On Sunday November 22, during World Antibiotics Awareness Week, 20 senior representatives from health and medical organisations, including Medact, co-signed a letter, published in the Times, calling on the UK Government and European Commission to put an end to routine, purely preventative antibiotic use in groups of healthy animals – referred to in the letter as ‘inconsistent with all responsible-use guidance.’
The letter comes just a few days after a Veterinary Medicines Directorate’s report revealed that the total UK veterinary sales in 2014 of antibiotics classified as “critically important in human medicine” increased by 3% to a new record high. The total sales of antibiotics licensed for food animals only also increased by 4%.
Concerns about the routine use of antibiotics in farming have been heightened this week after the discovery of a new form of resistance in E. coli in pigs and in people in China which makes the bacteria resistant to colistin, an antibiotic used as a last-resort in human medicine. The VMD report also reveals that colistin-resistant salmonella has now been found in UK livestock: 5% of salmonella from egg-laying birds were resistant to the antibiotic which can be used in laying birds.
Farm animals account for almost two thirds of all antibiotics used in 26 European countries. Medical experts have now set out their wish for the current revision of the EU Veterinary Medicinal Products legislation to introduce a ban on the purely preventative treatment of groups of animals where no disease has been diagnosed in any of the animals being treated.
Babulal Sethia, President of the Royal Society of Medicine said: “While GPs strive to curb prescribing practices, the farming sector also needs to move towards more selective antibiotic administration. The preventative treatment of groups of healthy animals when no disease has been diagnosed is not responsible use.”
At present, the European Commission proposals for the new Veterinary Medicinal Products legislation would allow routine preventative use to continue. Furthermore, although the UK Government says it is opposed to routine preventative use of antibiotics in animals, it does not yet support proposals to end preventative treatment of groups of healthy animals.  In contrast, the European Medicine Agency wants to end such group treatments but does not have the power to legislate for a ban.
Kerry McCarthy MP said, “I am pleased that members of the health and medical community have spoken up on this issue. Within the EU, groups of animals – mainly pigs or poultry – are often ‘mass-medicated’ through their water or feed. If we are to truly tackle the resistance problem, which the Prime Minister has said he is committed to, routine dosing of groups of healthy animals must stop.”
Dr David McCoy, a physician and Director of London-based global public health charity Medact said, “The over-use of antibiotics in farm animals and its potential to accelerate antimicrobial resistance threatens to turn the clock on the history of medical advancement. Members of the medical community, with colleagues in veterinary medicine, must get involved with much-needed reforms of the industrialised farming sector in particular”.
Last month the farmers’ unions of Denmark, Finland, Iceland, Norway and Sweden also called on their governments to propose a full EU ban on the routine preventative use of antibiotics.
Emma Rose from the Alliance to Save our Antibiotics said: “Routinely dosing healthy animals on a purely preventative basis is something we simply cannot afford to do if we are to have a chance of preserving drugs for the future. If animals cannot remain healthy within the conditions in which they are placed, perhaps it is time to take a closer look at our farming systems”
Nearly 90% of farm antibiotic use in the UK is for group treatments of pigs and poultry, often via mass medication through feed or water. The VMD clarified earlier this year that no disease diagnosis in any of the animals is required before mass medication is applied.
 The Veterinary Medicines Directorate are responsible for advising on Defra’s policy on antimicrobial resistance and wrote to the Alliance to Save Our Antibiotics in September 2015 to state that they do support prophylactic (purely preventive) antibiotic use in groups of animals before clinical signs of disease appear, in circumstances where there could be a high risk of infection occurring.
The letter was drafted by the Alliance to Save Our Antibiotics and signed by:
Babulal Sethia, President, The Royal Society of Medicine
Professor Neena Modi, President, The Royal College of Paediatrics and Child Health
Professor John R Ashton CBE, President, UK Faculty of Public Health
Professor Murat Akova, President, European Society of Clinical Microbiology and Infectious Diseases
Professor Alan Boyd, President, Faculty of Pharmaceutical Medicine
Dr Giles Maskell, President, The Royal College of Radiologists
Dr Suzy Lishman, President, The Royal College of Pathologists
Professor Michael Dixon LVO OBE FRCGP, Chair, College of Medicine
Dr Ron Daniels, Chief Executive, UK Sepsis Trust
Vilma Gilis, President, Guild of Healthcare Pharmacists
Professor Chris Butler, Professor of primary care, University of Oxford. Cwm Taf University Health Board
Dr David McCoy, Director, Medact
Nina Renshaw, Secretary General, European Public Health Alliance
Derek Butler, Chair, MRSA Action UK
Professor Reinhard Hoffmann, Secretary General, German Trauma Society
Steve Nash, Co Founder Member, HUSH (Haemolytic Uraemic Syndrome Help) – The UK E. coli Support Group
Dr Evangelos J. Giamarellos-Bourboulis, Associate Professor of Medicine, Hellenic Sepsis Study Group
Gertrude Buttigieg, Honorary Secretary, Malta Health Network
Anja Leetz, Executive Director, Health Care Without Harm
Anna Zorzet, MSc, PhD, Coordinator, ReAct Europe
Emma Rose, Coordinator, The Alliance to Save our Antibiotics
Medact is working in partnership with the Alliance to Save Our Antibiotics (ASOA). The ASOA is an alliance of health, medical, environmental and animal welfare groups working to stop the overuse of antibiotics in animal farming. It was founded by Compassion in World Farming, the Soil Association and Sustain in 2009, and is supported by the Jeremy Coller Foundation. Its vision is a world in which human and animal health and wellbeing are protected by food and farming systems that do not rely routinely on antibiotics and related drugs.