Present and future use of antimicrobials in pigs with case studies from Uganda and Vietnam
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This document summarizes research on antimicrobial use and resistance in livestock production systems in developing countries. It finds that antimicrobial use is highest outside of OECD countries, with some developing countries using antibiotics at much higher rates. Case studies from Uganda and Vietnam show widespread antibiotic use in pig and poultry farming, and high levels of resistance found in bacterial isolates from pigs and pork. The document calls for concerted global action to address antimicrobial resistance as it poses a major threat to human and animal health worldwide.
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Present and future use of antimicrobials in pigs with case studies from Uganda and Vietnam
- 1. Present and future use of antimicrobials in pigs with case studies from Uganda and Vietnam Safe Pork 2015 Conference, Porto, Portugal 9 September 2015 Grace, D.1*, Unger, F.1, Roesel, K.1, Tinega, G.1, Ndoboli, D.2, Sinh Dang-Xuan3, Hung Nguyen-Viet1, 3and Robinson, T. 1 1 International Livestock Research Institute, Nairobi, Kenya 2 Makerere University, Kampala, Uganda, 3 Hanoi School of Public Health, Hanoi, Vietnam
- 2. Antimicrobial resistance • AMR infections currently claim at least 50,000 lives each year across Europe and the USA alone ….. with many hundreds of thousands more dying in other areas of the world • In 15 European countries more than 10% of bloodstream Staphylococcus aureus infections are caused by methicillin-resistant strains (MRSA) ….. closer to 50% in several of these Source: O’Neill (2014) The O’Neill Report (2014)
- 3. Livestock numbers & consumption increasingly driven by developing countries
- 4. Livestock numbers & consumption increasingly driven by developing countries
- 5. Livestock numbers & consumption increasingly driven by developing countries 0 200,000,000 400,000,000 600,000,000 800,000,000 1,000,000,000 1,200,000,000 1,400,000,000 Cattle Goat Sheep Swine Poultry '00 Developing Developed
- 6. Modelling pig systems Source: Gilbert et al. 2015
- 7. Source: Gilbert et al. 2015 Modelling pig systems Extensive Semi-intensive Intensive
- 8. Antimicrobial resistance Source: Van Boeckel et al. (2015) Global antimicrobial consumption in livestock (mg per 10km pixel)
- 9. Antimicrobial use in livestock • Total consumption in the livestock sector in 2010 estimated at 63,151 tons • Global antimicrobial consumption will rise by 67% by 2030 • It will nearly double in BRICS • Poultry>pork: e.g. in Asia, chicken by 129%, pork 124% by 2030
- 10. Reality check
- 11. • Animal disease is a key constraint: Remove it and animal productivity increases greatly • Africa: every year one in two young animals and one in five adult animals die, mostly of preventable disease Young Adult Cattle 22% 6% Shoat 28% 11% Poultry 70% 30% Otte & Chilonda, IAEA Annual mortality of African livestock Animal disease is a key constraint
- 12. Antimicrobial use varied and high: highest outside the OECD 0 20 40 60 80 100 120 140 160 Norway Sweden Iceland NewZealand Latvia Slovenia Ireland Lithuania Denmark Austria Estonia Australia Switzerland UnitedKingdom CzechRepublic Poland France Belgium Portugal Japan Netherlands Chile Hungary Germany Spain RepKorea USA Italy Antibiotic grams/VLU 0 50 100 150 200 250 300 350 400 450 500 SE Asia OTHER OECD
- 13. Global antimicrobial use in food animals Source: Grace,. 2015 • Total consumption in the livestock sector in 2000s estimated at 400,000 tonnes (vs. 64,000 tonnes from models) China, USA, Thailand France, Iran, S Africa Norway, Kenya Sweden 1 10 100 1,000 10,000 100,000 1,000,000 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 Antibiotics (tn) 0 100 200 300 400 500 600 700 800 900 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 Antibiotic grams/VLU China, Thailand USA, Philippines, S Africa Sw, Nor, Kenya
- 14. Does it matter? • In high use countries, great majority of antimicrobial sales are in the agricultural sector • Developing countries very little information on antimicrobial use • Probably some countries use at much higher rates than OECD • Large problem of antimicrobial under- use What contribution does agriculture make to AMR in human medicine ?
- 15. 15 Antibiotic use: Vietnam 0 10 20 30 40 50 60 70 80 Household Industrial Household Industrial Household Industrial Growth promoter Prophylaxis Treatment Piglets Chickens Livestock farmers • 45 antibiotics from 10 classes • 100% industrial farmers treat themselves; 60% of household farmers
- 16. Photo: ILRI Antibiotic use: Uganda
- 17. TET AMP PEN SXT resistant 22 (44%) 39 (78%) 11 (22%) 0 (0%) susceptible 19 (38%) 1 (2%) 30 (60%) 41 (82%) intermediate 9 (18%) 10 (20%) 9 (18%) 9 (18%) 1. Kampala pig abattoir Tinega, 2014
- 18. Kampala pork butcheries: Salmonella Heilmann & Ndoboli, 2015. All isolates were confirmed Salmonella at FUB using species primer S. enteritidis % Raw pork 33 Flies 25 Tomatoes 8 Roasted pork 1.3
- 19. Drug sensitivity tests • So far 25 of the 60 isolates tested (agar diffusion test) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% SA PRL PTZ AMC CZ AP FOX KF CPM CAZ CXM CTX AK MEM CIP IMI T GM C LEV OFX SXT R I S
- 20. Way forward • Very difficult to regulate use in the developing and emerging economies ➜ Global problem: Concerted action ➜ Emotion high, reason low problem: Strengthen evidence base ➜ Goldilocks challenge: Address the “too little” as well as “too much problem”
- 21. Acknowledgements • The research featured in this presentation was funded by DFID, ACIAR, A4NH and others 22
Editor's Notes
- ECF and Newcastle Disease are examples where the disease is the biggest constraint in the system. Several studies have shown that where these are controlled populations and/or offtake can double. The table summarises a number of studies in a systematic review of mortality in African traditional systems, by age group
- It will nearly double in BRICS (Brazil, Russia, India, China, and South Africa) countries China’s livestock industry by itself could soon be consuming almost one third of world’s available antibiotics.