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Antimicrobial resistance

Antimicrobials are agents that “kill” a wide range of organisms including bacteria, viruses, and fungi. Antibiotics are a type of antimicrobial medicine and act on bacteria specifically. Antimicrobial resistance (AMR) occurs when infectious agents (bacteria, viruses, fungi and parasites) evolve over time and acquire new characteristics which reduce or stop their susceptibility to antimicrobials. This makes infections harder to treat, easier to spread and more likely to cause severe illness and death. The inappropriate and excessive use of antimicrobials contributes to the development of AMR.

AMR is of significant concern to UK and global health authorities. In 2019, the UK Government published a paper which set out its 20-year vision of a world in which AMR is effectively contained, controlled and mitigated. This is supported by more targeted commitments in the latest of its five-year plans for AMR (2019-2024). These include working with industry to improve diagnostic tools to inform veterinary prescribing and improving the available data on antimicrobial prescribing.

The UK has also committed to global initiatives such as the World Health Organization’s Global Action Plan on AMR.

How are antibiotics used in livestock?

Although banned in the UK and the EU from 2006, animals were historically given antibiotics in their feed as a broad preventative measure to promote healthy livestock. There are three situations where antibiotics can be given to livestock. The first is therapeutic use for specific treatment of a diseased animal. The second is control or metaphylactic use – the treatment of a group of animals after the diagnosis of disease has been made in part of the group. The aim is to treat clinically sick animals and control the spread of disease to others in close contact which may already be infected. The third category is preventative or prophylactic – the treatment of an animal or group of animals before clinical signs of disease. The aim is to prevent the occurrence of disease or infection.

Some 73% of antimicrobials sold globally in 2017 were for use in animals used for food production.

What action is being taken to reduce antibiotic use in livestock?

Campaign groups such as World Animal Action have called for greater action at a global scale to cut antibiotic use and mitigate AMR developing through over use of antimicrobials in the animal population.

The UK’s use of antibiotics in farmed animals decreased in 2021 to the lowest recorded, with a 55% reduction since 2014. The UK is now one of the lowest users of antibiotics in Europe, and lower than any EU country with a significant livestock farming industry. The National Farmers’ Union has noted that “preventative use has been phased out completely in [many livestock] sectors, meaning many animals receive no antibiotic treatments at all in their lifetime”. None the less, the Government has policies to further reduce “unnecessary” use of antibiotics in animals and does not support the routine or predictable use of antibiotics, “including where antibiotics are used to compensate for inadequate farming practices”. Certain antibiotic classes are categorised by the World Health Organisation (WHO) as critically important antibiotics for human use, of which several are designated as ‘highest priority critically important antibiotics’ (HP-CIA) Policies focus on limiting the use in animals of these types of  antibiotics, but to support the use of other antimicrobials to prevent disease.  Stakeholders including the British Veterinary Association and farming organisations broadly support this approach and are working with the Government on its implementation.

Future UK action

In January 2022, the routine use of antibiotics was banned in the EU, and preventative use was restricted to exceptional treatments of individual animals. Antibiotics can also no longer be applied to compensate for poor hygiene and animal husbandry practices. This ban does not apply to the UK, although products exported to the EU must comply with its requirements. The Government’s 5-year action plan for antimicrobial resistance published in 2019 said that the UK would align with new EU regulations on veterinary medicines. However, an addendum to the action plan published in May 2022 replaces alignment with a commitment to “implement similar provisions” to the EU regulations. 

The Government said in January 2023 that it proposed to strengthen the law on unnecessary antibiotic prescribing in animals. Farming Minister Mark Spencer said that the UK Veterinary Medicines Directorate had been in dialogue with stakeholders in 2022 about changes to the Veterinary Medicines Regulations 2013 which set out controls on marketing, manufacturing, supply and use of veterinary medicines. A full consultation was being prepared, with legislation expected to be laid in 2023.

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