[Editorial] OIE Initiatives for Responsible Use of Antibiotics

What is OIE?

  • OIE or World Organization for Animal Health is an intergovernmental organization of 182 member states for animal disease control.
  • It was set up as Office International des Epizooties in 1924.
  • In 2003, it became the World Organisation for Animal Health. It is headquartered in Paris.
  • The organization is under the control of a World Assembly of Delegates. This assembly elects a Director General for the day-to-day operation of OIE.
  • Compulsory annual contributions from the member countries and other voluntary contributions are the financial sources of the organization.
  • The World Trade Organization recognizes it as a reference organization.

How is OIE addressing antimicrobial resistance?

OIE Strategy on Antimicrobial Resistance and the Prudent Use of Antimicrobials:

  • This strategy was launched in 2016.
  • It has 4 key objectives:
    • Enhancing understanding and awareness
    • Use of surveillance and research for strengthening knowledge
    • Supporting capacity building and good governance
    • Implementing international standards

Animal Health Codes:

  • The OIE gives latest scientific information on antimicrobial resistance among terrestrial animals (under Terrestrial Animal Health Code) and aquatic animals (under Marine Animal Health Code).
  • This information is used by countries for surveillance and monitoring of antimicrobial use in animals. It is also used for enabling responsible use of antimicrobials.

OIE Terrestrial Manual:

  • This manual gives procedures for testing antimicrobial susceptibility in laboratories.

OIE List of Antimicrobial Agents of Veterinary Importance:

  • This is a list used by countries for responsible use of antimicrobials in the livestock sector and in aquaculture sector.
  • For instance, the OIE recommends, based on this list, that fluoroquinolones, cephalosporins (3rd and 4th generations) and colistin shouldn’t be used for preventive treatment, i.e. in absence of clinical signs. These should not be used as first line of treatment (unless justified). The OIE also recommends avoiding its use as extra-label / off-label, except when there are no other alternatives. It also prohibits their use as growth promoters. 
  • This list was first published in 2007. It was most recently updated in June 2021.
  • It has 3 categories:
    • Veterinary Critically Important Antimicrobial Agents
    • Veterinary Highly Important Antimicrobials
    • Veterinary Important Antimicrobials

Other undertakings:

  • The OIE maintains a global database on antimicrobial use in animals called AMU database.
  • It has developed several communication materials that target the stakeholders who have a role in addressing AMR in different countries.
  • The OIE observes the World Antimicrobial Awareness Week in November, every year. during this period, the organization undertakes advocacy events and provide financial and technical support to the countries.

In Asia Pacific Region:

  • The Asia-Pacific region is especially important with regards to AMR as it is the highest consumer of antimicrobials by animal biomass, according to the 5th OIE Annual Report on Antimicrobial Agents Intended for Use in Animals.
  • The OIE has regional representation in the area:
    • The OIE Regional Representation for Asia and the Pacific- based in Tokyo, Japan
    • The OIE Sub-Regional Representation for South-East Asia- based in Bangkok, Thailand
  • The organization has helped several countries in the region- Bhutan, Cambodia, Malaysia, Lao PDR, Myanmar, Mongolia, Nepal, Thailand, Timor Leste, Sri Lanka and Vietnam- in translating its awareness materials into national languages to improve their reach.
  • The organization has been conducting workshops in the Asia Pacific countries. These are mainly aimed at industries, livestock and aquaculture producers, veterinarians, animal health workers and aquatic animal health professionals.
  • It has also been conducting workshops for veterinary students and the faculty in veterinary schools in countries (including India). This is to encourage a professional culture that supports the responsible use of antimicrobials in animals.
  • It has been advocating for the inclusion of AMR in veterinary education core curriculum of universities
  • Monitoring workshops are being conducted to improve the monitoring aspect of AMR control. It is to help stakeholders understand the dynamics of AMU- the flow of the antimicrobials- import, manufacturing, distribution, use, quantities used, etc. This is to help stakeholders responsible for regulating AMU at each level develop a better understanding of the overall picture.
  • It has been promoting public-private partnerships (PPP) for AMR control.

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What are the challenges that need to be addressed?

  • Ineffective regulation and monitoring of antimicrobial use in many countries. This is mainly due to lack of coordination and data sharing between the stakeholders.
  • Even when legislations exist for the responsible use, there is weak enforcement.
  • Inadequate supervision by veterinarians regarding the antimicrobial use in animals- especially as growth promoters.

What is the way ahead?

  • The different stakeholders, including the regulators, manufacturers, retailers, importers, distributors, livestock associations, etc., need to come together to address the issue.
  • The OIE is now looking to adapt its activities to the changing times and is also reviewing the implementation of national AMR action plans, amid the pandemic.
  • It is also looking at what sort of data each stakeholder can provide to the national regulatory authority in countries. Improved data collection could improve AMU monitoring.

Conclusion:

The recently published 5th OIE Annual Report highlighted a positive trend: a 34% decrease in the quantity of antimicrobials used in animals. This is seen as indicative of increase in responsible use of antimicrobials in the livestock sector. However, challenges remain, especially in the Asia Pacific. The stakeholders must come together to address AMR which has potential to deprive humanity of a crucial medical tool.

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