving forward in this area, with the Cattle Health and Welfare Group (CHAWG) releasing metrics for the dairy sector at the end of last year. Measuring use on beef farms in more complex, and so the beef sector has just released a consultation to determine which measures will be the most appropriate and practical. It is hoping all those who work in the beef sector, whether farmers and vets or suppliers and supply chain, will respond by the 23 August deadline. More information and support materials at www.chawg.org.uk.
Nicola Williams, Professor in Zoonotic Bacterial Disease at the University of Liverpool, is the latest expertto join an independent scientific group which advises on the responsible use of medicines in UK farm animals. She will sit alongside other eminent scientists from veterinary, medical and microbiological fields, providing insight to inform the policies developed by the Responsible Use of Medicines in Agriculture (RUMA) Alliance.
Professor Williams is a microbiologist with over 17 years’ experience in conducting applied research, primarily on bacterial zoonoses and antimicrobial resistance (AMR). Her research interests include reservoirs and transmission of food-borne pathogens, transfer and maintenance of antimicrobial resistance, antimicrobial prescribing practice, and the epidemiology of AMR bacteria in wildlife, livestock and pets.
Speaking of her appointment, Professor Williams said: “I am delighted to join this unique group and have the chance to apply my learnings at the ‘coalface’ of changes to animal medicine stewardship in the UK.
“I’m particularly interested in how some areas of current research could add to the knowledge base of this scientific group – for example, work I’m now doing in the UK exploring what drives veterinary prescribing behaviour so we can understand how change can be implemented.
“Other relevant studies concern the characterising of relationships and transmission of pathogenic bacteria between different reservoirs, including humans, livestock and the food chain, and the wider environment.
“We are seeing a far stronger focus on AMR in the environment now emerging, so I hope that adding my knowledge in this area to the scientific group will help RUMA to identify what guidance it should be delivering onwards to the farming industry and in veterinary clinical environments,” Professor Williams added.
Catherine McLaughlin, chair of the Independent Scientific Group, has welcomed the addition of Professor Williams to the team, saying her broad global and inter-disciplinary experience will add valuable breadth to the team.
Ms McLaughlin said: “Professor Williams’ experience in the transmission of antibiotic resistance genes among not just farm animals but pets and wildlife within a range of environments will be extremely valuable.
“One Health really does mean considering all these areas together, so we can ensure the most sustainable and effective approach to stewardship and reducing resistance can be taken.”
RUMA’s Independent Scientific Group, now comprises (alphabetically):
- Professor David Barrett, Professor of Bovine Medicine, Production and Reproduction at University of Bristol (deputised by Dr Kristen Reyher, Reader in Veterinary Epidemiology and Population Health at University of Bristol)
- Dr Ian Brown, Consultant Clinical Research Fellow at Oxford University and Oxford University Hospitals and Chairman of the Government’s Advisory Committee on Animal Feedstuffs
- Professor Mark Fielder, Professor of Medical Microbiology at Kingston University
- Professor Nigel Gibbens, former Chief Veterinary Officer, and consultant with Itinerant Vets Ltd
- Mr Daniel Parker, avian expert for UK government, technical advisor to the British Poultry Council and lecturer at Cambridge University Veterinary School
- Professor Sharon Peacock, Professor of Clinical Microbiology at LSHTM
- Dr Shabbir Simjee, Chief Medical Officer, Elanco Animal Health
- Mr Martin Smith, Lead Veterinary Surgeon, British Quality Pigs
- Professor Nicola Williams, Professor in Zoonotic Bacterial Disease, University of Liverpool
Since 2014, the UK livestock farming industry has reduced use of antibiotics by 40% and is currently working on reaching a number of sector-specific targets for reducing, refining or replacing antibiotic use by 2020.