A blog post by Erik Ruiz
Safer Pharma Project Officer – HCWH Europe
The misuse and overuse of antimicrobials in farming contributes to antimicrobial resistance - a growing public health threat that is projected to kill more people than cancer and diabetes combined by 2050 if left unaddressed. We have a clear opportunity to drastically reduce antimicrobial overuse and healthcare professionals have a crucial role to play.
In 2020, over 5,000 tonnes of antimicrobials were sold for veterinary use in Europe. Though this number is decreasing, modern farming practices still rely on healthy animals consuming antimicrobials.
Antimicrobial misuse in farming is associated with a growing number of multi-drug resistant bacteria that originate in animals but can spread to humans through processing, transport, or handling, as well as through the environment.
This raises some questions - when should animals take antimicrobials? Should animals take antimicrobials at all?
There is no doubt that when an animal is sick, it should be treated with antimicrobials as prescribed by a veterinarian. However, the routine use of antimicrobials in Europe is helping the conventional farming system to avoid protective measures that would prevent animals from developing infections. In other words, antimicrobials are used to support unsustainable farming practices.
Food-producing industries aim to maximise their profits and reduce costs. This includes maximising the use of space and minimising the time an animal spends in farms. This comes at the cost of animal welfare and disease prevention standards.
The weaning period, when animals change from mother’s milk to other sources of feed, is a moment of high-stress, especially for piglets, who are separated from their mothers. Due to this stressful situation, piglets commonly develop post-weaning diarrhoea.
Antibiotics, primarily colistin, are provided to them through food or water for treatment. These food and water resources are common to the whole herd, so all the piglets end up taking antibiotics, regardless of whether they are sick or not. In Europe, 99.5% of colistin sales were in forms suitable for group treatment, i.e. oral solution, oral powder, and premixes.
Early weaning has a massive impact on antimicrobial consumption. In Sweden, the weaning period for piglets is 10-12 days longer than piglets in countries such as France, Belgium, or Germany. As a consequence, recent studies show that piglets from those countries consume between 20-30 times more antibiotics than those in Sweden.
Overcrowded farming spaces often exacerbate the development and spread of infections that require antimicrobial treatment - a common occurrence in poultry farms, where infections spread through the whole flock. Sick animals are then treated en masse through medicated feed, which again leads to healthy animals taking antimicrobials.
Healthcare professionals can help reduce antimicrobial misuse
Traditionally, the healthcare sector has not been considered as a key actor in antimicrobial misuse and overuse in food production. However, the COVID-19 pandemic has given greater visibility to cross-border healthcare issues and healthcare professionals are now in a position to play a major role in tackling the overuse and misuse of vital antimicrobials in animals and help reduce the spread of antimicrobial resistance (AMR).
In the EU, the new Veterinary Medicinal Products regulation will enter into force at the beginning of 2022. One of the provisions of this new regulation will be the creation of a list of antimicrobial agents reserved for human health. It is crucial that colistin, a last resort antimicrobial for human health commonly used to sustain intensive farming practices, is included on this list. That’s why we have mobilised healthcare professionals across Europe to advocate for the inclusion of colistin on that list. Join the #SafeguardColistin initiative and help us preserve colistin for human health.
Healthcare institutions can drive systemic change
In addition to individual healthcare professionals, healthcare institutions have the opportunity to support a reduction of antimicrobial use in animals.
European hospitals serve thousands of meals every day. Most of the food purchased by European hospitals is food produced locally, which means that hospitals have a relevant impact when it comes to changing their local food chains. Health Care Without Harm Europe has launched an initiative to bring together stakeholders from across the healthcare sector to develop standardised procurement criteria for food produced with responsible antimicrobial use.
Join the healthcare market transformation network’s working group and contribute to reducing antimicrobial overuse and misuse in food production.