esvac (european surveillance of veterinary antimicrobial
TRANSCRIPT
An agency of the European Union
ESVAC (European Surveillance of Veterinary Antimicrobial Consumption)
Present and future activities
60th Meeting of the EFSA advisory forum
Presented J. Torren, Scientific Administrator, Animal and Public Health, Veterinary Medicines
Department on 8 June 2016
Content of the presentation
• History
• Objectives
• Method
• Results
• Caveats of the ESVAC project
• Future activities
• Conclusions
ESVAC 1
European Commission request to EMA on collecting consumption data
To develop harmonised approach for collection and reporting of data on use of antimicrobial agents based on national sales figures, as well as estimates on consumption in at least the major groups of animal species.
Fifth report of the ESVAC series, all the reports available from: www.ema.europa.eu
ESVAC 2
Intended use of surveillance data on antimicrobial consumption: .
• To aid interpretation of patterns and trends regarding antimicrobial resistance (AMR);
• As input to risk profiling and risk assessment regarding AMR;
• For setting risk management priorities;
• To evaluate the effectiveness of measures being implemented to promote prudent use;
• To identify changing patterns of use of veterinary antimicrobial agents;
• To aid comparison of use of veterinary antimicrobial agents between human and veterinary medicine, time periods and countries;
• As a basis for focused and targeted research and development.
3 ESVAC
The ESVAC technical approach
Data sets
• Sales data provided at package level (name, pharmaceutical from, pack size ingredient(s) and strength(s). Calculated to express tonnes of active ingredient
• Animal population data from Eurostat, TRACES and national (horses).
The main indicator applied to express the consumption of veterinary antimicrobials is mg active ingredient normalised by the population correction unit (mg/PCU):
Amount sold in metric tonnes × 109
PCU in kg
4 ESVAC
ESVAC indicators
The ESVAC main indicator is:
• mg active ingredient sold per population correction unit — mg/PCU.
Other indicators:
Tonnes sold for food producing species, of the various antimicrobial veterinary
classes, per country, per year (Table A1).
Sales for food producing species, in milligrams active substance per Population
Correction Unit (mg/PCU), of the various antimicrobial veterinary classes, per
country, per year. (Figure 9).
Sales for food producing species, in milligrams active substance per Population
Correction Unit (mg/PCU), by form, per country, per year (Fig 7).
* Refers to the 2013 ESVAC report figures and tables
ESVAC 5
ESVAC indicators (cont.)
Changes in sales (mg/PCU) for the
countries and years for which data
are available.
ESVAC 6
Results: Sales for food-producing species, including horses, in mg/PCU,
of the various veterinary antimicrobial classes, for 26 countries, in 2013
7
Differences likely to be partially due to differences in the composition of the animal population in the various countries
ESVAC
Spatial distribution of overall sales of all antimicrobials for
food-producing animals, in mg/PCU, for 26 countries, for 2013
8 ESVAC
Changes by 23 EU/EEA countries, 2011-2013
9
Percentage changes in PCU, in tonnes sold and in sales of veterinary antimicrobial agents for food-producing species, including horses, in mg/PCU, from 2011 to 2013, aggregated by 23 EU/EEA countries
-2.8% -10.5%
-7.9%
-15%
-10%
-5%
0%
5%
10%
PCU Tonnes sold mg/PCU
ESVAC
Distribution of sales, in mg/PCU, of the various pharmaceutical forms of veterinary
antimicrobial agents for food-producing animals, including horses, aggregated by the 26
EU/EEA countries for 2013
10 ESVAC
Sales of antimicrobial agents by antimicrobial class as percentage of the total
sales for food-producing species, including horses, in mg/PCU, aggregated by 26
countries, for 2013
11 ESVAC
Caveats of the ESVAC data
• It takes at least three to four years in order to establish a
valid baseline for the data on sales of veterinary antimicrobial
agents.
• Data provided at package level, but not by animal species.
• Data reported as tonnes.
• 80% of the data are provided by the pharmaceutical industry.
• Heterogeneous source of data (pharmaceutical industry,
wholesalers, pharmacies, prescription data).
• No benchmarking within the country.
• Data from Greece and Malta missing.
12 ESVAC
Animal and
Public Health
AWP Antimicrobial Working Party
Expert Groups
AMEG Antimicrobial Advice ad hoc Expert Group
JIACRA Joint Interagency Antimicrobial Consumption and Resistance
RONAFA Reduction of the Need of Antimicrobials in Food Producing Animals
TATFAR Trans-Atlantic Task Force on Antimicrobial Resistance
ESVAC European Surveillance of Veterinary
Antimicrobial Consumption
Sales
Advisory Group
Species
Advisory Group
Use antimicrobials
Stratification
Units of Measurement
Advisory Group ESVAC 13
Future of ESVAC project
• Overall sales data will continue in the future.
• EC review of legislation likely to require antimicrobial consumption data per species
from Member States.
• Consumption data per species is resource demanding and requires time and
experience.
• ESVAC dedicating careful considerations on how to achieve systems at national level
that are comparable at international (EU) level.
• Automated collection of continuous data will facilitate the collection of such data,
but it will take years to be implemented in the EU.
• Complementary systems (stratification) will be explored by ESVAC.
• DDDvet and DCDvet now published. 14 ESVAC
Conclusions of ESVAC
15
• Until now we have observed a reduction on antimicrobial use in the EU/EEA.
• Considerable heterogeneity on the trends of antimicrobial use is observed.
• The overall reduction in sales is mainly accounted for by a few countries suggesting that
there it is a potential for reduction in the others as well.
• The sales of fluoroquinolones and 3rd- and 4th-generation cephalosporins were stable
during the period of 2010-2013.
• The most sold antimicrobials are tetracyclines, penicillins and sulfonamides administered
orally.
• Data on sales of antimicrobials are powerful tools to encourage countries to take action
on the use of antimicrobials in animals.
ESVAC
Conclusions (cont.)
ESVAC 16
• ESVAC data allows for targeted objectives.
• Reduction of use of colistin below 5 mg/PCU
• No increase in use of fluoroquinolones or
3rd and 4th generation cephalosporins
• No increase in overall antimicrobial use
Thank you for your attention
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