Professor Ulf Magnusson DVM Ph D Department of

Professor Ulf Magnusson*, DVM, Ph. D Department of Clinical Sciences and SLU Global Swedish University of Agricultural Sciences, SLU (*public funded only) ANTIMICROBIAL RESISTANCE AND ANIMAL AND HUMAN HEALTH – A ONE HEALTH TASK Panama, 20 -23 June 2016

The One Health dimension of Antimicrobial resistance (AMR) Human health A One World issue as well! AMR Environment health Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016 Animal health

Animal health – the entry point Animal health • Productivity - Income, Food security - Natural resource use efficiency, GHG-emissions • Ethics/Animal Welfare • Public health Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

Animal health – the elements Animal health Genetics Feed Management, incl. use of antimicrobials Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016 Antimicrobials • antibiotics • antivirals • antiparasitics • fungicides

The emerging issue of resistance to antimicrobials (AMR) The threat to human health and global actions taken: o 10 M deaths and a cumulative economic output of 100 trillion USD at risk by 2050 (O’Neil, 2016) o In 2015, resolutions/action plans by WHO, FAO and OIE o AMR-session at 71 st Session of the UN General Assembly – September 2016 Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

The AMR network and the livestock sector • A shared, crosssectorial, responsibility to take action • Relative importance of the different routes unclear Source: P. Huey (Science) Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

The link between Antimicrobial use and AMR In livestock: Note, this is also true for the human health sector Chantziaras et al. 2014 O’Neil, 2015 Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

The use of Antimicrobials o USA: about 70% of antimicrobials are used in the livestock sector (FDA , 2012) o Sweden: about 15% of antimicrobials are used in the livestock sector (SVA, 2013) o Global estimate : more then 50%are used in the sector Global use of antimicrobials in livestock Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016 Van Boeckel et al. 2015

Antimicrobial use in the livestock sector • Estimated to double by 2030 in the BRICS countries (Brazil, Russia, India, China and South Africa) • Most use in intensified pig and chicken operations • Global data about use and resistance are weak Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

What are the options for the future? o New antimicrobials? o Mitigate the emergence of AMR? Ø Reduce the use of antimicrobials Regulations are not sufficient! Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016 Sales of veterinary antimicrobial agents in 26 EU/EEA countries in 2013, Fifth ESVAC report

How to reduce the use of antimicrobials in the livestock sector? Animal health Stop the non-rational use of Antimicrobials Genetics Feed Management, incl. use of antimicrobials u use without proper diagnosis and/or indication; u use without adequate dosing and length of treatment; u use for growth promotion and prophylaxis; u routine treatment of herds instead of individuals Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

To stop the non-rational use of antimicrobials o Good animal health management • • • Treatment just after proper diagnosis and/or indication Correct dosing and length of treatment Treat individuals rather than herds Don’t use antimicrobials as growth promoters or routine prophylaxis Improve biosecurity procedures and sanitation/hygiene Stocking densities and facilities/buildings More vaccines Vector control Antimicrobials should ……. not be used for compensating poor livestock management Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

Reducing AM-use without loosing productivity 50 Individual treatment Group treatment 40 mg per PCU o Sweden banned AM as growth promoters 1986 (on demand from Swedish farmers) o Drop in productivity but recovery within a few years o Compensated with good animal health management o Now lowest AMR in the EU o Other EU-countries have followed, without loosing much in productivity 30 20 10 0 808284868889909192939495969798990001020304050607080910111213 Sales of antimicrobials for farm animals, Sweden Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016 Swedres-Svarm, 2013

The incentives and financing…. “Tragedy of the commons” Negative externalities Regulations/policies incl. taxation and subsides AMR Consumer’s demands and the market Increased productivity…. Public goods Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

The Global Context – High, Middle and Low-income countries o Differences in productivity in current livestock systems o Differences in animal health technical capacity o Differences in policies and capacity in enforcing policies SOFA, 2009 o Differences in financial resources ………. . and a large knowledge deficit about the Global Situation Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016

Gracias! Acknowledgements: Dr. Timothy Robinson, International Livestock Research Institute, Nairobi Dr. Christina Greko, National Veterinary Institute, Uppsala Sixth Multi-stakeholder Partnership (MSP) meeting Panama 20 -23 June 2016