Leading from the front on AMR

Posted on November 15, 2017 by John Fishwick

As we are all well aware, antimicrobial resistance, or AMR, poses a very real and urgent risk as it threatens our ability to treat animals and protect human health in the future. In a recent blog post launching our AMR in Focus series, UK Chief Veterinary Officer (CVO) Nigel Gibbens called it ‘the biggest threat to modern medicine’; a sentiment echoed by England’s Chief Medical Officer Dame Sally Davies last month, when she called for global action to combat AMR.

The stark reality is that no new classes of antimicrobial agents have been discovered for over 20 years, giving rise to the fear that, unless there is a concerted effort across the medical and veterinary professions to steward responsible use and prescription of the antimicrobials we do have, we face heading back to a pre-antibiotic era when treatment of even simple infections was difficult, if not impossible.

The veterinary profession in the UK has been committed to championing the responsible use of antimicrobials through joined-up working with UK governments, industry and other health sectors, as part of a One Health approach to tackling the threat of AMR.

We believe that medicines should not be used to compensate for poor husbandry practices. At the same time, vets must continue to have the right to prescribe last-resort antibiotics for the sake of animal and public health.

A One Health approach

As members of the Responsible Use of Medicines in Agriculture (RUMA) Alliance, including their Targets Task Force (TTF), BVA and BVA specialist divisions worked closely together over the last year with leaders of the farming sectors and stakeholders in Government, including Defra, the Veterinary Medicines Directorate(VMD) and Food Standards Agency (FSA), to develop appropriate and evidence-based targets for eight livestock sectors - beef, dairy, egg, fish, gamebird, pig, poultry meat and small ruminants. These were published and announced at the RUMA conference last month in London. One of the great successes of the TTF was that the different sectors worked collaboratively together to reach a common aim.

In May, BVA hosted a conference, attended by the UK’s CVO, England’s Chief Medical Officer and leading experts to offer cross-sector perspectives on antimicrobial resistance and to explore how these could be integrated under the One Health banner to achieve better, lasting outcomes for humans and animals alike.

In a bid to encourage responsible antibiotic use, we continue to encourage veterinary practices and medical GPs to download and put up our poster on antibiotic awareness, created last year in partnership with the British Medical Association (BMA), Public Health England (PHE) and VMD, in waiting rooms of practices and surgeries.

Working together for positive change

Last month saw a landmark in our collective efforts to reduce antibiotics use in agriculture, with the VMD report for 2016 confirming a 27% reduction in antibiotic use in livestock since 2014 - achieving the Government’s multi-species average target of 50 mg/kg two years in advance. There has also been a significant reduction in the use of colistin and other critically important antibiotics (CIAs).

The eight livestock sectors have also committed to further reducing, refining or replacing antibiotic use to meet the targets developed by the RUMA Targets Task Force, and BVA will continue to support BVA specialist divisions in helping achieve those goals.

Building on progress

These very positive results achieved through collaborative working between various stakeholders must be commended and offer much for all of us to be proud of. But the nature and scale of the threat posed by AMR means that there is no room for complacency.

The UK must continue to lead from the front with the eight livestock sectors working towards achieving the targets set out by the RUMA task force. We would also like to see national and international discussions around responsible antibiotic use encompass the companion animal and equine sectors as well. And as the Government’s 2013-2018 AMR plan draws to a close, BVA will continue to work with Government and other stakeholders to contribute towards plans for the next five-year strategy.

Increased collaboration between the health sectors, underpinned by a commitment from each of us within the veterinary profession to maintain the highest standards of stewardship in using antimicrobials, most especially CIAs, is the only way we can preserve these essential medicines for future generations.

John Fishwick

Written by John Fishwick

BVA President from September 2017 to September 2018

John is senior lecturer in Dairy Herd Medicine and former head of the Department of Production and Population Health at the Royal Veterinary College (RVC). He is a former President of the British Cattle Veterinary Association (BCVA). Prior to this he worked in mixed practice and he was once head veterinarian to the world’s largest fully integrated dairy company, farming over 25,000 high producing dairy cows in Saudi Arabia.