Doc. 8591

1 December 1999

Ban on antibiotics in food production

Report

Committee on Agriculture and Rural Development

Rapporteur: Mrs Maggi Mikaelsson, Sweden, Group of the Unified European Left

The discovery of antibiotics has vastly increased the ability of medicine to cure diseases, not only in humans but also in animals. When added to animal feed, they also turn out to be excellent growth promoters, despite the fact that they are often used to alleviate the negative effects of poor hygiene and husbandry.

However, the excessive use of antibiotics in veterinary medicine, particularly as growth promoters in animal feed may lead to the development of resistance. This is a serious potential risk to human health.

Based on the Swedish example and recommendations by different international organisations, the report calls for a correct and restrictive use of antibiotics which should only be used for therapeutic purposes and not as prophylactics or growth promoters.

I.       Draft recommendation

1.       Antibiotics have represented extraordinary progress in the treatment of infectious diseases and have helped to save millions of human lives. They have also represented a great step forward in veterinary medicine. They have, however, gradually come to be increasingly used for prophylactic purposes, and even as animal feed additives, as "growth promoters". Evidence of their excessive use for such purposes was presented to the Seminar on the Use of Antibiotics in Food Production (London, 8 June 1998) organised by its Committee on Agriculture and Rural Development.

2.       Misuse of antibiotics has resulted in the appearance of strains of bacteria resistant to ever larger numbers of antibiotics, at such speed that pharmaceutical research and the pharmaceutical industry can no longer develop new and sufficiently strong antibiotics quickly enough. This state of affairs gives an early indication of a medical risk that diseases resistant to any treatment may soon have to be faced.

3.       This situation has for several years been causing concern to the health authorities. Studies have been conducted to evaluate the development of resistance to antibiotics, and measures are gradually being taken to limit antibiotic use. European citizens are also becoming increasingly aware of these problems, and particularly of the use of antibiotics in animal feed, especially in the wake of the recent food crises in the animal production sector.

4.       Antibiotics are frequently administered in the feed used in animal production to promote growth, for they help to increase the speed at which livestock develops, but in fact they are often used merely to alleviate the negative effects of poor hygiene and husbandry. The Assembly considers such misuse unacceptable.

5.       The Assembly acclaims the pioneering work of the Public Health Committee (Partial Agreement in the Social and Public Health Field) and on this subject it draws attention to the resolutions of the Committee of Ministers on the use of antibiotics in animal husbandry [AP(77)2, AP(78)2 and AP(84)1], which already emphasised the risks of bacterial resistance. In the light of the importance for health of wholesome food, it regrets that only seventeen member states are participating in this Partial Agreement.

6.       The Assembly calls for the use of antibiotics to be reduced or restricted whenever possible to therapeutic purposes only. It takes the same position on this as other international institutions and organisations, such as the European Parliament and European Commission, the World Health Organization and the World Organisation for Animal Health (OIE).

7.       The Assembly also welcomes the prohibition by certain member states (Finland and Sweden) of the use of antibiotics as animal feed additives, which has not led to diminished productivity at the establishments concerned. It also welcomes the fact that, on 14 December 1998, as a precautionary measure, the Council of Ministers of the European Union provisionally prohibited the use of four antibiotics as feed additives.

8.       Accordingly, the Assembly calls on the European Union definitively to prohibit the use of all antibiotics in animal feed, in the light of the scientific studies already available, especially that of the Scientific Steering Committee on resistance to antimicrobials.

9.       The Assembly calls on the governments of member states:

i.       to prohibit the use of antibiotics as growth promoters;

ii.        to adopt the European Union's decision prohibiting certain antibiotics in animal feed;

iii.       to reduce to the minimum the use of antibiotics in animal production, so that they are used only for therapeutic reasons and only on veterinary prescription;

iv.       to set up common systems to monitor resistant microorganisms;

v.       to improve health monitoring in animal production establishments;

vi.       to strengthen national legislation on animal welfare so as to improve animal health, drawing particularly on the Council of Europe Convention for the protection of animals kept for farming purposes (Strasbourg, 1976);

vii.       to co-operate on the introduction of common rules on the prudent, restrictive and supervised use of antibiotics in animal production;

viii.       to work for complete transparency of information about food safety and about the use of antibiotics in animal production;

ix.       to organise better training for stock farmers on the prevention of infection and on the prudent use of antibiotics;

x.       to promote research with a view to developing alternatives to the use of antibiotics in animal production.

10.       The Assembly recommends that the Committee of Ministers:

i.       invite member states that have not yet done so:

a. to accede to the Council of Europe's Partial Agreement in the Social and Public Health Field, so that they take part in particular in the work and the decision-making of the Public Health Committee;

b. to sign and/or ratify the European Convention for the protection of animals kept for farming purposes (Strasbourg, 1976);

ii.       include the use of antibiotics for humans and animals in the Council of Europe work programme on health, on the basis of data from member states about the administration and consumption of antibiotics in both human and veterinary medicine;

iii.       invite the Standing Committee of the European Convention for the protection of animals kept for farming purposes (T-AP) to take further its work on animal feed, particularly in regard to medicines (particularly antibiotics) used as feed additives, in co-ordination with the Public Health Committee (CD-P-SP) of the Partial Agreement in the Social and Public Health Field, with a view to adopting common rules on the prudent use of antibiotics in food-producing animals.

II. Explanatory memorandum by Mrs Mikaelsson

Table of contents

Page

1.       Introduction …………………………………………………………………       5

2.       Background …………………………………………………………………       5

3.       Effects of the use of antibiotics ……………………………………………..       9

4.       The Swedish example ………………………………………………………       9

5.       Consumer concern ………………………………………………………….       10

6.       Animal welfare ……………………………………………………………..       10

7.       Recommendations from other bodies ………………………………………       11

8.       Previous Council of Europe action …………………………………………       16

      8.1       Intergovernmental co-operation …………………………………….       16

      8.2       Partial Agreement in the Social and Public Health Field …………..       16

      8.3       Parliamentary Assembly ……………………………………………       17

1.        Introduction

1.       With Alexander Fleming’s discovery of penicillin, medicine took a tremendous step forward and the subsequent discovery of other sorts of antibiotics increased the possibilities to cure diseases, not only in humans but also in animals. It was almost a miracle and it was soon discovered that antibiotics could be used not only to cure diseases but to prevent them. And when added to animal feed it turned out to be an excellent growth promoter as well.

2.       It is obvious that antibiotics are one of the most important and efficient ways of curing infections and have indeed increased human life expectancy by many years. However, it is clear that throughout the internal market certain antibiotics are not only used in a curative way but are also added to livestock feed as growth promoters.

3.       But bacteria defend themselves by developing resistance. And this could be a threat to public health if resistance in bacteria grows faster than the developing of new medical treatment of diseases.

4.       The Council of Europe is concerned about the potential risks to human and animal health which may result from the excessive use of antibiotics within animal medical care, animal food production and as growth promoters.

5.       The growing use of antibiotics in human and animal disease treatment, in animal disease prevention and in animal growth promotion and the rapidly developing resistance in bacteria, viruses, and parasites to drugs that once were effective diminishes our ability to protect ourselves against new and serious diseases.

6.       The Council of Europe fears that such extensive practices will lead to an increasing antibiotic resistance which threatens human medicine as well as agricultural production worldwide.

7.       It is clear that a more restrictive use of antibiotics helps to avoid the problem of resistant bacteria.

8.       The Council of Europe recognises that antibiotics are valuable medicines, but they should only be added to feed for the purpose of easing or curing disease or the symptoms of disease and not be used on a routine basis as prophylaxis or growth promoters. Therefore the Council of Europe calls for the correct and restrictive use of antibiotics for the following, scientifically-based, reasons.

2.        Background

9.       Antibiotics were discovered toward the end of the 1920s and are some of our most valuable medicines today. Scientists knew early on that the unrestricted use of such medicines could cause bacteria to develop resistance. Bacteria are “clever" organisms which transform themselves to survive and thus develop tolerance and resistance to antibiotics. In spite of this, the feed industry began using antibiotics routinely in animal feed in the 1940s and 1950s to increase productivity. Many strains of bacteria have now become resistant to many common antibiotics. Salmonella and campylobacter are two examples.

2.1       What is antibiotic resistance?

10.       Many infectious diseases are caused by bacteria. Antibiotics work by a variety of mechanisms to kill bacteria and have proven vital in curing infectious diseases. However, bacteria have the capacity to evolve defence mechanisms against antibiotics and become resistant to their effects. When such resistance develops bacteria are no longer killed by the antibiotic and, thus, the antibiotic is no longer capable of treating or curing the disease. The more an antibiotic is used, the more likely that bacteria will “learn” to evade it.


11.       Natural selection plays a key role in the development of antibiotic resistance. Most bacteria die when exposed to antibiotics to which they are sensitive. That leaves more space and available nutrients for surviving bacteria (i.e. for antibiotic-resistant bacteria). As a result the resistant bacteria can reproduce and multiply freely and pass on the antibiotic-resistant genes to the next generation.

12.       Not only can resistant bacteria proliferate after other bacteria are killed off by an antibiotic, but they also can transfer that resistance to other bacteria that have never been exposed to the antibiotic. Bacterial cells can join briefly and exchange loops of DNA (called plasmids) that contain genes that confer antibiotic resistance. For example, if one bacterial species becomes resistant to a broad-spectrum antibiotic, it could transfer its resistance genes to other bacteria that have never encountered those antibiotics.

13. The genes that cause antibiotic resistance function in a number of ways. Some do not permit the antibiotic to get into the bacteria; others actively pump it out of the bacteria; some produce enzymes that inactivate the antibiotic; and others modify the antibiotic's target site in the bacteria. To make matters worse, many bacteria have become resistant to multiple antibiotics. That property can result from the cumulative effect of treating stubborn infections with multiple types of antibiotics.

2.2        The use of antibiotics in humans

14.       The diseases that could be cured with different kinds of antibiotics have increased over the years. Many new kinds of antibiotics have been discovered, and the problem of antibiotic resistance was postponed temporarily, as new innovations kept pace with the development of resistance.

15.       Now this is changing and the number of bacteria resistant to antibiotics is increasing faster than the discovery of new antibiotics. It is also a trend that antibiotics are often seen as a quick-fix solution for patients and are used when not necessary. But overuse of antibiotics also contributes to antibiotic resistance.

16.       Another trend that is contributing to the problem of antibiotic resistance is the shift in the types of antibiotics that are prescribed. Increasingly, stronger, newer, and more broad-spectrum antibiotics are being prescribed in place of narrower-spectrum antibiotics.

17.       Antibiotics also are used to prevent disease in humans. That use is sometimes appropriate and necessary. Prophylactic treatment with antibiotics includes giving low doses of antibiotics for long periods of time in an attempt to control infection-causing bacteria. For example most surgical patients receive systemic antibiotics to prevent infection.

18.       Giving antibiotics preventively also contributes to the development of antibiotic resistance. Some studies have shown that patients given prophylactic doses of antibiotics were more likely to develop infections caused by resistant organisms because the antibiotic treatment allowed resistant organisms to grow in the absence of competition from sensitive bacteria.

2.3       The use of antibiotics in agriculture

19.       While medical use of antibiotics is probably the major contributor to the emergence of antibiotic resistance, agricultural uses also pose a problem. Agricultural uses include treatment of diseases in animals, prevention of disease in animals, growth promotion and improved feed efficiency and spraying of fruit trees and vegetables to prevent blemishes due to fire blight.

20.       The subtherapeutic use of antibiotics related to those used in human medicine poses a significant hazard to human health. That use involves routine and prolonged subtherapeutic dosing of animals with antibiotics for growth promotion and improved feed conversion. Subtherapeutic use of antibiotics, including penicillin and tetracyclines, accounts for as much as 80 percent of the antibiotics used in agriculture.

21.       In many cases, poultry, cattle and pigs are routinely given low doses of such antibiotics to increase their growth rates and reduce the amount of feed required to raise an animal to slaughter size.

22.       Soon after it became routine practice to add antibiotics to animal feed in the 1950s, health officials expressed concern that long-term treatment of livestock with low doses of antibiotics could be harmful to human health.

23.       The mid-1980s was a time of new discovery and new activity concerning antibiotic use in animal feed. Researcher Thomas O'Brien and colleagues from Harvard Medical School published a study showing that antibiotic-resistance genes found in bacteria infecting humans were identical to some of those found in bacteria infecting animals. Holmberg and colleagues at the Center for Disease Control in the USA (CDC) linked an outbreak of antibiotic-resistant Salmonella in humans to beef cattle that had been fed subtherapeutic doses of chlortetracycline for growth promotion.

24.       The Holmberg results are noteworthy because that type of study is difficult to perform. By the time an outbreak is discovered, the contaminated food is usually long gone. Although none of the contaminated meat was available for sampling, all of the victims had consumed hamburgers from the same source.

25.       An Institute of Medicine report published in 1989 concluded that there was considerable indirect evidence that feeding penicillin and tetracyclines in subtherapeutic doses to animals increases resistance to those antibiotics. Results of its risk assessment indicated that subtherapeutic uses of penicillin and/or terracyclines result in about 40 human deaths per year. The USA and Canada still permit their use. The European Union, Japan, Australia, and New Zealand have banned subtherapeutic use of penicillin and tetracyclines.

26.       The routine use of antibiotics such as penicillin and tetracyclines to promote growth has rendered those antibiotics less effective in treating animal diseases. For example, in Denmark, where the subtherapeutic use of tetracyclines and penicillin is banned, tetracyclines are effective in treating calf scours, whilst in the USA tetracyclines are not effective against calf scours.

27.       As therapeutic options become less effective, drug companies and veterinarians have urged the approval of additional human-use antibiotics, such as fluoroquinolones, to treat animal diseases, jeopardising the usefulness of a greater number of antibiotics for treating human diseases.

28.       Another likely contributor to the inappropriate use of antibiotics in livestock is that many antibiotics commonly used in human medicine (penicillin, tetracyclines, and tylosin, which is related to erythromycin) are available to farmers over the counter for the treatment of animal diseases. In contrast, those drugs are available to human patients only through a prescription from a physician. As a result, there may be no veterinary supervision in the treatment of animal disease.

29. There are no safeguards to prevent a farmer from giving antibiotics that may not be medically warranted. Additionally, because it is often difficult to treat individual animals in a flock or herd, the entire group may be dosed with antibiotics when only a few animals are sick. Dosing the entire herd or flock greatly increases the number of animals exposed to the antibiotic and thus increases the chances that antibiotic-resistant bacteria will emerge.

30.       The lack of appropriate controls over agricultural uses of antibiotics continues to jeopardise the usefulness of antibiotics for treating human diseases. In 1995, despite vigorous opposition by the CDC and the Infectious Disease Society of America (IDSA), the Food and Drug Administration in the USA (FDA) approved the use of fluoroquinolones to prevent E. coli infection in poultry. The CDC and IDSA opposed the use of fluoroquinolones in poultry feed or drinking water, an approach that doses many birds when only a few may have an infection.

31.       Fluoroquinolones are an important line of defence used in humans to treat urinary tract infections, sexually transmitted diseases, invasive Campylobacter and Salmonella infections, respiratory infections, infections in patients with cystic fibrosis, and many other diseases.

32.       An initial report from the Minnesota State Department of Health shows that only two years after fluoroqulnolones were approved for use in poultry, there has been an increase in fluoroquinolone resistance in Campylobacter bacteria isolated from chickens, turkeys, and humans. That finding suggests that the use of fluoroquinolones in the drinking water of poultry poses a risk to human health.

33.       Another use of antibiotics in agriculture is the spraying of crops with antibiotics to prevent and treat diseases. The species of bacteria that cause diseases in plants are different from the bacteria that cause diseases in humans, though they may belong to the same families. The main bacterial pathogen that harms plants is Erwinia, which attacks fruit trees causing fire blight, which damages the fruit. Erwinia is related to bacteria that include E. Coli, Salmonella, and Shigella, common foodborne pathogens that infect humans.

34. Streptomycin is the antibiotic typically used to combat Erwinia, although in some regions, resistance has developed, necessitating the use of oxytetracycline. Although streptomycin is rarely used in humans, streptomycin resistance is still important because it is often found in conjunction with other antibiotic-resistance genes. Using streptomycin in agriculture may select for bacteria that are resistant to commonly used antibiotics. If those resistance genes are transferred to bacteria that infect humans, the resulting infections would be more difficult to treat.

3.        Effects of the use of antibiotics

35.       Many studies have been done to study the effects of the use of antibiotics as well as the risk of resistance in bacteria. The results are frightening, as they stress the connection between an uncontrolled use of antibiotics in human use as well as in agriculture and the development of antibiotic-resistant bacteria.

36.       In Holland, 80 percent of salmonella bacteria are resistant to certain antibiotics. In Ireland, 90 percent of staphylococci bacteria in cattle are resistant to penicillin, whilst in Sweden, where antibiotics are used moderately, only a small percentage of bacteria are resistant.

37.       Regardless of whether antibiotics are used to promote growth or as a medicine, doses must be phased out prior to slaughter. Otherwise, there is a risk that the meat will contain antibiotic residue. In 1996 the Belgian consumer magazine «Test Achats» monitored how much antibiotic residue there was in European meat. The worst results were found in Irish pork. Antibiotic residue was found in 17 percent of the samples. Greek, Spanish, Belgian and British meat also had poor ratings. Only the samples from Sweden, Denmark, Finland and Portugal were entirely free of antibiotic residue.

38.       There is a long history of circumstantial evidence that antibiotic resistance can be transferred from animals to humans, and scientists have warned of the danger. However, it was not until spring 1997 that the first case of a human who had been infected by an animal was published, in the scientific journal The Lancet. A 43-vear old-lorry driver from Birmingham was taken to the hospital after he broke his leg in an accident at a poultry packing plant. The man's leg was set in an operation, the subsequent wound was infected and the man became feverish despite antibiotic treatment. The wound contained the bacteria enterococcus, a “super bacteria" that is resistant to vancomycin.

39.       Using methods from modern molecular biology, scientists recently demonstrated that a turkey farmer carried exactly the same antibiotic-resistant bacteria as his animals did. Researchers believe that such resistance can also be transmitted via food products. In October 1997, the World Health Organisation announced that bacteria and genes, including genes for resistance can be transmitted between humans, animals and the environment.

4.        The Swedish example

40.       Sweden banned antibiotics as a growth agent as early as 1986, mainly for ethical reasons. It was thought that animals should be kept healthy through improved management and hygiene and through health control programmes. Sales of antibiotics fell sharply and are now 30% of the amount sold before 1986. Today the general use of antibiotics in animal feed is banned. Antibiotics may only be used for medicinal purposes and must be prescribed by a veterinarian after a diagnosis has been made. Furthermore, the veterinarian must choose an antibiotic that has a low risk of increasing resistance in bacteria.

41.       For consumers and farmers in Sweden, and to a certain degree in other Nordic countries, it is entirely unacceptable to give antibiotics to healthy animals to promote growth.

42.       The early years without antibiotics in animal feed were far from easy for Swedish farmers. At first, the number of animal deaths rose, and production declined. This was particularly evident on farms with poor hygiene and poor living conditions for the animals.

43.       The transition was most difficult for pig breeders. Above all, it was the weaning process that was the most difficult for piglets. The solution consisted of a battery of measures, such as appropriate weaning times, improved hygiene, less stress, a more stimulating environment for the animals, better supervision and changes in their feed.

44.       Today, representatives of the agricultural sector regard the antibiotics ban as having caused only slightly higher production costs, at least in the long run, because the animals have become healthier and more productive.

45.       In connection with the Swedish ban, it is also important to note that Swedish legislation also prohibits the use of teeth- and tail-cutting on pigs and bill-cutting on poultry.

5.        Consumer concern

46.       The use of antibiotics and the risk of resistance is a threat to consumers and their right to safe and healthy food. This has also been of great concern to consumer organisations. Several European consumer organisations are extremely critical of the liberal use of antibiotics and support the Swedish ban on antibiotics in feed. Euro Coop (European Community of Consumer Co-operatives) calls for the correct and restrictive use of antibiotics for the following scientifically-based reasons:

- bacterial cross resistance acquired between animal and human antibiotics has been confirmed (as with avoparcin and vancomycin or tylosin and erythromycin);

- resistant bacteria have spread from animals to man;

- certain antibiotic growth promoters may encourage the colonisation of the gut by salmonella species;

- growth promoters that are not yet used for therapy can be valuable models for future drugs and must therefore be safeguarded.

47.       Euro Coop stresses consumers’ increasing demands for more openness, transparency and accountability in foodstuff production. The consumer cooperatives believe that the use of antibiotics as growth promoters, together with intensive and industrialised production systems, does not address consumer expectations on food safety.

6.        Animal welfare

48.       When discussing the use of antibiotics as growth promoters and feed additives in agriculture, it is also appropriate to discuss animal welfare. The use of these substances allows more animals per unit, mixing age-groups, early weaning and in general poor conditions because the risk of disease is limited in the short term.

49.       The main reason for the Swedish ban on the use of antibiotics as growth promoters in 1986 was ethical concerns. Sweden has strong legislation on animal welfare, based on the principle that animals are sentient beings which have the right to live as naturally as possible. The ban puts pressure on the farmers to provide a healthy and sound environment for animals.

50.       If regular use of antibiotics as growth promoters is prohibited, it is necessary to improve the living conditions of the animals. This also limits the risk of large-scale outbreaks of diseases. And when a disease appears it is possible to limit the number of animals which need to be treated. Therefore, antibiotics should never be allowed to be used as a substitute for adequate hygiene.

7.        Recommendations from other bodies

7.1        WHO, Berlin, October 1997

51.       At a meeting in Berlin in October 1997, the World Health Organisation (WHO) expressed its concern about the increasing antibiotic resistance among bacteria. The WHO recognised that public health consequences from the excessive use of antimicrobials in livestock production include the emergence of resistant microbes which can then be transferred to humans through the food chain.

52.       Resistant strains of four bacteria that cause disease in humans have been transmitted from animals to humans and shown to have consequences for human health. They are Salmonella, Campylobacter, Enterococci, and E. coli.

53.       Direct evidence that antibiotic use in food-producing animals results in resistant salmonella infections in humans was presented at the meeting. Experts cited the widespread use of fluoroquinolones, an important group of medical antibiotics, in food animals as a particularly important issue. Fluoroquinolone-resistant Campylobacter has been detected in foods and has also been associated with treatment failure in humans infected with this organism.

54.       Participants also stressed the need for monitoring of the presence or emergence of antibiotic-resistant bacteria in livestock and food of animal origin. Quantitative data should be collected, using standardised methods, from all points along the food chain.

55.       WHO will work to integrate resistance monitoring in food animals and food of animal origin with its ongoing programme of antimicrobial resistance monitoring of bacteria that cause human disease.

7.2        European Parliament, May 1998

56.       In May 1998 the European Parliament passed a resolution on antibiotics in animal feed. The resolution stresses:

- that the protection of consumers and livestock must take precedence over economic interests,

- that the possible risk or danger posed by the use of antibiotics in animal feed must be adequately proven by scientific means in order to justify a ban,

- that recent WHO studies would appear to show that the systematic use of antibiotics during fattening periods may have adverse effects, including increased resistance of some bacteria;

- that healthy breeding practices must aim to limit the use of antibiotics to purely therapeutic purposes.

57.       The resolution calls on the Commission:

- to use the experiences of various member states in banning certain antibiotics, such as avoparcin, tylosin, spiramycin and virginiamycin, and similar substances, such as carbadox and dimetridazole, as an opportunity to review the whole use of antibiotics and similar substances in animal feed in order to ascertain whether they pose a health risk;

- to apply stringent scientific standards when assessing whether the use of antibiotics and similar substances as additives in animal feed and/or as medicinal products poses a health risk, so that any ban which might prove necessary may be implemented not only in the individual member states of the EU but also in respect of imports of animal feed and meat from non-member countries;

- that the precautionary principle must be applied to guarantee consumer health and safety as well as to safeguard producers' interests.

7.3        Copenhagen, September 1998

58.       In September 1998, a European Union Conference on "The Microbial Threat" was held in Copenhagen. The conference stated that resistance to antimicrobial agents is a major public health problem in Europe and that the international spread of microorganisms means that resistance to antimicrobial agents can no longer be regarded as a national problem. It is a European and global problem and requires a common strategy.

59.       The conference stated that antimicrobial resistance among microorganisms that cause disease in the community and in hospitals is leading to increased deaths, illness and costs, and that the full extent of the problem is not yet known.

60.       The conference further stated that all antimicrobial drugs can select microorganisms that are resistant and that there is an established but complex relationship between the consumption of antimicrobial agents and the prevalence of drug resistance in microorganisms. Dissemination of resistant microorganisms occurs both in hospitals and in the community. The major route of transmission of resistant microorganisms from animals to man is through the food chain.

61.       Pharmaceutical companies are making great efforts to develop new antimicrobial agents and ways of countering infectious disease and they should be encouraged to continue this important work. But such innovations cannot be expected to solve the problems in the near future. It is thus essential to introduce policies on the rational use of antimicrobials to avoid further increases in resistance.

62.       The conference recommended that:

- The European Union and member states must recognise that antimicrobial resistance is a major European and global problem.

- Pharmaceutical companies should be encouraged to develop new antimicrobial-agents, but these will not solve the problem in the near future.

- The European Union and member states should set up a European surveillance system of antimicrobial resistance.

- The European Union and member states need to collect data on the supply and consumption of antimicrobial agents.

- The European Union and member states should encourage the adoption of a wide range of measures to promote prudent use of antimicrobial agents.

- The European Union member states and national research councils should make coordinated research on antimicrobial resistance a high priority.

- A way should be found to review progress with these recommendations and proposals.

7.4       European Commission and Council of Ministers, November-December 1998

63.       In November 1998, following various earlier studies and recommendations (WHO, International Office of Epizootics (OIE), Economic and Social Committee, Copenhagen Conference, etc) and in the light of findings by the Scientific Committee on Animal Nutrition, the European Commission proposed to the Council of Ministers of the European Union that the use of four antibiotics as animal feed additives (growth promoters) should be banned. The antibiotics in question were virginiamycin, spiramycin, tylosin phosphate and bacitracin-zinc. The proposal was made in keeping with the precautionary principle in order to prevent the risk of development of resistance to these antibiotics in human medicine.

64.       On 14 December 1998, the Council of Ministers (meeting at agriculture minister level) decided to ban these four antibiotics in animal feedstuffs. They were thus added to the fifteen other antibiotics that had already been banned. The ban was due to take effect on 1 July 1999 (except in Denmark, Finland and Sweden, where a ban was already in force and the new ban took effect on 1 January 1999). The ban is temporary and is due to be reviewed by 31 December 2000 in the light of the scientific reports now being prepared, in particular by the Scientific Steering Committee.

7.5        Paris, March 1999

65.       A European Scientific Conference entitled “The Use of Antibiotics in Animals - Ensuring the Protection of Public Health” was held at the headquarters of the International Office of Epizootics (OIE) in Paris from 24-26 March 1999.

66.       The conference stressed the precautionary principle, stated principles for good veterinary practices and proposed the establishment of a European antibiotic resistance monitoring system for animal bacteria.

67.       The conference recommended that countries should:

- establish antibiotic resistance monitoring within their territory;

- establish a European resistance monitoring system for food borne and indicator bacteria in animals;

- generate all necessary data which is required for the conduct of proper risk assessment.

68.       The conference also recommended that international organisations promote:

- the harmonisation of existing resistance monitoring systems;

- the standardisation and harmonisation of resistance testing methodologies;

- the elaboration of appropriate risk analysis models which will provide guidance as to what data should be collected by resistance monitoring systems.

7.6       Opinion of the Scientific Steering Committee (May 1999)

69.       At the request of the European Commission, the Scientific Steering Committee conducted a study of the current situation regarding the existence and development of resistance to antimicrobials and the consequences for human and animal health.

70.       The report concludes that resistance to antimicrobial agents poses major problems for the prevention and treatment of infectious diseases in both humans and animals. Despite the lack of scientific evidence for some aspects of the problem, the findings already available show that the selection of resistant bacteria is promoted by the use of antimicrobial agents. It would therefore be wrong to wait any longer before intervening to reduce the widespread use of antimicrobials both in human and veterinary medicine and in animal and plant production.

71.       The Scientific Steering Committee recommends that there should be Europe-wide co-operation. Four main areas of action can be picked out from the recommendations in the report:

      - prudent use of antimicrobials (tighter controls on the distribution of antimicrobials, avoiding the use of combinations of antimicrobials, education of professionals and consumers, gradual elimination of antimicrobials as growth promoters, etc);

      - prevention of infection and containment of resistant organisms (harmonisation of infection control standards, reduction of the risks of infection, education of professionals and consumers, improvements in animal husbandry, etc);

      - new modalities of prevention and treatment for infections (co-operation between academic departments, the pharmaceutical industry and medical and veterinary research bodies, new ways to control and contain resistance, research on the transfer of resistance factors between plants, animals and humans, etc);

      - monitoring of the effects of intervention (improved European co-ordination, development of research, keeping of records and controls on the use of antimicrobials, etc).

7.7       Council of the European Union resolution (June 1999)

72.       In June 1999 the Council of the European Union passed a resolution on antibiotic resistance: A Strategy Against the Microbial Threat.

73.       The Council considers that antibiotic resistance and its various causes needs a multidiciplinary and cross-sectorial approach as well as co-operation with the member states and international organisations such as WHO, Food and Agriculture Organisation (FAO) and International Office of Epizootics (OIE).

74.       The Council also reiterates its commitment to define an overall strategy to guard against the development of antibiotic resistance based on risk assessment, a precautionary approach, co-ordinated control and preventive actions.

75.       The Council further calls upon the member states:

- to establish multi-diciplinary and cross-sectorial policies in order to facilitate the containment of the spread of antibiotic resistance;

- to co-operate in order to permit an effective comparable monitoring of the supply and use of antibiotics and effective comparable surveillance of antibiotic resistance,

- to maintain the principle of antibiotics authorised as human and veterinary medicine being “prescription-only-medicines” and to ensure vigilance on the implementation of this principle;

- to promote adherence to the principles of infection control both in hospitals and in non-hospital care, as well as in animal production;

- to promote optimal prescribing and use of antibiotics and to prevent their unnecessary and inappropriate use in human and veterinary medicine;

- to promote actions aimed at raising the awareness of health professionals, farmers and the general public of the problem of antibiotic resistance;

- to promote health-orientated animal production system, thus reducing the need for antibiotics;

- to promote research in this area;

- to co-operate closely with the Commission.

8.       Previous Council of Europe action

76.       The Council of Europe began looking into the question of the use of antibiotics in animal feedstuffs several years ago – long before the issue caught the headlines in recent times as a result of growing concerns among scientists and consumers about the abuse of antibiotics in animal husbandry and the development of resistance to antibiotic treatments.

8.1       Intergovernmental co-operation

77.       At the level of intergovernmental co-operation, there are two sectors that deal with these issues. The first is the Directorate of Legal Affairs, which is responsible for the Standing Committee of the European Convention for the Protection of Animals kept for Farming Purposes (Strasbourg, 1976). Article 6 of the convention deals with animal feed in general. The Standing Committee of the convention (Article 9) is “responsible for the elaboration and adoption of Recommendations to the Contracting Parties containing detailed provisions … based on scientific knowledge concerning the various species of animals.” To date, the convention has been ratified by 24 member states, and the European Community has also acceded to it.

78.       A protocol of amendment to the convention has also been adopted (Strasbourg, 1992), clarifying certain aspects and extending the scope of the convention. Article 4 of the protocol states that “no other substance with the exception of those given for therapeutic or prophylactic purposes shall be administered to an animal … ”.

79.       In implementing the convention, the Standing Committee has adopted various recommendations, some of which refer to the presence of drugs in animal feedstuffs. One example here is the Recommendation concerning Domestic Fowl (November 1995), Article 11-5 of which states that “routine or systematic use of drugs to compensate for poor hygienic conditions or management practices shall not be allowed.”

80.       More recently, in June 1999, the Standing Committee adopted a recommendation concerning ducks, Article 11-6 of which also states that “routine or systematic use of drugs to compensate for poor hygienic conditions or management practices shall not be allowed.” A draft recommendation concerning turkeys (in the course of adoption) contains a similar clause. It can therefore be seen that the committee is increasingly concerned about feedstuffs in animal husbandry, in particular the question of the addition of substances such as antibiotics.

8.2       Partial Agreement in the Social and Public Health Field

81.       The second relevant sector of Council of Europe activity in this area is the Partial Agreement in the Social and Public Health Field (Directorate of Social and Economic Affairs). The Public Health Committee, which is in charge of the activities of several committees of experts, operates in this framework. The Public Health Committee’s work is aimed at protecting consumer health, and covers, in particular, food and food hygiene, cosmetic products, pesticides and pharmaceutical questions. A new Committee of Experts on Nutrition, Food Safety and Consumer Health has been set up recently. The various technical committees prepare recommendations that are submitted to the Committee of Ministers for adoption.

82.       As far as the use of antibiotics is concerned, work began several years ago, leading to the adoption of a number of Committee of Ministers resolutions. For instance, Resolution (77) 2 on antibiotics that could be included in animal feedstuffs to stimulate growth and antibiotics that should only be used for therapeutic purposes. This resolution lays down some general principles. Among other things, it stresses that the use of antibiotics may reduce their effectiveness in human therapy and that they should not be added to animal feedstuffs for growth promotion purposes. It also recommends that steps should be taken to prevent the persistence of unacceptable residues in food products of animal origin.

83.       Resolution AP (78) 2 on the use of antibiotics and other antimicrobial agents in animal husbandry. Among other things, the resolution recommends that the use of antimicrobial substances should only take place under veterinary control and that their use in animal feedstuffs should be limited so as to prevent resistance phenomena.

84.       It was followed by Resolution AP (84) 1 on antibiotics that could be included in animal feedstuffs to stimulate growth and antibiotics that should only be used for therapeutic purposes, which replaced and updated the Committee of Ministers Resolution AP (78) 2.

85.       In 1986, the results of a study on residues of veterinary drugs in food of animal origin were published. At the time, the committee of experts responsible for the study concluded that additional evidence was needed to prove that antibiotic residues in food products of animal origin could cause resistance in humans, and recommended that further research be carried out on the matter. As the findings of studies in this area are now available, the Public Health Committee is likely to take up the matter again and issue new recommendations.

8.3       Parliamentary Assembly

86.       In spite of the Parliamentary Assembly’s interest in food, health and animal protection issues, it has only recently begun looking into this particular question. Last year, for instance, the Committee on Agriculture and Rural Development organised a Seminar on the Use of Antibiotics in Food Production (London, 8 June 1998). Following that seminar, several members of the Assembly presented a motion for a recommendation on the use of antibiotics in food production (Doc. 8155), which was referred to the committee and led to the present report.

Reporting committee: Committee on Agriculture and Rural Development

Budgetary implications for the Assembly: none

Reference to committee: Doc. 8155 and Reference No. 2465 of 4 November 1999 (modifying Reference No. 2311)

Draft recommendation unanimously adopted by the committee on 21 October 1999

Members of the committee: Mr Behrendt (Chairman), MM. Seiler, Hadjidemetriou, Hornung (Vice-Chairmen), MM. Agius, Aliko, Anton, Aylward, Bojars, Calmes, de Carolis (Alternate: Robol), Carvalho, Čiupaila, Eltz, Etherington, Mrs Gatterer, MM. Ghesquière, Gremetz, Haraldsson, Janowski, Jung (Alternate: Goulet), Kharitonov, Kitov, Kofod-Svendsen, Korkeaoja, Lazarenko, van der Linden, Mrs Loule, Mrs Mikaelsson, MM. Myrvoll, Pisanu, Prokes, Prusak, Rupar, Shugarov, Simon, Skopal, Steolea, Taylor, John D., Uriarte (Alternate: Gonzalez Laxe), Yürür.

N.B. The names of those members present at the meeting are printed in italics.

Secretary to the committee: Mr Sixto.