Several studies (1, 2, 3) show that 75 % of the disease burden from resistant infections in the EU is due to problems in human health care systems; such as bad prescriptions practices, or hygiene deficiencies in clinics. Therapeutic overuse of veterinary drugs in farm animals is another major root cause of the increasing spread of human resistances. More restrictive EU rules recently adopted by the European Parliament will curb veterinary drug overuse and promote safer health management in farms.
A new EU regulation on veterinary use of antibiotics on farms was approved by the European Parliament with a vast majority vote in October 2018. The regulation will be directly applicable in all Member States three years after its entry into force (end of 2018/early 2019). The new rules will be fully operational as of end of 2021. The new law not only sets clear limits for preventive antibiotic prescriptions for farm animals, but also introduces reciprocity on EU standards for foodstuffs from third countries imported into the EU. Trading partners will have to respect the ban on antibiotics for growth promotion, as well as the restriction on antimicrobials reserved for use in humans. This might therefore affect imports from the United States of America, South America and Asia.
Because farmers in most EU countries have increased their use of antibiotics to fight infectious diseases in farm animal, scientists and health experts recommended restrictions for veterinaries when prescribing drugs on farms. With the new ‘veterinary medical products’ regulation replacing legislation from 2001/2004, the European Parliament agrees that it is time to update standards for the authorisation of veterinary pharmaceutical products. The new standards encompass regulations on sales, on pre-emptive prescriptions, and on documentation and surveillance across Europe. The standards will meet the latest WHO guidelines suggesting a halt to the transmission of drug resistance from animals to humans and to keep resistant pathogens off farms, and out of the environment and human food chain. The legislation is seen as a milestone in the global fight against antibiotic microbial resistances (AMR).
Is there any evidence that reduced drug levels lead to less resistance in farm animals?
Jaap Wagenaar, Faculty of Veterinary Medicine, Department of Infectious Diseases and Immunology, Utrecht University: “Some European countries have already pre-empted the new EU measures in their national laws. For example, in the Netherlands, practices changed considerably ten years ago. Since then, antimicrobial usage in animals has been cut by 64 %. As a consequence, we saw a clear drop in antimicrobial resistance levels in national surveillance of healthy animals, as performed according to the European Food Safety Authority.”
Food producing farm animals such as chicken, pigs and cattle are the most often treated by antimicrobials or antibiotics for preventive purposes – fighting inflammation, parasites, salmonellosis or other contagious pathogens that can damage herds and flocks. However, due to excessive medication, mostly for prevention purposes, the animals develop a wide variety of resistant bacteria, with the consequence that they no longer respond to medicine and become untreatable.
Increased drug resistance is caused mainly by overuse of these antimicrobials in humans and animals. Resistant bacterial strains between the two can be transmitted on many different pathways, i.e. through treatment in hospitals, waste water, sewage, natural fertilisers, soil and air, but also through animal food products entering the human food chain, as the EU-funded multi-country study ‘EFFORT’ (Ecology from farm to fork of microbial drug resistance and transmission) demonstrated, showing huge country-specific differences in farm practices and antibiotic animal resistance.(4)
Was less AMR in human pathogens also measured when veterinary drugs were reduced?
Jaap Wagenaar: “It is difficult to get a clear picture, because measuring influences on resistance in human pathogens are biased, due to the way we collect samples. Most of the samples are from humans that have been treated or hospitalised.”
The main focus of the new EU regulation on veterinary medicines is to provide a harmonised set of standards for authorisation, indication, marketing, labelling and packaging leaflets of veterinary medical products. Working together with the Member States to institute better surveillance mechanisms will allow for more efficient monitoring of quantities and inputs to the environment.
Cases where medicines can still be prescribed by a veterinarian for preventive purposes will be restricted under the new regulation. This is expected to be a major lever in reducing the spread of resistance from animals to humans. The new law indicates that ‘Veterinary medicines must not under any circumstances serve to improve performance or compensate for poor animal husbandry’.
The updated legislation to reduce the use of farm antibiotics is expected to lead to:
- smarter farming practices for the prevention of contagious animal diseases on farms while saving antibiotics and antimicrobials;
- separate lists of antibiotic classes reserved for humans and others for veterinary applications;
- pharmaceutical and veterinary reciprocity rules for third countries selling meat to the EU.
Will we see a reduction of antibiotics usage on farms with the new EU regulation – what should have received greater focus?
Jaap Wagenaar: “Proper criteria to scrutinise the new regulation are the five pillars of the WHO global action plan on the fight against antimicrobial resistance (AMR). Many of these requirements seem to be recognised with the new legislation. However, we still see a gap in the field of ‘creating awareness’. Although it might be questionable whether education should be part of an EU regulation on veterinary medical products, this education element is important for graduates as well as for post-graduates and for practitioners.”
Press release of the Parliament’s Rapporteur,
The legislative procedure,
Report of the ENVI Committee on a European “One Health” Action Plan,
Impact Assessment of the new law by EPRS | European Parliamentary Research Service,
European Antibiotic Awareness Day
EPRS: Antibiotic users -What Europe does for you