Martin Seychell on Veterinary Pharma: The Weakest Link in Countering AMR

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As deputy director of health and nutrition at the European Commission EC, Martin Seychell has a lot on his plate if we are to achieve the UN Sustainable Development Goals (SDGs) –which aim to significantly improve life for all people on earth by 2030.

One of the biggest challenges we face in global health is antimicrobial resistance (AMR). AMR occurs when – bacteria, viruses, fungi and parasites – no longer respond to the drugs designed to kill them.

The EC has developed the One Health Action Plan which aims to tackle this problem that spans across humanity, agriculture and the environment. The use of antibiotics in animals that we eat (particularly those that are mass produced) is a huge contributing factor to the problem of AMR. The meat that we eat is often pumped full of antibiotics and therefore, so is the waste that these animals produce. The antibiotics in the waste then merge with the environment and the cycle continues.

We spoke to Seychell about what is being done to regulate the use of antibiotics in animals and how to safeguard our food chain.

We have proposed legal measures that in future will ban the use of antibiotics in animals that are used in humans.

So, why is the use of antibiotics in animals such an issue?

Really there is a completely unregulated use of antimicrobials for veterinary purposes, growth promoters and a substitute sometimes for elementary good animal husbandry. If there is no action in the veterinary field we would have to find a solution exclusively within the human health field, which is impossible. We can and we should reduce the use of antimicrobials, but there are antimicrobials that are extremely necessary for human medicine.

We see the use of antimicrobials in beef and pork but a real issue is poultry. There are now markets for premium beef and pork but chicken is cheap and the main source of protein for people in developing parts of the world. 

 

If meat is a real issue, is there something that can be done to educate people around eating less of it?

Yes, although that is, of course, easier said than done. It especially depends on the country concerned. Intervening In people’s lifestyles is not usually a very safe political option. I think it has to be done in more of a nudging kind of way.

Poultry is a convenient source of animal protein so we can’t just say ‘stop eating chicken.’ Some people rely on it and the alternatives might simply not be there.

In Europe, there has been an evolution towards a more quality policy. As I said there is a market for premium beef, so that means raising the price because consumers are willing to buy less but better. But, that has to happen gradually and in line with the social development and economic vision of society.

One way to change this is to make the alternative more affordable or cheaper and you can work to increase its nutritional quality. And then, of course, there are ways to re-educate the public.

Also, we have to keep in mind tackling things like food waste. It’s a problem if people eat too much meat but it’s even more of a problem if meat ends up being wasted because the antibiotics have already been used but nobody’s benefiting from them — its just waste.

Something we’ve done successfully in the environmental field is to tax wasteful patterns of consumption to subsidise more sustainable technology.  For example, we taxed the wasteful use of electricity or water to subsidise UV panels and insulation. Using the funding from tax revenue to turn the pyramid around to make — the good choice, the default choice. Tax is a wonderful instrument for doing that if used in an intelligent way.

There’s not much research going into creating antibiotics specifically intended for animals.

What can be used to safeguard our food chain other than antibiotics?

We have seen improvements with aquaculture for example which is an increasing source of animal protein for many people. There’s a lot of antimicrobial use in aquaculture but there are alternatives like vaccines.

In countries such as Norway, and I believe also in Scotland, they grow a lot of Salmon which were in the past exposed to large amounts of antimicrobials to keep diseases under control. Now they’re using vaccination. It’s even less costly so you improve profitability, reduce the anti-microbial in the finished product and the water and you still have your salmon.

How can the agricultural sector be stopped from overusing antibiotics?

We have proposed legal measures that in future will ban the use of antibiotics in animals that are used in humans.

Then there are some examples of good practice that we can learn from. The Netherlands for example, have a very intensive model of farming but have managed to reduce the use of antimicrobials in animal husbandry. They did that by working with the farmers first of all and identifying alternative techniques.

The one thing you should not do is damage the farmers’ livelihood. The farmers are not the enemy. They are the ally, the partner. We have to work to ensure that they can still make a profit without antibiotics and we need to show them new techniques, like the vaccination example in aquaculture.

Infrastructure is needed to treat the waste before it’s discharged and we must also work with the veterinarians to have a much better control over the amount of antimicrobials that they actually use.

We could return to a time like 80 years ago when you can die from a tiny cut you got while gardening.

Are there many big pharma companies working to develop antimicrobials specifically for animals?

No. And this is a general problem. There’s not much research going into creating antibiotics specifically intended for animals. The reason is — and this may seem strange — the veterinary pharmaceutical market is not very profitable. When you consider all the costs and look at the veterinary pharma market, half of it is for companion animals like cats and dogs, this is what people are prepared to pay for. All the other species (including species of major importance) are often overlooked. We tend to think of cattle and pigs, but what about apiculture? What about bees?

The market is too small and no company is going to invest In the costs of developing a pharmaceutical for this. The price is similar to developing a pharmaceutical for humans in that you still have to prove, quality, safety and efficacy. Then there is the fact that with producing veterinary antimicrobials, you have the added challenge that you don’t have for a human antibiotic — the residues, and how long they stay in the products, meat or honey.

So, when you look at this with an impact assessment, it wipes out a huge amount of your profit. Because of this, there is very little investment going into new categories of antimicrobials that are specific to animal biology. They are basically spin-offs of human pharmaceuticals.

What are the challenges we face when trying to develop new antibiotics that we are not already resistant to?

Well, we don’t have any real innovation in this sector. Most of the antimicrobials, even for human medicine, are derivatives of fungal products. Penicillin was discovered from a fungus/mould, and moulds often produce toxins to compete against bacteria. This is the origin of most of our antimicrobials. We modify them chemically but the same basic chemistry is there. The problem is that this competition between bacteria and fungi has been happening on this planet for over a billion years. The genes for resistance are already in the bacteria which have been evolving since the beginning. What we’re doing when we’re misusing antimicrobials is selecting in favour of the resistant strains but the genes are already there.

So, if we could incentivise research and create completely new categories that are not derived from natural origin it would make it much more difficult for resistance to appear because the genes are not there.

Even Fleming, when he discovered penicillin immediately realized this and was seeing resistance within a few weeks. This is the oldest battle on this planet — the competition between bacteria and fungi. What we’re doing is just accelerating the selection. And it’s happening at a crazy speed. I mean, it’s really a race against time.

That sounds quite apocalyptic. Can you hazard a guess or a timeframe for a completely devastating outbreak occurring?

It could happen within the next few years. Certainly within our lifetime.

Imagine — essential procedures like chemotherapy where the immune system is very much compromised. The biggest risk for chemotherapy patients is often not the cancer but contracting an infection while under treatment and dying from it. The same goes for all kinds of major surgery. Today no doctor would hesitate to recommend a hip replacement for someone who needs it, but if you don’t have antimicrobials, the risk of infection becomes so high that it would be a life or death matter. We could return to a time like 80 years ago when you can die from a tiny cut you got while gardening.

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