Addressing Antibiotic Concerns on a United Front

January 28, 2016
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Matthew Salois, PhD, Economic Research & Policy Advisor – Elanco Animal Health – A Division of Eli Lilly and Company

 

Consumers have a right to know where their food comes from and how it was produced, especially when it comes to antibiotic use in animals. Antibiotic resistance is a public concern and is a consequence of the use and misuse of antibiotics across society with responsibility shared by the human, animal, and environmental health communities.

The concern about the potential dangers of widespread antibiotic use in both humans and animals is justified. Scientific studies have revealed evidence that some antibiotics have become less effective and certain microbes have developed resistance to treatment. This is a genuine threat and the preservation of antibiotic effectiveness is in the best interest of human health.

But we also need to be clear about what is causing the problem of antibiotic resistance and how it can be most effectively addressed. Animal, human, and environmental health are intrinsically linked together and so logically they must be addressed together as part of a single and integrated One Health approach. To improve and defend the health of people, animals, and the environment will require broad thinking, not finger-pointing or one-sided alternatives. Physicians, veterinarians, and environmental health professionals must take shared responsibility and they must act together in a forward-looking, cooperative, and accountable way.

From the perspective of the agriculture community, antibiotics are one way, but not the only one, that farmers help to keep their animals healthy. Relying on antibiotics alone, or using excessively, is not sound farming. Veterinarians and farmers use many other methods to support animal health including vaccines and enzymes, as well as, high nutritional standards and stringent hygiene practices. Thorough application of good farming practices along with responsible use of antibiotics helps to enhance animal welfare and food safety.

What does responsible antibiotic use mean in agriculture?

Using antibiotics responsibly means treating an animal that is sick with the right dose of antibiotics at the right time to help them get better. It also means using antibiotics to control the spread of infection when there is a disease threat and identifying animals when they are at risk to help prevent unnecessary illness and suffering. This includes supporting veterinarian oversight of antibiotic use in treating animals to ensure that the most appropriate treatment is given at the right time in the right form following labeled instructions approved by our regulatory agencies.

Using antibiotics responsibly also means sometimes using them a little less to ensure they remain effective when it really matters. This is why the animal health community has been dedicated to finding alternatives to medically important human antibiotics and developing separate types of antibiotics for animals. Innovation in animal-only antibiotics not only helps to protect the important benefits of antibiotics for everyone, but also helps to support animal welfare and food safety.

Finally, using antibiotics responsibly means supporting the regulatory agencies that scientifically review antibiotics to ensure they are safe for the animal, the people who consume food provided by those animals, and for the environment. These agencies, such as the U.S. Food and Drug Administration, provide clearly identified rules on precisely what antibiotics animals can receive, in what dose, and for how long. This also means clearly communicating established guidelines on how long it takes to completely eliminate that antibiotic from the animal’s body before any meat, milk, or eggs go to restaurants, stores, and supermarkets.

Addressing concerns about antibiotic use and it how it affects public health, food safety, and animal welfare requires a shared commitment to: 1) evidenced-based decisions of how antibiotics should be used, either by the physician or by the veterinarian, grounded on sound and unbiased scientific information; 2) a united partnership between human, animal, and environmental health communities; and 3) providing transparent information about how and why antibiotics are used and making that information more accessible and transparent.

Clearly, responsible antibiotic use is a commitment that transcends boundaries between industries, geographies, and even animal species. As a company, Elanco is dedicated to protecting animal and human health, and we view it as our responsibility to move nimbly and successfully.

Elanco’s 8-Point Antibiotic Stewardship Plan, announced in 2015 at the White House Forum on Antibiotic Stewardship, outlines our commitment to an aggressive eight-step plan to help safeguard animal and human health. This plan, aimed at making tangible advances quickly, includes significant research funding aimed at delivering new alternatives to the most challenging diseases. Specifically the plan outlines,

  1. Act with responsibility globally
    • We encourage policies that narrow the use of shared-class antibiotics and increase veterinarian oversight of the use of antibiotics.
    • We continue to partner with stakeholders across the globe and across the supply chain to develop policies for the responsible use of antibiotics. A global approach is essential for antibiotic stewardship.
  1. Cease marketing of growth promotion
    • We are focused on two areas:
      1. Discontinuing the marketing of growth promotion uses for shared-class antibiotics.
      2. Working with regulatory agencies globally to update the product labels for shared-class antibiotics by the end of 2016.
    • Our goal is and continues to be to help preserve the effectiveness of antibiotics for human health while ensuring animals have appropriate treatment options.
    • Shared-class antibiotics will continue to be available to treat animals for therapeutic uses. Animal-only antibiotics continue to be available for both growth promotion and therapeutic uses.
  1. Eliminate continuous use
    • In certain geographies shared-class antibiotics are used for extended periods of time to treat specific diseases. This could lead to almost continuous use of antibiotics and thus a concern for resistance development.
    • We are working to find alternatives that lessen the need for all shared-class antibiotics use.
    • We support the veterinarians and other animal health experts who decide the most appropriate treatment currently available to ensure the health and welfare of the animal.
    • We believe that leading with science is critical to developing alternative treatments and making the best decisions for animal health and welfare.
  1. Eliminate over-the-counter sales
    • Veterinarians have specialized training in selecting and administering treatment. Where available, we are working to ensure that the disease diagnosis and administration of antibiotics is managed with veterinarian oversight.
    • We are working to develop standards through legislation and policy that supports veterinarian oversight.
    • In places where veterinarian oversight is not available, we are working to educate farmers and others on the responsible use and administration of antibiotics.
  1. Eliminate concurrent use
    • Responsible use programs generally discourage concurrent use. There is concern that concurrent use of antibiotics (using two shared-class antibiotics at the same time for the same condition) may lead to potential resistance.
    • In instances when concurrent use may be the most appropriate treatment to ensure the health and welfare of the animal, the use should be done under veterinary oversight.
    • We support efforts to ensure that the use of shared-class antibiotics focuses on the right drug, right dose, right duration, and right time.
  1. Support veterinary oversight
    • We believe that veterinarians and other animal health experts are uniquely qualified to determine how best to treat, control and prevent animal diseases to keep animals healthy.
    • Where veterinary infrastructure is lacking, we will identify opportunities to support and invest in the global development of legislative, professional, and educational veterinary infrastructure to further enable responsible use and oversight of antibiotic use in animals.
  1. Develop new animal-only antibiotics
    • Antibiotics classes used exclusively in animals pose virtually no risk of contributing to human bacterial resistance. Animals are susceptible to different diseases and have different health needs than humans.
    • We continue to invest in the development of new animal-only antibiotics to help ensure animal welfare by treating the specific needs of animals without compromising the use of antibiotics in humans.
    • Animal-only antibiotics continue to be available for both growth promotion and therapeutic uses.
  1. Create alternatives
    • We are committed to pursuing new advancements that broaden our approach to keeping animals healthy, including R&D and technical support in best management practices, farm hygiene, proper nutrition, husbandry, genetics, etc.
    • Alternatives, such as vaccines and enzymes, will help reduce reliance on the use of shared-class antibiotics. Additionally, they will also help preserve effectiveness of antibiotics for human and animal health while ensuring food safety.

Achieving responsible antibiotic use requires a sound strategy that is global in scope and must include stakeholders across the supply chain to be effective. Science and technology are key to the solutions, which need to take a balanced approach in order to preserve animal health and welfare while also protecting human health and ensuring food safety. Elanco will provide updates on our progress and will host a summit in mid-2016 to bring together key stakeholders.

Only a united front, not a divided one, can we successfully and effectively address these antibiotic concerns. Only then can people make the decisions that are right for them and for their animals when it comes to responsible antibiotic use.