Management of antimicrobial resistance in animals in ... · PDF fileMeasures in veterinary medicine in the ‘One Health’ context ECVPH - Liège, 4th October 2017 Federal Agency

Federal Agency for the Safety of the Food Chain

Management of antimicrobial resistance in animals in Belgium :

Measures in veterinary medicine in the ‘One Health’ context

ECVPH - Liège, 4th October 2017


Dr. Jean-François HEYMANS DVM,

Director ‘Animal Health and Safety of Animal Products’.

Chief Veterinary Officer (CVO) – Belgian Delegate to the OIE

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Table of contents

1. Introduction

2. Belgian background

3. 2016 - Pivotal year1. Convention ’stakeholders’ - authorities

2. New legislation ‘veterinary drugs’

4. Results 2016

5. Future

2

Management of antimicrobial resistance in animals in Belgium


Service structures (Authority) and place of AMCRA

FASFCFederal Agency for

the Safety of

The Food Chain

(‘Operational’

standards

+ Controls)

3

Non-profit organization

Federal

Agency for

medicines

(Standards +

Controls)

FPS Public HealthFood Chain Safety and Environment (Standards)

Federal Ministers of Agriculture and Public Health

Federal Agency for the Safety of the Food Chain4


1. Introduction

Priority of world public health addressed in the ‘One Health’

context



1. Introduction

Priority of a European public health

addressed in the context of

‘One Health’


• Priority of the Belgian Government, the

Administrations and the Sectors concerned.

• Set up 'the enrolment’ of the sectors for an effective

implementation of recommendations and rules

• From autoregulation to co-regulation (2016).

• Approach ‘One Health’


1. Introduction

Priority of public health in Belgium

addressed in the context

’One Health’

What to do together?


Link ’Resistances - used quantities of Abios’

Major axis = decrease the used quantities

7


1. Introduction


Environmental

Economical and Soci(et)al

8


1. Introduction

Causes - Consequences - Solutions

Public Health

Human medicine

Animal Health

Veterinary medicine


Table of contents

1. Introduction


3. 2016 - Pivotal year1. Convention ‘stakeholders’ - Authorities

2. New legislation ’veterinary drugs’

4. Results 2016

5. Future

9



1999 : Creation of the Belgian Antibiotic Policy

Coordination Committee (BAPCOC).

10




2011 : First Key year - the collective awareness

(Authorities - Sectors)

11



Source: Belvetsac

2012 : The reaction: Setting up of the AMCRA non-profit oganization

AntiMicrobial Consumption and Resistance in Animals

– Authorities + sectors (Vets+Agri+Pharma+feed) => actions and financing

– Sustainable use of antibiotics (reduce use and resistances)

– Gather information - Analyse - Advise - Communicate







First encouraging results


Table of contents

1. Introduction


3. 2016 - Pivotal year1. Convention ‘stakeholders’ - Authorities

2. New legislation ‘veterinary drugs’

4. Results 2016

5. Future

14



From autoregulation to ‘co-regulation’

An agreement convention between

Authorities & stakeholders on common

goals and leading actions

A new legislation

15


3. 2016 - Pivotal year

2016 : Pivotal year (= 2d Key year) - The need to go further

faster


2016 : Pivotal year - The need to go further faster




Convention ‘stakeholders’ - Authorities

Goals:

1. Gather Human + Veterinary Authorities &

the stakeholders around objectives of

common quantifiable goals of decrease

2. Define the role, the actions and the

commitments of everyone to reach that goal

17





Who:

– Political authorities: Fed. Min. De Block (Public Health) and Borsus

(Agriculture) => Signatories

– Administrative bodies: FASFC, FAMHP

– AMCRA (including coordination)

– Fed. professional agricultural organizations (FWA, BB, ABS),

veterinarians (UPV, VDV), pharmaceutical industry (Pharma.be), feed

manufacturer (Bemefa-Apfaca)

– Managers of specifications

– First-line laboratories: ARSIA/DGZ

=> Authorities + 16 organizations

18





Strategic goals: Reductions of (based upon reference 2011)

• 50 % of use of antibiotics in general until end 2020,

• 75 % of use of the most critical antibiotics (third- and

fourth-generation fluoroquinolones and cephalosporins)

from now until end 2020,

• 50 % of use of medicated feed containing antibiotics for

end 2017.

Operational goals - ‘tools’

• Measure

• Decrease via regulatory pathway

• Everyone acts at their own level

19




New legislation ‘veterinary drugs’

20




New legislation ‘veterinary drugs’ - 2016

3 Parts:

1. Administrative - veterinary drugs (veterinaries and

breeders) = modernisation legislation 2000

2. Conditions of use of critical antibiotics

3. Compulsory system of collection of data use of

antibiotics

21

Fight against AMR




Part 2: Use of critical antibiotics

22

General rule: prohibition of use

➢Preventive: ban without exceptions

➢Metaphylactic & curative: derogation under

conditions1. Clinical examination on-the-spot of VT

2. Bacterial causes

3. Appropriate sampling or requested autopsy

4. Identification of the bacterial strain based on the samples

5. Standardized sensitivity lab test of AB: min. 7 non critical AB (min. 5

different classes) + critical AB

6. Only efficient AB = critical AB




Part 3: Compulsory system of data collection of antibiotics use

Central data base

Authority




Part 3: System of data collection of antibiotics use:

Goals:

• General use

• Reporting of veterinarian and breeder of his own

data => Benchmarking

24


Table of contents

1. Introduction


3. 2016 - pivotal year1. Convention ‘stakeholders’ - Authorities


4. Results 2016

5. Future

25




4. Results 2016

Global use

2015-2016 - 4.8 %

Since 2011: - 20 %



4. Results 2016

Antibiotics of critical importance

2015-2016 - 53 %

Since 2011: - 56.1 %



4. Results 2016

Medicated feed

2015-2016 - 29 %

Since 2011: - 38.2 %



4. Results 2016

Evolution of bacterial resistances of antibiotics


Table of contents

1. Introduction


3. 2016 - pivotal year1. Convention ‘stakeholders’ - authorities


4. Results 2016

5. Future

30



5. The future

31

Analyse/Evaluate

Actions adapted

Measure the use of antibiotics and the AMR

Use Reduction goal Resistances



Thank you for your attention!

Dr. Jean-François HEYMANS DVM,

Director ‘Animal Health and Safety of Animal Products’.

Chief Veterinary Officer (CVO) – Belgian Delegate to the OIE

32


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Management of antimicrobial resistance in animals in ... · PDF fileMeasures in veterinary medicine in the ‘One Health’ context ECVPH - Liège, 4th October 2017 Federal Agency