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Raising awareness

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ENCLOSED with print copies of this week's issue of Veterinary Record are two BVA posters – one on responsible use of antimicrobials in veterinary practice, the other on responsible use of anthelmintics. The antimicrobials poster updates a poster first produced by the BVA in 2009. It outlines a seven-point plan to assist veterinarians in ensuring that products are used responsibly in animals to maintain their efficacy and minimise the development of resistance, and is being distributed in advance of European Antibiotic Awareness Day, which falls each year on November 18 (ecdc.europa.eu/en/eaad). The anthelmintics poster, meanwhile, provides a useful reminder that it is not just resistance of bacteria to antibiotics that poses a threat to effective treatment, and that these products, too, must be used responsibly to maintain their efficacy for the future. Both posters are also available for download from the BVA's website (www.bva.co.uk). The idea is that they should be displayed in practices as a point of reference and as a constant reminder of the need to make sure that products are used appropriately.

The antimicrobials poster refers to additional resources relating to antimicrobial resistance on the BVA's website, and these have also recently been updated (www.bva.co.uk/eaad).

There is no doubt that European Antibiotic Awareness Day has done much to raise awareness of the threat posed by resistance since it was launched in 2008, and that it has contributed to the momentum around this subject that continues to grow (see, for example, VR, November 15, 2014, vol 175, p 466). Its success in this respect is perhaps reflected in the fact that this month will also see the launch of the first ‘World Antibiotic Awareness Week’, which will run from November 16 to 22. With the theme ‘Antibiotics: handle with care’, this new campaign is being launched by the World Health Organization (WHO) ‘to increase awareness of global antibiotic resistance and to encourage best practices among the general public, health workers and policymakers’. The WHO agreed a new action plan aimed at tackling antibiotic resistance in May this year (VR, May 30, 2015, vol 176, p 556). A key objective of this was to improve awareness and understanding of antimicrobial resistance through effective communication, education and training, and World Antibiotic Awareness Week can be seen as a logical extension of that. Although in many respects similar to the European initiative, the WHO's campaign should have a wider reach and serves to emphasise that antimicrobial resistance is not just a local, national or regional problem; it is very much a global problem that needs to be tackled at every level. More information about the campaign is available at www.who.int/mediacentre/events/2015/world-antibiotic-awareness-week/en/

That more action is indeed needed globally was highlighted by a report published by the WHO in April this year, discussing the results of a survey it had undertaken in 2013 and 2014. Among the findings were that few countries (34 of 133 completing the survey) had comprehensive national plans for fighting antimicrobial resistance, and that monitoring for resistance was infrequent. Sales of antibiotics without a prescription remained widespread, and public awareness of the issue of resistance was low in all regions.1 As well as improving awareness and understanding of resistance, other key elements of the WHO action plan agreed in May include strengthening knowledge through surveillance and research, reducing the incidence of infection, and optimising the use of antimicrobial agents. Another key objective is to develop the economic case for sustainable investment that takes account of the needs of all countries, and to increase investment in new medicines, diagnostic tools, vaccines and other interventions.2 There is clearly a difference between developing a plan and effecting real change, and the ambitious nature of some of those objectives gives an indication of the scale of the challenges ahead.

Arguments continue about the extent to which use of antibiotics in animals contributes to the problems with resistance being encountered in human medicine but one thing that is clear is that tackling the problem requires a One Health approach. This is recognised in the UK Five Year Antimicrobial Strategy which firmly advocates such an approach and which, although it notes that ‘increasing scientific evidence suggests that clinical issues with antimicrobial resistance that we face in human medicine are primarily the result of antibiotic use in people rather than the use of antibiotics in animals’, also points out that ‘use of antibiotics in animals (which includes fish, birds, bees and reptiles) is an important factor in contributing to the wider pool of resistance, which may have long-term consequences’ (VR, September 21, 2013, vol 173, p 254). It is also recognised in the UK's ‘Antibiotic Guardian’ campaign, in which veterinary and human healthcare professionals, as well as students, educators and members of the public, are being encouraged to make a simple pledge about how they intend to make better use of antibiotics ‘to help save these vital medicines from becoming obsolete’ (https://antibioticguardian.com).

In view of the global challenges, and various other initiatives that are likely to be highlighted over the next week or so, the BVA's antimicrobials poster might seem like a relatively small contribution to the fight against resistance but, given the vital role that veterinarians play in helping to ensure that antimicrobials are used responsibly, it is an important contribution nonetheless.

1. www.who.int/mediacentre/news/releases/2015/antibiotic-resistance-lacking/en/. Accessed November 11, 2015

2. www.who.int/drugresistance/global_action_plan/en/. Accessed November 11, 2015

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