FAI Presents a 3Rs Approach to Antimicrobial Stewardship in Livestock Supply Chains
Antimicrobial1 resistance (AMR) is a challenge of global significance to human health, resulting in increasing mortality and growing pressures on health care systems across the world [1,2]. Antimicrobial use in humans is considered to be the main driver of AMR, but the contribution of medicine use in food-producing animals is now widely acknowledged [3,4].
In response to increasing pressure from the media and consumer groups, some food companies have adopted 'antibiotic free' or 'raised without antibiotics' policies in their livestock supply chains. However, without systemic change in the agricultural system, aimed at decreasing the underlying need for frequent or routine antibiotic prophylaxis and therapy, this approach risks compromising animal welfare, becomes wasteful and unsustainable, and fails to recognise that the transmission of resistant bacteria is not necessarily restricted by farm, supply chain, or geographical borders .
To achieve meaningful change in the way antimicrobials are used in agriculture and thereby reduce the risk of emergence of antimicrobial resistant pathogens in livestock, FAI proposes that food companies address the antibiotics challenge in partnership, as a pre-competitive issue, and adopt the '3Rs' [6,7] framework in their policies. This framework promotes practical and evidence-based solutions to 'Replace, Reduce and Refine' the use of antimicrobials, and is sufficiently flexible to allow tailored stewardship programmes to be developed for individual species, production systems and farms across the world.
We propose three goals of antimicrobial stewardship in animal agriculture at farm, national or international level, embodied in the 3Rs:
Goal 1: REDUCE the annual usage of antimicrobial agents in animal agriculture, per unit of livestock produced (mg/PCU), whilst preserving animal health and welfare.
Implementation: Usage data should be monitored in terms of livestock species and antimicrobial classes, with a particular focus on discontinuing the use of routine prophylactic treatments and medicines classified by WHO (2017)  as highest priority critically important to human health.
Goal 2: REPLACE the use of antimicrobial agents in animal agriculture where possible, with sustainable solutions to prevent diseases such as vaccination and improved husbandry practices, to protect animal health and welfare.
Implementation: Proactive herd/flock health planning and analysis of medicine records should support the identification and control of prevalent diseases on farm, with a view to replacing antibiotic use with sustainable alternatives such as vaccines, biosecurity policies, improved husbandry practices and application of novel technologies.
Goal 3: REFINE the use of antimicrobial agents in animal agriculture, by ensuring the responsible and informed selection and administration of products to animals that have a clinical indication for treatment.
Implementation: Engage veterinary surgeons in responsible medicine dispensation and communication on correct medicine use (including handling, storage and disposal) to farmers, for animals that have a therapeutic or metaphylactic need for treatment. Support the appropriate use of diagnostic testing, and the training of farm staff involved in animal care on responsible medicine use.
CASE STUDY 1: A FARMER-CENTRED APPROACH TO ANTIMICROBIAL STEWARDSHIP IN A FOOD SERVICE SUPPLY CHAIN
Applying the principles of the FAI Roadmap, farmers and veterinary surgeons were consulted using farmer group meetings and online surveys to identify knowledge, attitudes and practices in medicine use on UK farms supplying livestock products to a global restaurant chain. Responses were used to identify species-specific, farmer-led solutions to reduce, replace and refine medicine use, and to characterise farms and respondents that practice responsible medicine use, as well as those that do not, in order to target future interventions. The findings of these studies will be used to communicate and roll-out best practice to the wider supply base, and disseminate findings to the industry through farm media.
CASE STUDY 2: A SUPPLIER-LED APPROACH TO MONITORING ANTIMICROBIAL USAGE IN LIVESTOCK TO DRIVE REDUCTIONS IN A RETAIL SUPPLY CHAIN
Suppliers of livestock and aquaculture raw materials to a UK retailer were engaged in an 'outcome measures' programme to quantify the impacts of animal agriculture on animal welfare, people and the environment. A key outcome measure for animal welfare and public health risk is antimicrobial use, and data was submitted by suppliers across all species categories relating to usage on individual farms, on a monthly or quarterly basis. Together with accompanying measures on animal health and welfare, this data is analysed to identify critical disease challenges necessitating antibiotic use and to identify 'best practice' farms, with a view to revising production standards or implementing R&D, where necessary. As per the FAI Roadmap, best practices and solutions to reducing antibiotic use whilst protecting animal health and welfare will then be shared across the supply base, and ultimately, the industry.
Multi-disciplinary, collaborative action is urgently required to preserve the efficacy of our vital portfolio of antimicrobial agents and address this One Health challenge of global importance. We propose that food companies unify behind a 3Rs approach to 'replace, reduce and refine' the use of antimicrobials in livestock supply chains.
1 'Antimicrobials' are defined as antibacterial agents for the purposes of this publication, in line with OIE and EFSA definitions of the term.
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