Issued to The Bureau of Investigative Journalism (TBIJ) on 24 November 2022
On behalf of the Responsible use of Medicines in Agriculture Alliance (RUMA) we wrote to The Bureau of Investigative Journalism (TBIJ) in response to a report released on 22nd November 2022 and associated articles written about that report re: antibiotic use on UK farms (from World Animal Protection (WAP) and the Alliance to Save Our Antibiotics (ASOA)).
We were very disappointed that the media reporting fell short of highlighting exactly how much work has been done, and progress made, on antibiotic reductions across UK livestock sectors despite a comprehensive comment being submitted by RUMA detailing the industry’s commitment to, and achievements in tackling antimicrobial resistance (AMR). There are also significant deficiencies in the report, namely an almost complete lack of methodological detail, quantitative results, and statistical analyses.
The limitations of the research presented are many and varied, including the small number of sites tested and the possibility of bias in selecting those. Basing virtually a whole article on such a small piece of research feels irresponsible and misleading and, sadly, there were many facts that had been supplied that failed to be referenced in the article in order to present a balanced view. Clearly much more research needs to be done to determine the complex interrelationships with on-farm use of antibiotics and selection and transmission of AMR. There are many pieces of peer-reviewed research which show that there are a myriad of sources from which antibiotics can find their way into our watercourses. Sadly, these alternative scientific views and the complexity of the issue were not presented in a balanced or fair way.
In summary, the significant flaws in the report include (not exhaustive):
- – A very small sample size across a small number of locations
- – No detail on site selection which may suggest sample bias
- – No inclusion of crucial information such as the overall antibiotic use on the farms
- – Sampling only at one time (during a period of unusual drought in the UK) and no notation of temperature (known to be associated with AMR levels) included
- – No consideration or assessment of any other potential sources of contamination into the watercourses (e.g. human sewage or people/human products)
- – The work seems to show resistant bacteria upstream as often as downstream. Much more research needs to be done to determine the complex interrelationships across all potential environmental contaminants (hospitals, sewage works, farms, domestic waste)
- – No clear information about how farms were categorised as ‘intensive’ or ‘extensive’ – no animal numbers/farm sizes are provided, and neither is the proximity of the farms to the watercourse quantified
- – No clear description of the microbiological techniques used and reporting of only a few genes, but not the significance of those genes
It is fully acknowledged across both the human and veterinary professions that resistant bacteria exist in the environment, but the causal links are likely to be many and varied.
There is other research that exists which uses robust sample sizes and proven surveillance techniques which would have provided more balance and context. For example, a study by Bath University released in November 2022 showed resistant bacteria in the environment rarely transferred over to humans but were much more likely to be acquired in hospitals. In the largest scale study ever conducted, the team collected 6,548 samples over a 15-month period in Italy and identified that, whilst the bugs are found in livestock, pets and the wider environment, they are rarely transmitted to humans through this route.
What was also fundamentally missing from the article were the facts about the work and achievements of UK livestock sectors in tackling AMR – a journey that has been robustly monitored and reported on over the last decade and which evidences significant reductions in antibiotic use. The details are as follows:
- -The Veterinary Medicines Directorate’s (VMD) Veterinary Antimicrobial Resistance and Sales Surveillance (UK-VARSS 2021) report which was released in November 2022, shows that UK antibiotic sales for food-producing animals have reduced by 55% since 2014, to 28.3 mg/kg. This represents the lowest sales to date
- – These efforts also include an 83% reduction in the use of highest priority critically important antibiotics for human medicine
- – In addition, the latest RUMA Targets Task Force (TTF) Report update, also released in November, features detailed sector insights on the work and achievements of UK livestock sectors, with many reporting positive progress against their antibiotic reduction targets
This demonstrates huge collaborative efforts, and these successes across the livestock industry have put the UK ahead of most food-producing EU countries.
The VARSS report also gives detailed information of surveillance of AMR, carried out by government agencies, which shows that levels of AMR which occur in livestock are on a clear downward trend in tandem with the reduction in use of antibiotics. However, this is not about achieving zero use; antibiotics are important ‘tools’ that the veterinary sector needs at its disposal to protect animal health and welfare against disease challenges.
Less than a quarter of all the antibiotics used in the UK are now used on farmed livestock which signifies a massive switch over the last ten years.
The agriculture industry has, and continues, to take ownership of defining realistic antibiotic reduction targets and working in collaboration with stakeholders and government to drive positive change – as evidenced in the RUMA TTF and VARSS reports. The efforts and achievements to date have also been independently praised in a recently released FAO Report, produced jointly by the Food and Agriculture Organization of the United Nations (FAO) and the UK’s Veterinary Medicines Directorate (VMD).
The FAO report recognises the industry’s positive antibiotic reduction journey including the work of the RUMA Targets Task Force, which has a specialist farmer and vet representing each livestock sector to set targets and provide a forum for learning and experience to be shared across all sectors.
Antibiotic stewardship is now part of everyday language, with farmers and vets working collaboratively to embed best practice for responsible use across all sectors. The continued voluntary work and achievements show a solid commitment to improving and protecting the health and welfare of animals, underpinned by the principles for responsible medicine use of reduce, refine, replace.
Whilst we and all of our stakeholders always welcome any new research that can help support and address AMR, any surveillance should always be carried out robustly and presented in a fair and balanced way, underpinned by science and evidence rather than conjecture and flawed research.
Responsible use of Medicines in Agriculture Alliance (RUMA)
 Study shows superbugs in the environment rarely transfer over to humans: Hospitals are more risky than farms — ScienceDaily; Harry A. Thorpe, Ross Booton, Teemu Kallonen, Marjorie J. Gibbon, Natacha Couto, Virginie Passet, Sebastián López-Fernández, Carla Rodrigues, Louise Matthews, Sonia Mitchell, Richard Reeve, Sophia David, Cristina Merla, Marta Corbella, Carolina Ferrari, Francesco Comandatore, Piero Marone, Sylvain Brisse, Davide Sassera, Jukka Corander, Edward J. Feil. A large-scale genomic snapshot of Klebsiella spp. isolates in Northern Italy reveals limited transmission between clinical and non-clinical settings. Nature Microbiology, 2022; DOI: 10.1038/s41564-022-01263-0