World Antibiotic Awareness week 16-22 November 2015
Risks associated with the use of antimicrobials in animals worldwide
The World Organisation for Animal Health (OIE) has evaluated the quality of national animal health systems, including Veterinary Services, in more than 130 countries.
More than 110 of the countries evaluated – mainly developing and emerging countries – do not yet have relevant legislation concerning appropriate conditions for the importation, manufacture, distribution and use of veterinary products, including antimicrobials. In some cases, legislation is totally non-existent. Where it does exist it is very often not properly applied because of lack of public funds for the implementation of controls.
In such countries, antimicrobials are usually freely available to anyone, directly or indirectly, without restriction. Worse still, they circulate as normal goods and are often adulterated (dosage less than that mentioned on the packaging, different molecule or complete placebo). Thousands of tonnes of adulterated antimicrobials destined for use in animals are circulating worldwide (and the same is true of antimicrobials for human use).
Unfortunately, the use of antimicrobials in animals by untrained personnel is not confined to developing and emerging countries. In a significant number of Member Countries of the Organisation for Economic Co-operation and Development (OECD), it is easy to acquire antimicrobials, particularly via the internet, and many farmers do so. Some of these countries still allow the use of some antimicrobials on fruit trees to control certain bacterial diseases, as well as the incorporation of some antimicrobials into animal feed as growth promoters or for other non-therapeutic purposes. Political action, for example by the G8 countries or the World Trade Organization, could hope to persuade countries in this category to change these practices, estimated by many credible scientists as risky.
In the area of preventing antimicrobial resistance in animals (and its potential benefits for public health), although some countries and regions are already very cautious, the adoption of effective provisions by the rest of the world is likely to be long, difficult and controversial, not to say illusory.
Unfortunately, globalisation of the food trade, coupled with traditional and medical tourism, enable (and will continue to enable) existing or future resistant bacteria to colonise the entire planet with ease, regardless of any preventive measures implemented locally.
How can we face this important challenge?
The OIE trains national Focal Points appointed by its Member Countries and forms networks to enable them to develop and modernise legislation on the production, importation, distribution and use of veterinary products, as well as to carry out such tasks as monitoring the consumption of antimicrobials, because very little is yet known about actual volumes used in the 180 Member Countries involved in the OIE veterinary legislation support programme.
OIE Member Countries adopt international standards on the prudent use of antimicrobial agents and on the harmonisation of the risk assessments that they undertake to implement. International cooperation in the form of development aid is crucial to helping developing countries, and even emerging countries, to apply these standards, especially since, in the short term, animal production is expected to grow by more than 50% owing to increasing use of intensive production systems in these countries.
The OIE also recommends policies to introduce minimum geographical coverage by veterinarians so as to ensure animal health surveillance, using this network to guarantee the early detection of potential epizootics (including zoonoses such as animal influenza) and a rapid response to contain outbreaks at source. Such a network can also improve the general health of animals by allowing the judicious and proper limited use of antimicrobials. The network’s existence and sustainability is partly dependent on revenues from services provided by veterinarians, many to mainly poor customers in the isolated or deprived areas where they work, which are home to the numerous animals to be monitored. These revenues come mainly from the delivery of products, including antimicrobials, which veterinarians administer directly to the animals. This can raise a potential conflict of interest that needs to be addressed. It is why our organisation provides:
Standards and programmes to improve the quality of veterinary education worldwide, including in the fields of microbiology, pharmacology and ethics.
A standard on the design and functioning of national and regional Veterinary Statutory Bodies empowered by the law and by State delegation of the necessary powers to oversee qualifications, ethical standards and professional excellence, as well as to expel anyone whose conduct is improper.
While some countries have decoupled prescription from delivery for certain veterinary drugs, including antimicrobials, this may pose logistical problems of responsiveness to diseases, particularly at the farm level, and may facilitate illegal practices (direct and uncontrolled self-supply and intervention of unscrupulous and ignorant individuals, mainly via the internet). The risks associated with these practices may have consequences that are much more serious than any irregularities in drug prescription or delivery by veterinarians, which are much easier to control and prevent. Several countries that have implemented decoupling have seen an increase in the general consumption of antimicrobials (according to those in a position to assess such consumption). It is worth noting that the human consumption of antimicrobials continues to grow despite the fact that decoupling of drug prescription and delivery is widespread in human medicine.
It appears that measures to limit the emergence of resistance in animals, including managing and limiting globally what are deemed to be the riskiest practices, (including the use of antimicrobial agents in plant production), should be made a global priority, including in developed countries.