Management of antimicrobial resistance in animals in Belgium : Measures in veterinary medicine in the One Health context

Transcription

1 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

2 Table of contents 1. Introduction 2. Belgian background Pivotal year 1. Convention stakeholders - authorities 2. New legislation veterinary drugs 4. Results Future 2

3 FASFC Federal Agency for the Safety of The Food Chain ( Operational standards + Controls) Service structures (Authority) and place of AMCRA Federal Ministers of Agriculture and Public Health FPS Public Health Food Chain Safety and Environment (Standards) Federal Agency for medicines (Standards + Controls) Non-profit organization 3

4 1. Introduction Priority of world public health addressed in the One Health context 4

5 1. Introduction Priority of a European public health addressed in the context of One Health 5

6 1. Introduction Priority of public health in Belgium addressed in the context 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 What to do together? 6

7 1. Introduction Link Resistances - used quantities of Abios Major axis = decrease the used quantities 7

8 1. Introduction Public Health Human medicine Causes - Consequences - Solutions Animal Health Veterinary medicine Environmental Economical and Soci(et)al 8

9 Table of contents 1. Introduction 2. Belgian background Pivotal year 1. Convention stakeholders - Authorities 2. New legislation veterinary drugs 4. Results Future 9

10 2. Belgian background 1999 : Creation of the Belgian Antibiotic Policy Coordination Committee (BAPCOC). 10

11 2. Belgian background 2011 : First Key year - the collective awareness (Authorities - Sectors) 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 11

12 2. Belgian background 12

13 2. Belgian background First encouraging results 13

14 Table of contents 1. Introduction 2. Belgian background Pivotal year 1. Convention stakeholders - Authorities 2. New legislation veterinary drugs 4. Results Future 14

15 Pivotal year 2016 : Pivotal year (= 2d Key year) - The need to go further faster From autoregulation to co-regulation An agreement convention between Authorities & stakeholders on common goals and leading actions A new legislation 15

16 Pivotal year 2016 : Pivotal year - The need to go further faster 16

17 Pivotal year 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

18 Pivotal year 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 18

19 Pivotal year 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 Operational goals - tools Measure Decrease via regulatory pathway Everyone acts at their own level 19

20 Pivotal year New legislation veterinary drugs 20

21 Pivotal year New legislation veterinary drugs Parts: 1. Administrative - veterinary drugs (veterinaries and breeders) = modernisation legislation Conditions of use of critical antibiotics 3. Compulsory system of collection of data use of antibiotics Fight against AMR 21

22 Pivotal year Part 2: Use of critical antibiotics General rule: prohibition of use Preventive: ban without exceptions Metaphylactic & curative: derogation under conditions 1. 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 22

23 Pivotal year Part 3: Compulsory system of data collection of antibiotics use Central data base Authority 23

24 Part 3: System of data collection of antibiotics use: Goals: General use Reporting of veterinarian and breeder of his own data => Benchmarking 24

25 Table of contents 1. Introduction 2. Belgian background pivotal year 1. Convention stakeholders - Authorities 2. New legislation veterinary drugs 4. Results Future 25

26 4. Results 2016 Global use % Since 2011: - 20 % 26

27 4. Results 2016 Antibiotics of critical importance % Since 2011: % 27

28 4. Results 2016 Medicated feed % Since 2011: % 28

29 4. Results 2016 Evolution of bacterial resistances of antibiotics 29

30 Table of contents 1. Introduction 2. Belgian background pivotal year 1. Convention stakeholders - authorities 2. New legislation veterinary drugs 4. Results Future 30

31 5. The future Measure the use of antibiotics and the AMR Analyse/Evaluate Use Reduction goal Resistances Actions adapted 31

32 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