India drags its feet Why EU succeeds and US fails
EU has curbed antibiotic resistance by banning antibiotics
OVERUSE and misuse of antibiotics contribute to the rise of antibiotic resistance. So do poor or unenforced regulations. India seems to suffer from both.So far, it does not have an effective integrated policy to control the use of antibiotics in livestock and poultry with a viewpoint of containing antibiotic resistance, except for a few sporadic initiatives that either do not target antibiotic resistance or lack teeth (see ‘India’s lax attitude’).
The latest is a circular issued by the Department of Animal Husbandry, Dairying and Fisheries (dadf ) in June 2014, requesting states to advise veterinarians on judicious use of antibiotics and to bar the use of antibiotics in feed.But it does not mention how to implement and monitor the advisories. Neither is there any mention of alternatives, time frame and punitive measures.
When dte asked dadf about how it plans to implement the advisory, assistant commissioner Sujit Kumar Dutta said, “Since animal health care and other animal husbandry practices are looked after by the state governments, it is their primary responsibility to implement the advisory in consultation with the state drug controllers.” Dutta, however, admitted that “not very substantive work has been done on antibiotic residues in animals”.
In the absence of data on antibiotic residues, no one knows about the extent of antimicrobial resistance in the country. The only planned surveillance of antimicrobial resistance, under the National Programme on Containment on Antimicrobial Resistance, 20122017, is in humans and has not yet started. There is no apparent plan for integrated surveillance, including animals and food, which has been instrumental in containing antibiotic resistance in several EU countries.
Even the 2011 National Policy for Containment of Antimicrobial Resistance overseeing the programme does not focus on resistance other than in humans, says Chand Wattal, chairperson of Department of Clinical Microbiology, Sir Ganga Ram Hospital, Delhi, who was a member of the task force that drafted the policy. “It was a waste of time. We had made presentation showing importance of containing resistance coming through poultry. But we were told the poultry industry will protest and the government cannot risk it.We cannot have half-hearted ways of dealing with a big problem like this.You cannot cover only half a route in science. Tough measures have to be taken, ”he says. Governments worldwide are adopting regulations to control the use of antibiotics. But only those countries have shown signs of improvement that have tak-
en stringent actions. European countries were the first ones to ban penicillin, streptomycin and tetracyclines as feed additives in the 1970s. In 1986,Sweden banned all antibiotic growth promoters in feed. Denmark,a major livestock producer in Europe and the largest exporter of pork in the world, followed the suit and started regulating the use of antibiotics in the early 1990s.Based on scientific evidence, it banned avoparcin, virginiamycin, tylosin, spiramycin and zinc bacitracin as growth promoters between 1995 and 1998. In 2002, it restricted the use of fluoroquinolones, a crucial antibiotic for humans, in animals.The cattle and broiler industry voluntarily stopped use of all antibiotics as growth promoters in 1998 and the swine industry followed it in 2000.
Estimates show that the use of antibiotics has decreased by 90 per cent in poultry and 51 per cent in pigs between 1995 and 2008.Productivity of poultry farms was not affected during this time, while the cost of production remained almost same. Antibiotic resistance significantly decreased in both broilers and pigs (see ‘Antibiotic resistance is...’).
“We separated sale of antibiotics from veterinary advice, so that veterinarians had no economic incentive to prescribe large quantities,” says Jan Dahl, veterinary epidemiologist, Danish Agriculture and Food Council. “Vetstat (Denmark’s antibiotics database) was introduced to know what was used in the poultry farms. You cannot expect to change things if you have no information,” Dahl adds. Denmark’s success prompted the EU to ban all antibiotic growth promoters by 2006.
The US, where 80 per cent of antibiotics (13,542 tonnes) are attributed to non-human use, recognised the problem around the same time as EU, but is far be- hind in addressing it. In 1977, the US Food and Drug Administration (usfda) proposed banning tetracyclines and penicillins as additives in feed, but is yet to do it. Amid protests from public health advocates, usfda introduced two policy documents in 2013 as guidances for the industry.Its objective was to phase out the use of medically important antibiotics in food-producing animals and bring therapeutic uses of such drugs under the oversight of licensed veterinarians. But unlike the EU, these guidances do not ban the use of antibiotics as growth promoters.In the name of judicious use these guidances do not strictly control use of antibiotics in animals.
While the initiative is considered an important first step, they are voluntary in nature.In recent years there is a significant increase in the use of lincosamides, penicillins and tetracyclines antibiotics.In chicken, resistance in select bacteria has been increasing against antibiotics of public health importance (see ‘In US, resistance...’). Resistance in Salmonella was also found to be increasing in retail poultry meat against third generation cephalosporins and ampicillin between 2001 and 2011.During the same period increased resistance was found in Campylobacter against ciprofloxacin.
Poultry meat accounts for half of the total meat
produced in India