EMA and EFSA Joint Scientific Opinion on measures to reduce the need to use antimicrobial agents in animal husbandry in the European Union, and the resulting impacts on food safety (RONAFA)
EMA Committee for Medicinal Products for Veterinary Use (CVMP) and EFSA Panel on Biological Hazards (BIOHAZ),
David Murphy,
Antonia Ricci,
Zanda Auce,
J. Gabriel Beechinor,
Hanne Bergendahl,
Rory Breathnach,
Jiří Bureš,
João Pedro Duarte Da Silva,
Judita Hederová,
Peter Hekman,
Cornelia Ibrahim,
Emil Kozhuharov,
Gábor Kulcsár,
Eva Lander Persson,
Johann M. Lenhardsson,
Petras Mačiulskis,
Ioannis Malemis,
Ljiljana Markus‐Cizelj,
Alia Michaelidou‐Patsia,
Martti Nevalainen,
Paolo Pasquali,
Jean‐Claude Rouby,
Johan Schefferlie,
Wilhelm Schlumbohm,
Marc Schmit,
Stephen Spiteri,
Stanko Srčič,
Lollita Taban,
Toomas Tiirats,
Bruno Urbain,
Ellen‐Margrethe Vestergaard,
Anna Wachnik‐Święcicka,
Jason Weeks,
Barbara Zemann,
Ana Allende,
Declan Bolton,
Marianne Chemaly,
Pablo Salvador Fernandez Escamez,
Rosina Girones,
Lieve Herman,
Kostas Koutsoumanis,
Roland Lindqvist,
Birgit Nørrung,
Lucy Robertson,
Giuseppe Ru,
Moez Sanaa,
Marion Simmons,
Panagiotis Skandamis,
Emma Snary,
Niko Speybroeck,
Benno Ter Kuile,
Helene Wahlström,
Keith Baptiste,
Boudewijn Catry,
Pier Sandro Cocconcelli,
Robert Davies,
Christian Ducrot,
Christian Friis,
Gregers Jungersen,
Simon More,
Cristina Muñoz Madero,
Pascal Sanders,
Marian Bos,
Zoltan Kunsagi,
Jordi Torren Edo,
Rosella Brozzi,
Denise Candiani,
Beatriz Guerra,
Ernesto Liebana,
Pietro Stella,
John Threlfall,
Helen Jukes
Affiliations
EMA Committee for Medicinal Products for Veterinary Use (CVMP) and EFSA Panel on Biological Hazards (BIOHAZ)
Abstract EFSA and EMA have jointly reviewed measures taken in the EU to reduce the need for and use of antimicrobials in food‐producing animals, and the resultant impacts on antimicrobial resistance (AMR). Reduction strategies have been implemented successfully in some Member States. Such strategies include national reduction targets, benchmarking of antimicrobial use, controls on prescribing and restrictions on use of specific critically important antimicrobials, together with improvements to animal husbandry and disease prevention and control measures. Due to the multiplicity of factors contributing to AMR, the impact of any single measure is difficult to quantify, although there is evidence of an association between reduction in antimicrobial use and reduced AMR. To minimise antimicrobial use, a multifaceted integrated approach should be implemented, adapted to local circumstances. Recommended options (non‐prioritised) include: development of national strategies; harmonised systems for monitoring antimicrobial use and AMR development; establishing national targets for antimicrobial use reduction; use of on‐farm health plans; increasing the responsibility of veterinarians for antimicrobial prescribing; training, education and raising public awareness; increasing the availability of rapid and reliable diagnostics; improving husbandry and management procedures for disease prevention and control; rethinking livestock production systems to reduce inherent disease risk. A limited number of studies provide robust evidence of alternatives to antimicrobials that positively influence health parameters. Possible alternatives include probiotics and prebiotics, competitive exclusion, bacteriophages, immunomodulators, organic acids and teat sealants. Development of a legislative framework that permits the use of specific products as alternatives should be considered. Further research to evaluate the potential of alternative farming systems on reducing AMR is also recommended. Animals suffering from bacterial infections should only be treated with antimicrobials based on veterinary diagnosis and prescription. Options should be reviewed to phase out most preventive use of antimicrobials and to reduce and refine metaphylaxis by applying recognised alternative measures.
