The European Parliament finally passed, on 10/25/18, a resolution on the use of veterinary drugs in animal husbandry. Aiming to help mitigate the phenomenon of antibiotic resistance (AMR) in humans. (1) However, the problem has a far different magnitude, which has been neglected to date.
Antibiotic resistance, the problem to be addressed
TheECDC, the European Center for Disease Prevention and Control, published a study on 5.11.18 where it considers the serious public health impact-in the entire European Economic Area (EEA)-of five types of infections caused by antibiotic-resistant bacteria.
The study published in ‘
The Lancet
‘ estimates that about 33,000 people die each year as a direct result of infection due to antibiotic-resistant bacteria. The impact of these infections is comparable to that of influenza, tuberculosis and HIV/AIDS cumulated together. (2)
The increase in AMR, between 2007 and 2015, is significant and ‘worrisome – according to ECDC – ‘as antibiotics are the last available treatment options. When these are no longer effective, it will be extremely difficult or, in many cases, impossible to treat infections’.
Antibiotic resistance and reduction of veterinary drugs in animal husbandry, the proposed EU regulation
The European Commission, in 2014, had presented a series of regulatory measures. Based on existing EU rules-which already restrict marketing to veterinary medicines authorized for this purpose-Brussels intended to introduce additional limits, taking into account the actual sector-specific needs of animal health.
Finally, the European Commission’s proposals limited the authorization and use on farm animals of antimicrobials that should instead be reserved exclusively for the treatment of serious infections in humans.
The Council considered the above proposals from the second half of 2014 through 2015 under the Latvian and Luxembourg presidencies. At first reading, many delegations felt that the Commission’s proposal needed to be strengthened so that the EU could effectively combat AMR.
Antibiotic resistance and reduction of veterinary drugs in animal husbandry, Parliament’s position
The European Parliament, on 10.3.16, had adopted 285 amendments to the proposed Veterinary Medicines Regulation. The Strasbourg Assembly then agreed on a negotiating mandate, ahead of the CoRePer 20.12.17 meeting. (3) Based on this mandate, five informal trilogue meetings (Parliament, Council, Commission) and a series of technical meetings took place.
The European Parliament, in particular, insisted on the need to address the following issues:
-Antimicrobial -resistance, including the use of antimicrobials for preventive purposes,
-Collecting data on the sale and use of antimicrobials on animals,
-reciprocity of antimicrobial resistance measures with third countries,
-Environmental risk assessment related to the use of veterinary drugs.
Agreement on the entire text of the proposed regulation was reached at the sixth and final trilogue meeting on 5.6.18. With subsequent endorsements by CoRePer and the Strasbourg Assembly.
Antibiotic resistance and reduction of veterinary drugs in animal husbandry, the new EU regulation
The resolution of the European Parliament-derived from the report of Hon. Françoise Grossetete (4) and negotiations with the Council-concludes a number of measures, in relation to the following points.
–
Antibiotics, restrictions on use on farms,
–
Antimicrobials, exclusive reservation of use of certain molecules on humans only,
–
Incentives to foster innovation, including through data protection and research,
–
Compliance of foods imported from non-European countries with new EU regulations.
The new regulation stipulates that veterinary drugs should never be used to improve breeding performance or to compensate for hygienic deficiencies. The use of antimicrobials should be limited to individual animals, not also to groups of them. And it is not allowed for prophylactic use, that is, in the absence of clinical signs of infection.
Veterinary drugs, more generally, may only be used following appropriate prescriptions where a high risk of infection is found. The metaphylactic use of veterinary drugs-that is, the treatment of a group of animals on which signs of infection occur-should be thelast resort, to be allowed only following appropriate diagnosis and prescription.
The European Commission is delegated to select drugs to be reserved exclusively for the treatment of humans. The inter-institutional agreement (Parliament, Council, Commission) was approved by the Strasbourg Assembly by a very large majority (583 votes in favor, 16 against and 20 abstentions), and the regulation will soon be published in the EU Official Journal, following its formal adoption by the Council.
Medicated feeds, however, are the subject of another regulation, which was approved in Strasbourg by 583 votes to 31 with 6 abstentions. Again, under the auspices of combating antimicrobial resistance, new regulations have been introduced to hold supply chain operators accountable.
Final considerations
It took the European institutions four years to come up with standards that were certainly useful. The contents of which are not particularly innovative, although correct. As well as consistent with the guidelines moreover already adopted, in Italy, in the National Plan to Combat Antimicrobial Resistance (PNCAR) 2017-2020. (5)
In fact, the National Plan, which is based on prevention and control, considers all types of antimicrobial drugs (i.e., antibacterials, known as antibiotics, antifungals, antivirals, and pesticides). (6)
Animal husbandry and veterinary medicine work well, to the point of putting Italy at the forefront at the European level precisely on the prevention and pharmacovigilance fronts. (7) Indeed, they have gone even further by initiating voluntary programs aimed at lowering antibiotic use on several hundred farms. (8)
The real problem that needs to be addressed
is that of thereckless use of antibiotics
In medicine. Italy and Greece-according to the European study (ECDC) mentioned in the introduction-are now found to have the highest occurrence of infections with antibiotic-resistant bacteria. But since this figure cannot be traced to any peculiar criticality in animal husbandry, it is precisely to medicine and pharmaceutics that one must look
Dario Dongo
Notes
(1) Antibiotic resistance has been identified by the World Health Organization (WHO) as a major global public health threat to be addressed in the coming years. See in this regard http://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance
(2) See Alessandro Cassini, Liselotte Diaz Högberg, Diamantis Plachouras, Annalisa Quattrocchi, Ana Hoxha, Gunnar Skov Simonsen, Mélanie Colomb-Cotinat, Mirjam E Kretzschmar, Brecht Devleesschauwer, Michele Cecchini, Driss Ait Ouakrim, Tiago Cravo Oliveira, Marc J Struelens, Carl Suetens, Dominique L Monnet, and ‘the Burden of AMR Collaborative Group‘ study ‘Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis‘, https://doi.org/10.1016/S1473-3099(18)30605-4
(3) On CoRePer, Committee of Permanent Representatives, see.
https://eur-lex.europa.eu/summary/glossary/coreper.html?locale=it
(4) Hon. François Grossetete, France, V. President of the EPP(European People’s Party) Group.
(5) Cf. http://www.salute.gov.it/imgs/C_17_pubblicazioni_2660_allegato.pdf
(6) To date, however, less than half of the regions have implemented the conference agreement and less than a third have already approved a regional plan
(7) On Italian animal husbandry 4.0, we cite the previous articles
https://www.greatitalianfoodtrade.it/progresso/animali-sani-e-cartelle-cliniche-online-un-database-per-valorizzare-la-zootecnia-italiana-4-0
,
https://www.greatitalianfoodtrade.it/progresso/zootecnia-italiana-4-0-il-progetto-di-database-integrato-sulla-salute-degli-animali-di-allevamento
(8) See what has been written about the pioneering initiatives of Coop Italy, on https://www.greatitalianfoodtrade.it/progresso/alleviamo-la-salute-coop-italia-elimina-gli-antibiotici-dai-prodotti-d-origine-animale, https://www.greatitalianfoodtrade.it/progresso/uova-senza-antibiotici-nuovo-traguardo-coop-italia-per-alleviamo-la-salute, https://www.greatitalianfoodtrade.it/progresso/coop-italia-pesce-senza-antibiotici
Dario Dongo, lawyer and journalist, PhD in international food law, founder of WIISE (FARE - GIFT - Food Times) and Égalité.