Are we making progress on the use of antimicrobials in animals?

CANBERRA — A key report on the use of antimicrobial agents in animals — aimed at tackling the rising threat of drug-resistant diseases — has found strong progress on regulation and monitoring but called on governments to increase the capacity of authorities to deal with the problem.

Antimicrobial resistance is a growing concern in the global health community and is already responsible for an estimated 700,000 deaths each year. The misuse of antimicrobial agents to promote growth in animals is a leading cause.

The report,  published Feb. 14 by the World Organisation for Animal Health, or OIE, is based on questionnaires sent to member countries. Now in its third year, it began in response to a 2016 United Nations declaration on combating the global threat posed by antimicrobial resistance and contributes to a global database that supports monitoring of antimicrobial growth promoters at a country and regional level.

Antimicrobials are important in ensuring the health of animals, people and their livelihoods, as well as ensuring food security and safety. But the report warns about their misuse.

“I think all use of antimicrobial agents can create resistance,” Dr. Elisabeth Erlacher-Vindel, head of antimicrobial resistance and veterinary products at OIE, explained to media in an online press conference broadcast from Paris, France, on Feb. 13. “The more you use, the more the risk is growing. And overuse or misuse or use of very small quantities of antimicrobials might enhance this risk to create resistance.”

The results in numbers

This year, 155 countries contributed to the report, up from 130 in the first report in 2016, though they provided differing levels of data. Less than one-third of those 155 countries reported using antimicrobials for growth promotion — a total of 45 countries, declining from 89 countries in 2016. Among those that reported the use of antimicrobials for growth promotion, 40 percent of countries were in the Americas, followed by 31 percent in Asia, the Far East and Oceania, and 22 percent in Africa.

The report found a diverse use of antimicrobial agents. A total of 35 different agents were reported, dominated by the use of bacitracin in 18 countries, with tylosin and bambermycin both reported in 17 countries.

In Africa, the Americas, and Europe, antimicrobials are more commonly used in bovines. In Asia, the Far East, and Oceania, their use is more common in pigs. But they can also be found in a range of other food-producing animal species including poultry, sheep, rabbits, and farmed fish.

Barriers to reducing use

OIE asked member countries about the barriers to reducing the use of antimicrobial growth promoters. “There are regulations in some countries, they are lacking in others, and the enforcement of the regulation ... is very unequal,” Erlacher-Vindel said. Seventy-two responding countries had no regulatory framework on the use of growth promoters.

The development of a robust regulatory framework is a key component in managing the use of antimicrobial agents in animal health and production, according to the report, but countries reported other barriers too.

“The big challenge around implementation is to get the balance right between regulatory interventions and nonregulatory interventions,” Dr. Matthew Stone, deputy director-general of International Standards and Science at OIE, explained during the press conference. “The regulatory interventions obviously require clear rules — hopefully, developed through good regulatory practice engaging the stakeholders — and then obviously some element of enforcement or compliance that goes with it.”

But regulation can work hand-in-hand with nonregulatory interventions such as training and capacity building, he said. The lack of collaboration between national authorities, as well as between national authorities and the private sector, is another key barrier, Erlacher-Vindel explained. “We need commitment from political leaders,” she said.

The report also pointed to a lack of tools to collect data, with some countries still using a paper-based method of data collection. Dr. Delfy Góchez, a member of OIE’s antimicrobial resistance department, said the level of data was becoming more detailed over time and that OIE supports countries by helping them use the data to visualize change.

“Over the years we have really found out that our database is becoming a powerful tool to raise capacity within the countries,” Erlacher-Vindel said, helping countries to understand where the problem lies, domestic trends in antimicrobial use, and develop a baseline of information to work with.

Ways forward

OIE has made six recommendations to progress the U.N.’s commitment to fighting antimicrobial resistance.

Greater collaboration is one, with OIE saying it and other international organizations need to support governments to strengthen their capacity to monitor and regulate the use of antimicrobials in animal health. Within countries, governments need to work collaboratively with stakeholders in the food-producing animal supply chain including regulators, veterinarians, farmers, and the food industry.

Transparency around antimicrobial use and improving awareness and understanding of antimicrobial resistance is also important. And OIE is urging governments to bring an immediate end to the use of antimicrobials classified as highest priority by the World Health Organization.

“Many countries have already taken key actions, such as setting up surveillance systems and regulating the use of antimicrobials in human and animal health, but we still have a long way to go,” Tedros Adhanom Ghebreyesus, WHO director-general, explained to media. “Working together is the only way to avoid the huge human, social, economic, and environmental costs of antimicrobial resistance.”