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No universal remedies in sight, joint supranational efforts now compulsory: International Fresenius Conference discussed strategies for combatting antimicrobial resistance

Over half of the antibiotics used in Europe are administered to animals. This has resulted in a rising resistance of pathogens to antibiotics – one of the biggest and most urgent challenges currently facing the feed industry. Akademie Fresenius devoted their sixth international Feed Conference totally to the question of how to combat antimicrobial resistance (AMR). For their two-day conference on 20 and 21 March, they won the support of numerous top-ranking representatives from the research sector, the industry, the European Commission and the European Food Safety Authority EFSA.

The participants were provided with an overview of the plans and efforts of the European Commission to combat antimicrobial resistance – straight from representatives from Brussels. This was followed by reports by the experts on containment strategies and the regulation of the use of antibiotics in Belgium, Denmark and Spain. Also on the agenda: Options for replacing antibiotics through probiotics and new approaches to assessing the safety of feed supplements.

EU aims to become “Best Practice Region”

According to estimates made by the European Commission, at least 25,000 people die every year due to their resistance to antibiotics. Every year, antimicrobial resistance also results in health costs and loss of productivity amounting to around 1.5 billion Euros. To fight this problem, the EU has adopted an action plan to promote research and supranational collaboration. This is intended to turn Europe into a “Best Practice Region” in the fight to combat antimicrobial resistance. Marta Ponghellini of the EU Commission’s Health and Food Safety DG presented exactly what the targets of the plan aim to achieve, together with the preliminary results. She noted that the danger of antimicrobial resistance across Europe required immediate action, particularly due to the fact that there were great differences between the individual EU Member States with respect to their awareness, measures and strategies. One of the most important tasks, therefore, was to develop supranational collaboration. 

DART 2020: Germany is banking on a cross-sector approach

In 2015, the Federal Ministry of Health, together with the ministries for Food and Agriculture and Education and Research, compiled the German “DART 2020” Antimicrobial Resistance Strategy for Germany. This was adopted by the Federal Cabinet in May 2015. This strategy paper pools the measures and emphasises multisectoral collaboration (One Health approach).  In order to comply with this One Health concept, the DART 2020 targets apply equally to human and veterinary medicine. Anke Schröder of the German Federal Ministry of Food and Agriculture gave a detailed presentation of this approach at the conference. She stated that these efforts had already resulted in some initial success but that these concepts and measures needed to be consistently developed and further expanded upon. Recognising that human and animal health were closely interwoven when it came to infectious diseases set the direction for all future measures and activities. “The containment of antimicrobial resistance requires a cross-sector approach. We can only be successful, if we work closely together on an international scale and support the WHO’s Global Action Plan”, Schröder concluded. 

Denmark sets an example: Joint efforts by the industry and the authorities. The current focus is on reducing colistin usage

In the EU, Denmark is considered to be the pioneer in the fight against antimicrobial resistance. The European Food and Veterinary Office (FVO) recommends that the other Member States adopt numerous features of the measures carried out by Denmark to promote the prudent usage of antibiotics in animals, stating that these are “examples worthy of imitation”. Poul Bækbo of the Danish Pig Research Centre (SEGES) went through the efforts the country had made during the past 25 years. These included the ban on using antibiotics to promote growth issued in 1998 as well as the voluntary decision of the industry to forego the use of the broad-spectrum antiobiotic celaphalosporin. From 2014, the use of the antibiotic tetracycline had also been reduced significantly. Denmark is currently focussed on reducing the application of colistin which is used to treat intestinal disorders. 

First and foremost, Poul Bækbo views the path to success as being through a combination of legal provisions and industry initiative. He said that the industry not only needed up-to-date knowledge but also time to adapt food and feed methods accordingly.

Is China set for a pioneering role?

Reiner Sijtsma of the Dutch feed manufacturer Nutreco also believes that antimicrobial resistance can only be effectively combatted using an integrated approach that includes all instances along the value chain. Geneticists are being asked to breed more and stronger animals. He said that the feed industry needed to develop innovative foodstuffs. Health researchers should also contribute to increasing animal resilience through vaccines and improving intestinal health. It was the farmers’ job to improve hygiene and increase biosecurity on their farms. Sijtsma is convinced that antimicrobial resistance can be reversed. He pointed to successes achieved in the Netherlands where the spread of the multi-resistant E. coli bacteria had been reduced. He also referred to successes achieved in China and generally asked whether China might even be able to take on a new leading role in the fight to reduce antibiotic usage.

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