RUMA in conversation with The National Pig Association (NPA)

RUMA hears from Rebecca Veale, Chief Policy Adviser at The National Pig Association (NPA), who shares details about the sector’s successful antibiotic stewardship programme.

Antibiotic usage in the pig sector has seen an overall reduction of 69% since 2015.

RUMA: “Back in 2016 the NPA launched the Antibiotic Stewardship Programme. Talk us through how the sector got to that point covering inception, testing and launch and how any challenges were overcome?”

Rebecca: “In 2016 the sector was under intense scrutiny from both government and the media over antibiotic use due to the perceived high use of antibiotics by the pig sector. The British pig industry recognised that a failure to address the risk of antibiotic resistance not only threatened the ability of farmers and veterinarians to effectively treat infectious diseases in pigs, but consequently jeopardised pig health and welfare. As such the pig sector pioneered a proactive approach to protect the efficacy of the antibiotics and to demonstrate the requirement for progress.

“The NPA established the Antibiotic Stewardship Programme, with the support of AHDB, to set out measures which outlined how the British pig industry aimed to achieve and demonstrate responsible use of antibiotics, in line with the Replace, Reduce, Refine concept. This included antibiotic usage data collection and collation (via eMB-Pigs), benchmarking of antibiotic use by unit and against comparable units, education on disease control strategies, responsible reductions in antibiotic use, veterinary prescribing principles limiting the use of HP-CIAs, and review the use of antibiotics as a sector.

“The Antibiotic Stewardship Programme was received positively and brought about a change in both culture and management practice. It kick-started the journey for the sector which meant progress had been made by the time that voluntary industry targets for antibiotic reduction were set in late 2017 by The RUMA Targets Task Force (TTF). This was really helpful in demonstrating change was possible and helped to further engage both producers and vets. The requirement to record antibiotic use on a quarterly basis becoming a Red Tractor (RT) standard was yet another catalyst in helping to deliver our shared ambition – again not an easy step but one which paid dividends in the data generated at a farm and national level. The Antibiotic Stewardship Programme was pivotal in the early stages but a continued responsible approach to medicines and health is now ‘lived’ by the pig sector today. The second phase of RUMA Targets has further built on this and explored the more holistic side of responsible use in addition to the numerical targets.”

RUMA: There are a number of groups/sub-groups that have a key focus on AMR (PHWC and sub groups) – can you share how the infrastructures are set up to achieve the best outcomes?

Rebecca: “The Pig Health and Welfare Council (PHWC) is a hugely valuable group with four sub-groups which allow for focused discussion. One of these sub-groups focuses on antimicrobial use. The PHWC AMU sub-group has supported the RUMA TTF members when formulating the voluntary targets set by industry. As a group we discuss the challenges industry faces with regard to disease, and the implications this may have on antibiotic usage, and eMB-Pigs data etc. A smaller more focused group then takes this forward and explores the detail.

“To ensure consistency some representatives sit across all sub-groups with  experts brought into each sub-group to furnish the discussion with additional context and information relevant to the specific policy area. For instance, the VMD joins the PHWC AMU sub-group. Specific points of discussion will then be brought back to the PHWC if wider involvement is needed. The structure ensures great interaction with other stakeholders and helps to push forward important issues and policies collaboratively.”

RUMA: “How important has data collection been to the sector?”

Rebecca: “Data has been integral to the successes of the sector because it has provided the insight to be able to create meaningful targets for responsible reductions in antibiotic use.  At the very start the data coverage was much lower but once the requirement for recording antibiotic use in eMB-Pigs was made a Red Tractor standard, the coverage has been significant – currently 95% of pigs are RT assured.

“Whilst an annual eMB-Pigs figure is published, we confidentially discuss the progress on a quarterly basis at the PHWC AMU sub-group meetings to inform industry activity. We discuss the context of any changes or trends and this helps inform the commentary of progress made by the sector for the annual RUMA TTF report – it also helps when we’re formulating the next phase of voluntary targets.”

RUMA: “The programme’s first goal was to collect quantitative and qualitative data on the use of antibiotics in British pig husbandry using the online medicines book (eMB-Pigs). How much of a game-changer has this been?”

Rebecca: “This has been pivotal at both a herd and national level. 95% of pigs are RT assured and as part of this each herd has an annual herd health plan put together by a vet (PVS member) and undergoes a quarterly veterinary review. The eMB-Pigs data is submitted quarterly and eMB-Pigs is set up to allow for a producer’s vet to have access to the data; this is a key point for discussion at each visit.  Vets can benchmark their clients to see how they are doing against comparable units. The data also informed the antibiotic reduction targets.”

RUMA: ”Can you put the scale of the progress into context please?”

Rebecca: “The sector has reduced usage by 69% since 2015. HP-CIA use is at a very low level with usage recorded at 0.03mg/PCU in 2021. No Colistin use has been reported in pigs for several years.”

RUMA: “How difficult (or easy) was it to get industry buy-in?”

Rebecca: “There was an acknowledgement that the sector needed to take a more responsible approach to medicines but this didn’t happen overnight. It was very much a collaborative approach to health from both producers and vets. For many producers, once they started recording antibiotic use it provided more insight into their approach to health, welfare, and disease on their farm and informed their conversations and plans with their vet. The NPA Antibiotic Stewardship Programme was a great first step to achieving buy-in.

“There was a lot of nervousness from producers initially about submitting antibiotic usage data but there is oversight from the eMB-Pigs Steering Group and the data is still owned by producers, so they have complete autonomy over their information. Slowly, producers bought into the idea of submitting antibiotic usage data but like anything new, it took time to engage and reassure.”

RUMA: “Do you feel individual farmers now support the drive to responsible antibiotic use?”

Yes. Producers are very proud of the progress made. For the few producers where usage is a challenge, Red Tractor (RT) implemented a new requirement in its Pigs Standards in November 2021 for persistently high users (PHUs) of antibiotics (as defined by PHWC) to develop and implement an Antibiotic Reduction Plan, in conjunction with their designated vet to take action. PHUs are identified within the eMB-Pigs system.”

RUMA: “The data represents more than 95% of pigs slaughtered. What is being done about the remaining 5%?”

Rebecca: “Whilst the eMB-Pigs data covers 95% of pigs and gives us a very good picture of antibiotic usage, the PHWC always strives for more and encourages all keepers of pigs to submit their antibiotic usage data. As such this was included as a target in the second phase of the RUMA Targets (Target 5).

RUMA: “How does the pig sector drive the widely applauded voluntary collaboration? Are there any challenges to that continued voluntary approach and what does the future look like?”

Rebecca: “Communication has always been vital, and the success to date is largely built on the positive working relationship many producers have with their vet. Pig producers are engaged and are always striving to achieve the best outcomes. Changes have been made in a considered and measured way which is why the reductions in antibiotic use has continued.”

RUMA: “With regard to zinc oxide, is the sector prepared for when the current available supplies run out?”

Rebecca: “AHDB has carried out a Rapid Evidence Assessment (REA) on this topic and concluded there is no direct replacement for zinc oxide. Whilst there are other options to try and alleviate post-weaning diarrhoea, they vary in their effectiveness by herd and unit. Some have already transitioned away from using zinc oxide in the weaner diet; for some this has been an easy move and for others much more challenging. For producers still using zinc oxide, they will have to work with their vet and nutritionist to best manage their situation. However, it is imperative that the health and welfare of pigs is not compromised and when appropriate, some vets may prescribe antibiotics to treat the infection present.  

“This policy remains on the agenda for NPA and PHWC and it is important we continue to work with the VMD for more longer-term solutions.”

RUMA: “What is being done to address Persistently High Users (PHUs)?”

Rebecca: “When the PHWC started to explore the second phase of antibiotic reduction targets we recognised the divergence between producers –  most were taking a very responsible approach and some were consistently using more antibiotics. There will be times when it is appropriate to use more antibiotics, but for those using more antibiotics persistently it was felt we needed to support them.

“Persistently High Users are defined as the top 5% of antibiotic users in each of the main categories of production recorded by eMB-Pigs; except boar studs and gilt units, it is calculated using the last four quarters’ rolling data. PHUs are identified on eMB-Pigs when data is submitted and they are asked to complete an Antibiotic Reduction Plan (ARP) with their vet which identifies issues, actions and timescales for completion. The ARP was brought in as a voluntary measure by the PHWC initially but was adopted by RT as a standard in 2021.

“When we start to consider the third phase of RUMA TTF antibiotic reduction targets, we need to drill into the details to understand if we need to amend the system or plan to better support producers that are using more antibiotics.”

RUMA: “What is next for the pig sector – are there any new initiatives and/or challenges?”

Rebecca: “Based on the achievements to date, we need to keep doing what we’re doing well, and try to support those that have health issues on their units in the best possible way. The Animal Health and Welfare Pathway (AHWP) small grants are open until 15 June 2023 and we’re encouraging members to consider these, but for some it is the larger grants which will deliver the most benefit. The larger grants are in the early stage so we’re keen to push ahead the discussions with Defra to help shape the scheme into something which really works for the sector.

“The VMD withdrew the MA for the zinc oxide product last June but allowed for product already made to be sold through as long as it was within the use by period. It is estimated that the stocks will not last the year and so the loss of zinc oxide will be faced by many producers this year. The PHWC continues to discuss the policy with VMD.

“We’ve also had some early discussions about the next phase of antibiotic reduction targets and will explore the data first to identify key challenges. Then we will look at where producers and vets need the most support.”

RUMA: “If you could sum up in a few sentences the achievements of the pig sector over the past decade what would you say?”

Rebecca: “The sector has faced many challenges over the years but the last two have been unprecedented. Yet, despite a backlog of pigs on farm as well as huge increases in cost of production, the health and welfare of the pig herd has not been compromised and antibiotic usage has not increased – it has continued to decline. The proactive approach to health and welfare taken by producers and vets should be applauded and is evident with the reduction of antibiotic usage at 69% since 2015.”

RUMA: “Can the sector continue to reduce and how will you know you are reaching a defendable sustainable use level?”

Rebecca: “There is room for further reduction. However, it’s only natural that reductions slow down so I don’t think we’ll see any further big drops, although that is very much dependent on the resources we have available to prevent and treat disease. We will reach a level which is sustainable for the sector, and the eMB-Pigs data will be pivotal in helping us understand when we’re at that level. But there will be ups and downs because usage will always depend on the needs of the animals under veterinary care; if there is a disease issue then usage may increase to address this, and that is right and responsible to protect animal welfare.”

RUMA: “What would you say to other sectors who are at a different or earlier stage in their data collection journey?”

Rebecca: “Antibiotic usage data is hugely valuable, it helps inform reductions, initiate any activity to support producers and demonstrates the responsible approach taken. The data is owned by producers in the pig sector which is why they are willing to share it – it is not a tool to beat them with. Only good can come from collecting and collating data in this way.”

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