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
Federal Agency for the Safety of the Food Chain
Dr. Jean-François HEYMANS DVM,
Director ‘Animal Health and Safety of Animal Products’.
Chief Veterinary Officer (CVO) – Belgian Delegate to the OIE
Federal Agency for the Safety of the Food Chain
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
Federal Agency for the Safety of the Food Chain
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
Management of antimicrobial resistance in animals in Belgium
1. Introduction
Priority of world public health addressed in the ‘One Health’
context
Federal Agency for the Safety of the Food Chain5
Management of antimicrobial resistance in animals in Belgium
1. Introduction
Priority of a European public health
addressed in the context of
‘One Health’
Federal Agency for the Safety of the Food Chain6
• 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’
Management of antimicrobial resistance in animals in Belgium
1. Introduction
Priority of public health in Belgium
addressed in the context
’One Health’
What to do together?
Federal Agency for the Safety of the Food Chain
Link ’Resistances - used quantities of Abios’
Major axis = decrease the used quantities
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Management of antimicrobial resistance in animals in Belgium
1. Introduction
Federal Agency for the Safety of the Food Chain
Environmental
Economical and Soci(et)al
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Management of antimicrobial resistance in animals in Belgium
1. Introduction
Causes - Consequences - Solutions
Public Health
Human medicine
Animal Health
Veterinary medicine
Federal Agency for the Safety of the Food Chain
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
9
Management of antimicrobial resistance in animals in Belgium
Federal Agency for the Safety of the Food Chain
1999 : Creation of the Belgian Antibiotic Policy
Coordination Committee (BAPCOC).
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Management of antimicrobial resistance in animals in Belgium
2. Belgian background
Federal Agency for the Safety of the Food Chain
2011 : First Key year - the collective awareness
(Authorities - Sectors)
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Management of antimicrobial resistance in animals in Belgium
2. Belgian background
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
Federal Agency for the Safety of the Food Chain12
Management of antimicrobial resistance in animals in Belgium
2. Belgian background
Federal Agency for the Safety of the Food Chain13
Management of antimicrobial resistance in animals in Belgium
2. Belgian background
First encouraging results
Federal Agency for the Safety of the Food Chain
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
14
Management of antimicrobial resistance in animals in Belgium
Federal Agency for the Safety of the Food Chain
From autoregulation to ‘co-regulation’
An agreement convention between
Authorities & stakeholders on common
goals and leading actions
A new legislation
15
Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
2016 : Pivotal year (= 2d Key year) - The need to go further
faster
Federal Agency for the Safety of the Food Chain16
2016 : Pivotal year - The need to go further faster
Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
Federal Agency for the Safety of the Food Chain
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
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Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
Federal Agency for the Safety of the Food Chain
Convention ‘stakeholders’ - Authorities
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
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Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
Federal Agency for the Safety of the Food Chain
Convention ‘stakeholders’ - Authorities
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
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Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
Federal Agency for the Safety of the Food Chain
New legislation ‘veterinary drugs’
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Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
Federal Agency for the Safety of the Food Chain
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
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Fight against AMR
Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
Federal Agency for the Safety of the Food Chain
Part 2: Use of critical antibiotics
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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
Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
Federal Agency for the Safety of the Food Chain23
Part 3: Compulsory system of data collection of antibiotics use
Central data base
Authority
Management of antimicrobial resistance in animals in Belgium
3. 2016 - Pivotal year
Federal Agency for the Safety of the Food Chain
Part 3: System of data collection of antibiotics use:
Goals:
• General use
• Reporting of veterinarian and breeder of his own
data => Benchmarking
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Federal Agency for the Safety of the Food Chain
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
25
Management of antimicrobial resistance in animals in Belgium
Federal Agency for the Safety of the Food Chain26
Management of antimicrobial resistance in animals in Belgium
4. Results 2016
Global use
2015-2016 - 4.8 %
Since 2011: - 20 %
Federal Agency for the Safety of the Food Chain27
Management of antimicrobial resistance in animals in Belgium
4. Results 2016
Antibiotics of critical importance
2015-2016 - 53 %
Since 2011: - 56.1 %
Federal Agency for the Safety of the Food Chain28
Management of antimicrobial resistance in animals in Belgium
4. Results 2016
Medicated feed
2015-2016 - 29 %
Since 2011: - 38.2 %
Federal Agency for the Safety of the Food Chain29
Management of antimicrobial resistance in animals in Belgium
4. Results 2016
Evolution of bacterial resistances of antibiotics
Federal Agency for the Safety of the Food Chain
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
30
Management of antimicrobial resistance in animals in Belgium
Federal Agency for the Safety of the Food Chain
5. The future
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Analyse/Evaluate
Actions adapted
Measure the use of antibiotics and the AMR
Use Reduction goal Resistances
Management of antimicrobial resistance in animals in Belgium
Federal Agency for the Safety of the Food Chain
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
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Management of antimicrobial resistance in animals in Belgium