Last week the EU’s medicines regulator - the European Medicine Agency (EMA) - launched a consultation on use of last resort human antibiotics in animal agriculture.

The consultation comes in response to advice from the Agency’s Antimicrobial Advice Ad Hoc Expert Group (AMEG), which was updating its professional opinion, last delivered in 2013. AMEG proposed minimising sales of colistin for use in animals and restricting its use in animals to last resort treatments only. The proposal has gained support from EMA committees on human and veterinary medicine, but has attracted criticism from campaigners for stopping short of recommending a ban on colistin use on animals.

The EMA’s recommendation came as David Cameron announced new measures to tackle antibiotic resistance in England, including strict oversight - and possible bans - on farm use of antibiotics which are critical for human health, such as colistin, and a target for reducing the overall use of antibiotics.

In December, scientists discovered a gene that confers resistance to colistins and is readily transferrable between bacteria. Discovered on a pig farm in China, scientists reporting in medical journal the Lancet said there is a clear link between the resistance and the use of colistins on livestock animals. The resistant gene was also revealed to have spread further than first thought, and sooner, when it was discovered in samples from Europe.

It was this discovery that led EMA to request another opinion from its expert group; the AMEG group assessed the importance of colistin for human and animal health, the impact of resistance and the availability of alternative treatments. The group called for strict targets on colistin use in EU Member States, which could be expected to reduce use by about two thirds, and recommended it be reclassified for use only when no other treatments are available. They emphasised that reduced colistin use should not be compensated for by increasing the use of other types of antimicrobials. Instead, they said use of antibiotics should be reduced through improved farming conditions, better biosecurity in between production cycles, and vaccination.

Earlier this month, the UK government-commissioned O’Neill Review on antimicrobial resistance made a series of recommendations for tackling resistance - which has been described as posing as great a threat to humanity as climate change. Amongst these were introducing country-specific targets for the reduction of antimicrobial use in livestock and banning the use of last resort treatments in animal agriculture.

Reacting to the recommendations, campaigners in the UK criticised EMA for failing to push for a full ban in line with the O’Neill report’s findings. Campaigners from the Alliance to Save Our Antibiotics also pointed to EMA’s assessment in a new report that resistance to colistin is “likely” to be transferring from farm animals to humans in the European Union.
 
The Alliance said that, even if EMA’s target is achieved, over 100 times more colistin could still be used in farm animals than in humans in the EU.

Responding to announcements from both the UK government and EMA Cóilín Nunan, scientific adviser to the Alliance, said, “The European Medicine Agency is being grossly irresponsible and putting people’s lives at risk by supporting the mass medication of farm animals with a last-resort human antibiotic. While we welcome the government’s decision to tackle the overuse of farm antibiotics, if the Prime Minister is serious about protecting critically important antibiotics, he must immediately ban the use of colistin in farm animals.”
 
“We believe that the targets announced by Mr Cameron are not nearly ambitious enough as it would only require a relatively small reduction from current levels. The Alliance is calling for much more ambitious targets, which have been endorsed by the Labour Party: to cut farm antibiotic use by 50% by 2020 and by 80% by 2025, including a target to cut the use of critically important antibiotics by 80% by 2020 and by 95% by 2025.”

The deadline to respond to the EMA consultation on colistin is 26 June 2016.