VIV Animal Health Summit Closing CEO-level Conference, Erik de Jonge, VIV Asia 2013
AntibioticsDutch action plan animal production sectorsErik de Jonge14-03-13
Content1. Introduction / reasons for action plan on antibiotics2. Action plan3. Targets4. Results and conclusions
Introduction /reasons for action plan• Increasing antibiotic resistance is public health risk.• The use of antibiotics in animal production sectors is a risk for public health - Transfer of antibiotic resistent bacteria to humans (ESBLs, MRSA) - Relations between sectors and public health are becoming more prominent (ESBLs)• Relatively high use of antibiotics in animal production sectors compared to Dutch human use of antibioticsConclusionAnimal production sectors have responsibilty to take action.
Action plan antibiotics animal production sectors• Discussion on antibiotics in Government and Parliament since 2007• Agreement: sectors take initiative; Government monitors results and if necessary interveres• December 2008: official voluntary agreement on antibiotic resistance.• Participants agreement: - 4 animal production sectors (cattle, veal calves, pigs, poultry) - farmers, industry, veterinarians, feed industry - Facilitated by ministry of Economic Affairs• Aim: less, better and transparant use of antibiotics• Installation of an Authority for Veterinary Medicine• Action plan is a dynamic plan
Reduction targets for the use of antibioticsThe Government set targets for the reduction of the use of antibiotics in2010 and 2012.Overall targets for the use of antibiotics are set for the animal productionsectors (cattle, pigs, veal calves, broilers) 2011 (2009): -/- 20% 2013 (2009): -/- 50% 2015 (2009): -/- 70%Poultry sector follows the same targets: broilers, laying hens, turkeys
Main activities in the action planFor all sectors1. Registration of all delivered antibiotics in central databases2. One farmer, one vet (contract)3. Health and treatment plans4. Guidelines for the prescription of antibiotics5. Individual feed back with a benchmark to farmers / vets6. Approach for individual reduction on farmsSpecific actions per sector For example: transparancy, research in certain health issues,a ban on certain antibiotics in q.a.s. (3/4 gen. cefalosporines).
Implementation action plan1. Antibiotics agreement is implemented through private quality assurance programs (IKB)2. IKB – programs: from farm to processing plants3. Participation rates are very high4. 90 to 95% of the farmers in the pig sector, dairy sector, broiler sector and veal sectorNon participants: product board regulationApproved in boards PPE and PVV mid 2011
1. Registration in central databases• Every sector has a centrale database.• Vets have to register the delivered antibiotics in the central database: type of antibiotic, quantity, dosage, length of treatment, etc.• In the poultry sector standardised clinical signs and diagnosis are also registered.• Antibiotics database is connected with the database for animals and flocks on the farm (I&R)• Inspections on farm and incorrect registration is sanctioned• Starting date of registration: pig sector (01-01-10), veal calves (01-07- 10), broiler (01-01-11), cattle and layer sector (01-01-12).
1. Registration in central databasesGoals of registration of antibiotics in central database• Monitoring (do the actions have the required results)• Used for poultry health policies• Basis for individual feed back (benchmarking)• Basis for approach for individual reduction on the farm• Public accountablity (sector, government, public)
2. One farmer, one vet• Contract between farmer and vet• One on one relationship• Only prescriptions for antibiotics from contracted vet• Minimum frequency of visits (varies per sector and type of farm)• Poultry: every antibiotic is prescribed after diagnosis on farm• Health plan and treatment plan• Vet must use the veterinary guidelines from KNMvD when prescribing antibiotics• Replacement and responsibility
3. Health and treatment plans• Health plan: drawn up by farmer, vet and, preferably, other advisors - analysis of farm management with respect to animal health - climate, feed, use of antibiotica, watersystems, welfare – (model) - write down improvement measures and a target for the use antibiotics - farmer implements improvements• Treatment plan: drawn up by vet in cooperation with farmer - how diseases are tackeled in the next period - how diagnoses are made on the farm and for instance about the use of bacteriological tests and sensitivity tests - based on formularia• Both plans: at least a yearly evaluation
4. Veterinary guidelines for the use of antibiotics • Formularies for the prescription of antibiotics • Drawn up by expert groups from KNMvD per type of animal • List of relevant indications per type of animal • Per indication a first, second and third choise of medicins • Criteria for choises - effectivity of antibiotic - chance on developping or spreading resistance - minimum use of antibiotics that are important for human health (fluoroquinolones / cefalosporines are third choise)
5. Individual feed back (benchmark)• Individual feed back report at least every three months for farmers• Poultry: also individual reports for veterinary practises• Figures compared to colleagues (national average / best farmers)• Started mid 2011 (broilers, veal calves, pigs).• Feed back report: the report becomes more and more extended• Aim: awareness of use of antibiotics• Feed back reports are used in health and treatment plans
5. Individual feed back with benchmark Benchmark veterinarian practises: use of antibiotics 2012
5. Individual feed back with benchmark Example of use of antibiotics in 2012 on a broiler farm
5. Individual feed back with benchmark Example: weeks in which treatment was started
5. Individual feed back with benchmark Example: reason for the use of antibiotics
5. Individual feed back with benchmark Example: which groups of antibiotics are used
6. Approach for individual reduction on farmsPoultry• Started 01-01-2013• Four categories: target category, signal category, action category 1 / 2• Every farm is assessed and categorized every 6 months• Every farm above target category should reach a lower level in 1 year• The higher the category, the firmer the measuresMeasuresWe do not tell the farmer what to do. Farmer decides which measures to take• Signal category: improvement plan within 4 weeks• Action category 1: extra mandatory screening of the farm (digital tool)• Action category 2: use of independent expert at own expense
Results: animal production sectorsDutch veterinairy sales of antibiotics from 1999 - 2012 Antibiotic sales 600 500 kg active substance x 1000 400 300 Antimicrobial growthpromoter 200 Therapeutic sales 100 0 jaar Source FIDIN: manufacturers and importers of veterinary medicines
Results Dutch broiler sectorUse of antibiotics in Dutch broiler sector (daily dosis per animal year) Use of antibiotics broilersector 40 35 30 25 20 broilersector 15 10 5 0 2009 2010 2011 2012Source: 2009 / 2010 database VMP (50% of farms) 2011 / 2012 database IKB CRA (98% of farms)
Results and conclusionsConclusions Reduction of the use of antibiotics in Dutch animal production sectors was 32% in 2011. Therefore the target for 2011 (20%) has been achieved. Reduction of the use of antibiotics in Dutch animal production sectors was 51% in 2012 (first 6 months). Therefore the target for 2013 (50%) has already been achieved in 2012. In the broilersector the reduction was 26% in 2011 and 40% in 2012.The Dutch broilersector is well on its way to reduce the use ofantibiotitcs. Individual programms on farms should lead to a 50%reduction for 2013. Then probably verder steps have to be taken.
Action plan antibiotics animal production sectorsActions 20132013: focus on critical antibiotics (poultry: fluoroquinolones)2013: expending benchmarks and feed back reports with feedsupplier, breed and hatcheries.2013: broilers: new requirements for all chicken meat deliveredto Dutch supermarkets in de period 2015 – 2020 (25%): slowergrowing broiler, lower density, maximum use of antibiotics, etc.