Importance of Policy in Public Health

Jacques Massol^*
*Correspondence: Jacques Massol, Department of Public Health Administration, University of Barcelona, Barcelona, Spain, Tel: 7653218901, Email:

Editorial

Data on usage of antimicrobial agents are essential for focusing efforts to scale back misuse and overuse of antimicrobial agents in food producing animals. Reducing the misuse and overuse of antimicrobial agents in food animals is vital in reducing selective pressures which cause development of resistance in bacteria and dissemination of resistant bacteria within the gastrointestinal tracts of animals and in farm environments. These resistant bacteria are often transferred to humans through direct contact with animals or through consumption of contaminated food or water. Transfer of resistant bacteria to humans can cause human infection caused by resistant pathogens. Resistant infections can cause treatment failures, leading to prolonged or more severe illness. Even those bacteria that aren't pathogenic to humans may bring along mobile resistance genes, which may be passed on to human bacterial pathogens. The adverse human health consequences of antimicrobial use in food-producing animals were highlighted by the international public health community at a gathering held by the planet Health Organization (WHO) in Berlin, in October 1997. This meeting of experts, entitled ‘‘The Medical Impact of the utilization of Antimicrobials in Food Animals’’, acknowledged that antimicrobial use can select resistant sorts of bacteria. The Berlin meeting also acknowledged that resistant bacteria and resistance genes are often exchanged between humans, animals, and therefore the environment.

Given these acknowledgements, experts at the 1997 meeting concluded that both antimicrobial resistance and antimicrobial usage should be monitored on a national. Furthermore, amongst the Berlin meeting recommendations intended to mitigate the results of using antimicrobials in food-producing animals was the advice that the WHO arranges an expert consultation to develop a code of practice for prudent use of antimicrobials in food animal production. The WHO subsequently convened a gathering in Geneva in June 2000 to develop principles for minimizing the negative public health impact of the utilization of antimicrobial agents in food-producing animals while also providing for the safe and effective use of antimicrobials in medicine. Published because the ‘‘WHO Global Principles for the Containment of Antimicrobial Resistance in Animals Intended for Food’’, these Principles are intended to assist reduce the misuse and overuse of antimicrobials in animals intended for food. The principles, which cover responsibilities of the many stakeholder groups, involve surveillance of antimicrobial resistance and usage.

The worldwide Principles for the Containment of Antimicrobial Resistance in Animals Intended for Food recognize antimicrobial usage data, alongside resistance data, as ‘‘essential’’ in developing national policies, pre- and postlicensing processes and treatment guidelines for veterinary use the necessity for monitoring the utilization of antimicrobials in food animals was further emphasized by a consultation meeting in Oslo, Norway in September 2001. The report from the consultation, ‘‘Monitoring Antimicrobial Usage in Food Animals for the Protection of Human Health’’ provides recommendations to support governments, national authorities, and various other stakeholders in establishing national monitoring systems to gather food animal production antimicrobial usage data.

The system for collecting antimicrobial usage data should be clear and transparent to facilitate analysis and comparison within and among countries. Therapeutic, prophylactic and 192 J. Nunnery et al./Preventive medicine 73 (2006) 191–195 growth promotion use should be recorded, alongside route of administration and animal species and/or production class treated. The usage data should be compared to resistance data, and therefore the comparison should be made available during a timely manner. Food animal usage data are available on the websites for several European countries, including Denmark (http://vetstat.vetinst.dk) and therefore the UK.