Sustainable antimicrobial use in animals and humans€¦ · Global Trends. Key considerations in agricultural antibiotic use. 1) Importance of the antibiotic to human health Sustainable

Sustainable antimicrobial use in animals and humans

Dr Robyn Martin31 May 2016

• How does AMR develop?

• The threat posed by AMR

• Strategies to mitigate AMR

• a one health approach

• a global approach

• an Australian perspective

Outline

Sustainable antimicrobial use in animals and humansDr Robyn Martin 231 May, 2016

Department of Agriculture and Water Resources

Antimicrobial resistance (AMR)



Antimicrobial resistanceAntibiotic resistance IS a natural evolutionary process

However….

Antibiotic use accelerates the development of resistance

Antibiotic Use



Source: Centre for Disease Control and Prevention, US Department of Health and Human Services

Antimicrobial resistance



The rising threat of antimicrobial resistance



“A post-antibiotic era means, in effect, an end to modern medicine as we know it. Things as common as strep throat

or a child’s scratched knee could once again kill”

Director General of the World Health Organisation

Dr Margaret Chan, 2012



• Many of modern medicine’s achievements are only possible with effective antimicrobials– Chemotherapy– Organ transplantation – Neonatal care– Routine and complex surgery– Modern obstetrics

When will the risks become too great?



Consequences of AMR

• Some infections may become difficult/impossible to treat: this is happening now

• Economic costs• Implications for animal health, welfare, biosecurity and

production outcomes, and trade implications

“….this serious threat is no longer a prediction for the future; it is happening right now in every region of the

world and has the potential to affect anyone, of any age, in any country. ”

World Health Organisation, 2014



Consequences of AMR

What are the consequences of

Taken from: UK Review of Antimicrobial Resistance, An overview of our work, Jan 2016

Estimated deaths attributable to AMR by 2050





Strategies to prevent antimicrobial resistance

Drivers of AMR

Poor infection

prevention & control

Collapse of antibiotic

R & D

Globalisation & international

travel

Poor & unrestrained

use of antibiotics

Substandard antibiotics

Antibiotic Resistance



Source: Harbarth et al. 2015 Antimicrobial resistance: one world, one fight! Antimicrobial Resistance and Infection Control



A one health approach

Global AMR mitigation

• World Health Organisation (WHO)

• OIE (World Organisation for Animal Health)

• Food and Agriculture Organisation (FAO)

• United Nations (UN)

• Organisation for Economic Cooperation and Development (OECD)

• Asia pacific Economic Cooperation (APEC) Food Safety Cooperation Forum



McDonald’s (U.S.)

• Policy on antibiotic use in their food products since 2003

• Have committed to stop the use in poultry of antibiotics

important to human medicine by 2017

• Oct 20 2015: only animals that never received antibiotics

• Chicken 2016, turkey 2019, pork and beef 2025

• Oct 23 2015: clarified that the policy only prevented

antibiotic use for growth promotion

Subway (27,000 U.S. stores)

Restaurant chains are committing to reducing antibiotic use



Global Trends

Key considerations in agricultural antibiotic use

1) Importance of the antibiotic to human health



Source: UK Review on Antimicrobial Resistance, Dec 2015, Antimicrobial use

in Agriculture & the Environment: Reducing Unnecessary Use and Waste



Key considerations in agricultural antibiotic use

2) Type of antibiotic use

A global example: colistin

1959: Colistin Discovered & used in agriculture, too toxic for humans

Growing antimicrobial resistance

2012: WHO reclassify as critically important for human medicine

Widespread agricultural use continues

Nov 2015: Colisitin resistance gene (MCR-1 gene) discovered in China

Spread of MCR-1 to south Asia, Europe, Africa and South America

2016 : Global calls to prevent colistin use in agriculture

Timeline of Resistance: A major breach in our last line of defence





An Australian perspective

Australia’s response

Responding To The Threat ofAntimicrobial Resistance

Australia’s First NationalAntimicrobial Resistance

Strategy 2015-2019

June 2015



National Strategy

Objectives set in seven key areas:

1. Surveillance

2. Antimicrobial stewardship

3. Infection prevention and control

4. Communication and education

5. Research and development

6. International partnerships

7. Governance



Australia’s response

• Low agricultural antibiotic

use compared to parts of

Europe and USA

Antibiotic use estimated in mg of antibiotics purchased for every kg of livestock biomass (Not include ionophores or oligosaccharides. Source: From UK Review on Antimicrobial Resistance.



Antibiotic use in Australian agriculture

• Low agricultural antibiotic

use compared to parts of

Europe and USA

• Conservative approach

• Colistin

• Fluoroquinolones

• Low risk of AMR development

from agricultureData sources: AGAR 2014, EARS-Net

2014 Polish data from 2012)



Antibiotic use in Australian agriculture

Antibiotic surveillance

• Little data available → Need improved surveillance of

• Antibiotic use

• Resistance levels

• Australia commenced international reporting of veterinary antimicrobial usage

to the OIE

• Proof-of-concept AMR surveillance programs:

• Pig industry

• Chicken meat industry

• Discussions with other intensive industries



• Issue of AMR is not expected to dissipate

• One health approach will be critical

• Sustainable antibiotic use in human and animal health is critical

• Agriculture - Antibiotics important for human health?

- Growth promotant antibiotics?

• Surveillance is central to supporting our status, maintaining trade

• International collaboration to stay at forefront of global trends



Summary



Documents

Sustainable antimicrobial use in animals and humans€¦ · Global Trends. Key considerations in agricultural antibiotic use. 1) Importance of the antibiotic to human health Sustainable