2nd Joint FAO/OIE/WHO Workshop on Non-human Antimicrobial Usage and Antimicrobial Resistance: Management Options, Oslo, Norway, 15-18 March 2004
Managing human health risks from non-human usage of antimicrobials and the resulting antimicrobial resistant bacteria requires national and international interdisciplinary cooperation. The 1st Workshop on Non-human Antimicrobial Usage, December 2003 in Geneva, conducted a preliminary scientific assessment considering all nonhuman uses of antimicrobials in animals (including aquaculture) and plants, and their role in antimicrobial resistance, based on the available scientific information. Based on the outcome of the 1st Workshop in Geneva, as well as other relevant input (e.g. reports of previous WHO and OIE workshops), the 2nd Workshop in Oslo considered the broad range of possible risk management options for antimicrobial resistance from non-human usage of antimicrobials. In particular, it focused on potential directions of future Codex, FAO, OIE and WHO work in this area, in order to prevent and minimize antimicrobial resistance at the global level. To ensure that the conclusions of the 2nd Workshop reflected the perspectives of affected parties, the major stakeholder groups (e.g., pharmaceutical industry, farmers, food processors, consumers, regulatory agencies, and veterinarians) participated in the meeting. The workshop process has resulted in suggestions for a way forward in this area, for Codex, as well as for OIE, WHO and FAO.
Among the important conclusions were:
- The risks associated with non-human antimicrobial use and antimicrobial resistance should be part of the human safety assessment. The concept of “thresholds of resistance” should be pursued as a tool for risk management. If these thresholds are exceeded, this should trigger a range of risk management actions.
- The concept of “critically important” classes of antimicrobials for people should be developed by WHO with a view to enabling specific resistance preventive actions for such antimicrobials related to non-human use. A similar list of “critically important” classes of antimicrobials for animals should be pursued by OIE.
- Through stringent implementation of good agricultural practices including good animal husbandry and good veterinary practices it is possible to reduce the necessity for antimicrobials.
- The need for rapid implementation by governments and all stakeholders of the WHO Global Principles for the Containment of Antimicrobial Resistance in Animals intended for Food and the OIE Guidelines on Antimicrobial Resistance is emphasised.
- There is need for capacity building, networking and co-ordination to facilitate implementation of surveillance programmes in various countries, in particular developing countries. FAO, WHO and OIE should take a leading role in this.
- A Codex/OIE Task Force should be established to develop risk management options for antimicrobial resistance related to non-human use of antimicrobials. Risk communication and transparency are critical to achieve effective risk management. Moreover, the International Code of Practice, General Principles of Food Hygiene should be reviewed to take account of antimicrobial resistance issues.