The co-chair of the Global Leader Group on Antimicrobial Resistance, Mia Amor Mottley, Prime Minister of Barbados was recently quoted as saying: “The world is in a race against antimicrobial resistance, and it’s one that we cannot afford to lose. We cannot tackle rising levels of antimicrobial resistance without using antimicrobial drugs more sparingly across all sectors.”
I fully agree that the challenge of antimicrobial resistance is a race against time and as a practising veterinarian I know there is good reason to be concerned about the potential dangers of overuse of antibiotics in both humans and animals.
But this challenge should not be diluted into a race that needs to be won through speed and sweeping actions alone. This challenge requires coordinated, strategic, and scientific action, and most of all – as global leaders agree – it requires a ‘One Health’ approach.
The European Union was fast out of the starting blocks with its One Health action plan to address antimicrobial resistance back in 2016. And the new EU regulation on veterinary medicines approved more than two years ago by the European Parliament takes bold steps to ensure ever stricter rules for the use of antibiotics in veterinary care, in order to protect both animal and public health.
In fact, the regulation is lauded by Commission representatives as the main tool to support farmers across Europe in achieving the target set in the Farm to Fork strategy of reducing antibiotic sales by 50% by 2030.
Ensuring that both farmers and companion animal owners are aware of the dangers of overuse or misuse of antibiotics is a task that has been taken on by the veterinary profession and those working in animal health care for more than a decade now. The European Platform for the Responsible Use of Medicines in Animals (EPRUMA) was created by veterinarians, farmers and the animal health industry back in 2005.
Since its inception, and since data collection on antibiotic sales started in the EU in 2011, sales of veterinary antibiotics have dropped by more than 34%. Perhaps more importantly, sales of antibiotics considered critically important in human medicine also show a decreasing trend over the years, with a 70% decrease in the use of colistin in particular.
It was therefore with an element of shock that the veterinary community learned of a call from a doctors association and an MEP to reject the scientific advice of the EU agencies and ignore the many strict measures already agreed in the veterinary medicines regulation after ten tough years of negotiations within the institutions.
“The challenge of antimicrobial resistance is a race against time and as a practising veterinarian I know there is good reason to be concerned about the potential dangers of overuse of antibiotics”
When it comes to setting a reserved list of antibiotics for human use only, the three voting institutions had all agreed that this should be decided by the EU’s own agencies. With that mandate, the European Medicines Agency developed the required scientific advice based on input from both human and animal health experts, and built upon the international expert advice from WHO, OIE and other EU scientific experts in human and animal health including the ECDC and the EFSA.
But this scientific approach, backed by a multitude of other measures, was dismissed as easily as the care of animals was dismissed by MEPs in the Environment Committee this summer, much to the dismay of hundreds of thousands of veterinarians, farmers and other animal guardians.
A wider than scientifically judged ban on antibiotics for use in animals will have little effect on the human antimicrobial resistance burden, as around 75% of the total burden of infections with antibiotic-resistant bacteria in EU and EEA countries are associated with human patients and healthcare settings.
In fact, too wide a ban may have a counter-effect as dependence on a tightly limited number of antibiotics for the treatment of infections in animals will increase the pressure on bacteria and accelerate the selection for antibiotic resistance towards the few available antibiotics.
“A wider than scientifically judged ban on antibiotics for use in animals will have little effect on the human antimicrobial resistance burden”
Veterinarians may be faced with the daunting situation of having to inform a family that their much-loved dog cannot be treated with the necessary medicines. Keen horse riders may be faced with the inability to ensure care for respiratory illnesses in their horses which may lead to pneumonia, or even worse. The list of potential impacts is long…
Animals – just like people – can become sick even when they are cared for in the best possible way. And just as animals are recognised as sentient beings (article 13 of the TFEU), so they deserve the right to be treated when they get sick.
The veterinarian is the sole person who is educated and trained to evaluate the health status, make a diagnosis and prescribe the correct treatment for sick animals, just as doctors do for people.
Now is the time for the European Parliament to stand by the rules agreed in the new Regulation for veterinary medicines, to uphold the scientific advice of the EU agencies and to ensure that animal health is also considered in the One Health approach we take to tackling the challenge of antimicrobial resistance.