EcoAntibio Plan and Antimicrobial Resistance: Version 2 of the National Plan for Risk Reduction in Veterinary Medicine

In the field of veterinary public health, the fight against antimicrobial resistance continues. Following an initial five-year national plan (2012–2016), the second plan has just been published* by the Ministry of Agriculture. The twenty actions outlined in the EcoAntibio 2 plan (2017–2021) build on those implemented over the past five years, with the aim of consolidating the progress made and drawing on the lessons learned. The overall objective, still guided by the “One Health” approach, remains the same: to reduce animals’ exposure to antibiotics in order to better preserve their effectiveness in human health. The EcoAntibio plan has generally achieved its main objectives, according to the report** by the General Council for Agriculture, Food, and Rural Areas (CGAAER) published on April 11. In particular, the five-year quantitative target appears to have been met, with a 25% use reduction in antibiotics in veterinary medicine between 2012 and 2016, and a 25% decrease in the use of critically important antibiotics between 2013 and 2016 . France thus shows one of the most significant reductions in antibiotic consumption among EU countries and now ranks within the European average. Among the measures that contributed to these positive results are awareness-raising campaigns on antimicrobial resistance and initiatives to promote best practices in antibiotic use: these efforts engaged professional veterinary and agricultural organizations, leading to the development of a variety of educational tools. Similarly, numerous studies have focused on public health and medical methods for preventing infectious diseases. However, the regulatory framework governing the use of antibiotics—primarily established by the “Law on the Future of Agriculture”—has drawn criticism due to its burden and complexity. It must be said that “the provision of self-assessment tools to livestock producers and veterinarians—which are essential for the full and sustainable adoption of responsible use of antibiotics—is significantly behind schedule ,” laments the CGAAER. Furthermore, “the identification and evaluation of existing alternative methods have not been carried out, and the search for new approaches has not been as active as hoped.” Building on the lessons learned from this assessment, the EcoAntibio 2 plan will aim to facilitate the engagement of professionals and recognize their efforts. It will also prioritize actions to prevent infectious diseases and promote alternatives to antibiotic therapy through interdisciplinary research (in the fields of biosecurity, vaccination, livestock management techniques, nutrition, genetics, livestock facility design, etc.). Furthermore, it must strike a better balance between voluntary initiatives, private sector involvement, and the regulatory framework. Finally, the new plan must be based on strengthened governance, which requires a clear definition of the roles of the various bodies.   Ultimately, the EcoAntibio plan consists of 20 measures—half as many as in the first plan—which are more incentive-based than regulatory. They are divided into four areas:

• developing measures to prevent infectious diseases and facilitating the use of alternative treatments;
• communicating and providing training on the challenges of combating antimicrobial resistance, the prudent prescribing of antibiotics, and other means of controlling infectious diseases;
• shared tools: providing tools for assessing and monitoring antibiotic use, as well as tools for their responsible prescribing and administration;
• shared efforts: ensuring the proper implementation of guidelines for the proper use of antibiotics at the national level and promoting their adoption at the European and international levels.

This plan must be part of a comprehensive strategy that takes into account animal health, animal welfare, the potential environmental impact of treatments, and the economic context of livestock farming. This integrated approach is in line with the Ministry of Agriculture’s agroecological initiative.   * EcoAntibio 2, National Plan to Reduce the Risks of Antimicrobial Resistance in Veterinary Medicine 2017–2021, published on April 19, 2017. ** Report No. 16041 of the General Council for Food, Agriculture, and Rural Areas (CGAAER): “The EcoAntibio Plan 2012–2016: Evaluation and Recommendations for the Next Plan”: click here  

The EcoAntibio plan 1

Launched by the Ministry of Agriculture in November 2011, the initial plan—which focused specifically on veterinary medicine—had two objectives:

• to reduce the contribution of veterinary medicine to the development of bacterial resistance;
• to sustainably preserve the veterinary therapeutic arsenal.

A specific quantitative target was also set: a 25% use reduction in antibiotics in veterinary medicine over five years. This plan comprised 40 measures divided into five areas: raising awareness among professionals about the issue of antimicrobial resistance; developing alternatives to the use of antibiotics; regulating the use of these drugs; monitoring their use; and actions to be taken outside the national framework. The coordination of these actions was entrusted to public entities (DGAL, DGER, DGS, DGPR, ANSES) and private organizations (SNGTV, National Council of the Veterinary Order, SIMV, Acta).  

The EcoAntibio 2 plan

> Priority 1: Develop measures to prevent infectious diseases and facilitate the use of alternative treatments— Action 1: Continue research, studies, and the development of methods related to public health and animal husbandry prevention measures (non-pharmaceutical solutions) - Action 2: Gather evidence on alternative treatments to limit the prescription of antibiotics— Action 3: Encourage the use of vaccines to prevent the onset of infectious diseases - Action 4: Reduce the introduction and spread of pathogens > Priority Area 2: Communicate and provide training on the challenges of combating antimicrobial resistance, the prudent prescribing of antibiotics, and other means of controlling infectious diseases- Action 5: Implement the “animal health” component
of the national and interministerial communication campaign to raise awareness 
about the prevention of antimicrobial resistance - Action 6: Expand the interministerial portal providing information and raising awareness among the public and professionals about antimicrobial resistance with information specific to the animal sector and ÉcoAntibio - Action 7: Strengthen knowledge
 of antimicrobial resistance, the prudent prescribing of antibiotics, and the promotion of alternative methods for controlling infectious diseases in the initial and continuing education
 of professionals and future professionals - Action 8: Evaluate the measures implemented by ÉcoAntibio and ensure broad communication of these results to stakeholders > Priority Area 3: Provide tools for assessing and monitoring antibiotic use, as well as tools for their responsible prescribing and administration —Action 9: develop, maintain, and disseminate self-assessment tools for veterinarians and livestock producers— Action 10: develop databases for reporting dispensed antibiotics and systems for analyzing these data - Action 11: Develop, update, and disseminate best-practice guidelines —Action 12: Regulate the use of colistin in veterinary medicine and develop tools to enable responsible use - Action 13: Expand the network of regional veterinary consultants in antibiotic therapy 
- Action 14: Monitor trends in antimicrobial resistance- Action 15: Improve biological diagnostic tools for veterinary medicine- Action 16: maintain the availability of antibiotic treatments —Action 17: evaluate the framework governing antibiotic use in the context of prescriptions “without a systematic clinical examination” > Priority 4: Ensure the proper application of guidelines for proper use at the national level and promote their adoption at the European and international levels - Action 18: Monitor compliance with rules governing the prescription, dispensing, and administration of antibiotics; combat fraud
and trafficking- Action 19: assert and defend the positions of French authorities at the European level to incorporate them into European law —Action 20: assert and defend the positions of French authorities at the international level to incorporate them into international recommendations