Antimicrobial resistance

Antimicrobial agents are medicines used to treat infections, particularly those of bacterial origin. These medicines are essential to protect human and animal health, as well as animal welfare.

©OIE/P.Vaclavek

Antimicrobial agents are medicines used to treat infections, particularly those of bacterial origin. These medicines are essential to protect human and animal health, as well as animal welfare. Excessive or inappropriate use can lead to the emergence of resistant bacteria which do not respond to antibiotic treatment, as seen in recent decades. This phenomenon, called antimicrobial resistance, which poses a threat to disease control throughout the world, is a primary concern for human and animal health, and it is the focus of the WOAH AMR Working Group.


Working Group on Antimicrobial Resistance

Discover


It is by ensuring the responsible and prudent use of these invaluable medicines in animals, in accordance with the intergovernmental standards of the WOAH that we will be able to safeguard their efficacy.

To achieve this, coordinated action between the human and animal health and environmental sectors is crucial.

Veterinarians are part of the solution; but they must be well trained and well supervised by the statutory veterinary bodies created by law.

Antimicrobial agents are a global public good.

We each have a role to play in the fight against antimicrobial resistance and, in so doing, can protect the efficacy of these vital treatments and, by the same token, our future.  



Resources


Scientific and Technical Review

Antimicrobial resistance in animal and public healthVol. 31(1), 2012

While the massive use of antimicrobials has taken place in human and animal health over recent decades, the world is confronting an accelerated increase in the emergence of antimicrobial resistance. Yet the discovery of new treatments is not enough to maintain the fight against bacteria, organisms responsible for often serious illnesses in people and animals. 

Furthermore, globalisation of the trade in food products, together with traditional and medical tourism, is allowing existing or future resistant bacteria to colonise the entire planet with ease, whatever local preventive measures are applied. Risks taken by one country are thus liable to endanger the effectiveness and availability of antibiotics for the whole planet.


Protecting the efficacy of antimicrobial agents

Antimicrobial resistance poses a worldwide health threat: its consequences, direct and indirect, can damage both human and animal health.

For those in the animal health sector, the use of veterinary medicinal products, including antimicrobial agents, is essential for the following reasons

  • To protect animal health and welfare, in the knowledge that animal diseases can cause production losses of up to 20%
  • To contribute to food safety, as world population growth leads to an increase in the demand for high-quality animal protein, for example,  that found in eggs, meat and milk;
  • To protect public health, because more than 60% of infectious animal diseases are transmissible to humans.

For all these reasons, antimicrobial agents constitute a global public good, and protecting their efficacy remains crucial.


Rationalising and supervising the use of antimicrobial agents

The WOAH recommends policies enabling a basic veterinary network for effective animal health surveillance that ensures the early detection of potential animal diseases (including zoonoses) and rapid response to contain them at the site of the outbreak. This network also guarantees a general level of animal health, facilitating the sensible, appropriate and limited use of veterinary products and antibiotics.

The WOAH advocates the responsible and prudent use of antimicrobial agents, under the supervision of veterinarians who have been well trained and well supervised by veterinary statutory bodies. In this context, the Organisation publishes intergovernmental standards, guidelines and recommendations aimed at the Veterinary Services of its Member Countries.


Surveillance of the use of antimicrobial agents in animals

In many countries, including developed countries, antimicrobial agents are widely available to all, directly and indirectly, with hardly any restrictions on appropriate conditions for the importation, production, distribution and use of veterinary products, including antimicrobial agents. Thus, these products are circulating like ordinary goods, without controls, and are often adulterated.

Moreover, as yet there is no harmonised surveillance system to monitor the use and circulation of antimicrobial agents in animals worldwide. Collecting this information would enable countries to better control the quality and effectiveness of the products being used. It is in this context that the WOAH has been mandated by its Member Countries to collect this missing information and establish a worldwide database to monitor the use of antimicrobial agents in animals. This database, which will eventually be linked to the WOAH World Animal Health Information System WAHIS), will make it easier to analyse and control the source of imported medicines, improving their traceability by WOAH Member Countries.


Developing alternative treatments to antibiotics

TheWOAH supports new research into alternatives to antibiotics (notably vaccines) and particularly welcomed an international symposium on the subject in 2012, organised by the International Alliance for Biological Standardization (IABS) and the United States Department of Agriculture (USDA).

Antimicrobial resistance is a global human and animal health concern which is influenced by the use of antimicrobial agents in both human and veterinary medicine, as well as in the plant sector. The human, animal and plant health sectors therefore have a shared responsibility to prevent or minimise antimicrobial resistance selection pressures on both human and non-human pathogens.

The WOAH has worked actively for more than ten years on the issue of veterinary products (including antimicrobial agents) and developed a coherent strategy for its activities in this area. Sine antimicrobial resistance is an animal and human health issue, the WOAH works closely with its Member Countries, WHO, FAO and the Codex Alimentarius Commission.

Following the FAO/WOAH/WHO workshops on non-human antimicrobial use and antimicrobial resistance held in 2003 (on scientific assessment) and in 2004 (on management options), the WOAH developed a list of antimicrobial agents of veterinary importance, in parallel with the WHO list for human medicine.


WOAH Strategy

In 2016, the WOAH’s 84th General Assembly unanimously adopted Resolution no. 36 , which mandates that WOAH compile AMR activities into a strategy. On November 2016 the WOAH Strategy on Antimicrobial Resistance and the Prudent Use of Antimicrobials  was published. Aligned with the WHO Global Action Plan the strategy recognizes the importance of a “One Health” approach involving human and animal health, agricultural and environmental needs. It outlines the goals and tactics the WOAH has in place to support Member Countries in their fight against AMR, and to encourage the national ownership and implementation of international Standards.


WOAH intergovernmental standards

The WOAH promotes the responsible and prudent use of antimicrobial agents in terrestrial animals, so as to preserve their therapeutic efficacy and prolong their use in both animals and humans. It has developed intergovernmental standards on antimicrobial resistance and on the monitoring of the quantities of antimicrobial agents used.

The WOAH has also developed standards and guidelines to provide methodologies for WOAH Member Countries to appropriately address the risk of the emergence or spread of resistant bacteria that result from the use of antimicrobial agents in food-producing animals.

Its texts cover both terrestrial animals and aquatics animals and are found in the following publications:

• Terrestrial Animal Health Code (chapters 6.7., 6.8.6.9.6.10. and 6.11.

• Manual of Diagnostic Tests and Vaccines for Terrestrial Animals (Chapter 2.1.1.)

•  Aquatic Animals Health Code (Chapters 6.1.6.2.6.3. , 6.4. and 6.5.)

These standards are regularly updated to take account of the latest scientific findings (latest update in May 2015).


Global database on antimicrobial agents intended for use in animals

In the framework of the Global Action Plan on Antimicrobial Resistance (AMR), the WOAH, supported by FAO and WHO within the tripartite collaboration, has taken the lead to build a global database on antimicrobial agents intended for use in animals. The WOAH’s partners acknowledge this accomplishment as a major milestone in the global effort to contain antimicrobial resistance. The database is designed to:

  • Monitor the type and use of antimicrobial products
  • Support Member Countries in implementing Chapter 6.9. of the Terrestrial Code and Chapter 6.3. of the Aquatic Code
  • Measure trends over time
  • Trace circulation and use patterns globally
  • Evaluate the quality and authenticity of antimicrobial products in use

The WOAH Database on antimicrobial agents intended for use in animals in WOAH Member Countries was launched in October 2015.

The template for data submission and relevant guidance documents were developed by the WOAH ad hoc Group on Antimicrobial Resistance, endorsed by the Scientific Commission for Animal Diseases and tested by Member Countries. Each successive year of data collection provides valuable feedback from Member Countries towards improvement of the template through this same process.

The template is designed to allow all countries to complete it, irrespective of whether national data collection system exists.


WOAH Annual Report on Antimicrobial Agents Intended for Use in Animals

The WOAH publishes an annual report on the use of antimicrobial agents intended for use in animals following the annual round of data collection sent to its Members, that takes place between September and May.

The latest report, published in April 2021, provides specific information on the global use of antimicrobial agents adjusted for animal biomass for the year 2017, and presents the overall findings of the fifth annual data collection on the use of antimicrobial agents in animals.


The Fifth Annual Report on Antimicrobial Agents Intended for Use in Animals

The fifth round of data collection took place between September 2019 and May 2020. Contributions to the WOAH Database have grown from reporting data from 130 Members for its first report in 2016 to 160 countries for its fifth report: 156 WOAH Members (86% of 182 WOAH Members), one non-contiguous territory of an WOAH Member and three non-WOAH Members.

The fifth round includes evidence on the barriers that 23 countries experienced in reporting quantitative data on antimicrobial agents intended for use in animals.

This report provides calculations of animal biomass for food-producing species from 102 countries reporting quantitative data for the year 2017 and allowed for an analysis of antimicrobial quantities reported adjusted by a denominator.

Additionally, and for the first time, the WOAH is presenting trends of the mg/kg, quantities by antimicrobial classes and animal biomass from 2015 to 2017 for 69 countries.


Previous WOAH Reports

WOAH Template, Guidance and Calculations

The WOAH considered the experience and feedback from Member Countries and annually update the template and guidance document based on requests for clarification from responding Members. The current version of these documents, are available below.


Network of WOAH Experts on Antimicrobial Resistance

The WOAH’s work is this area is supported by a Reference Laboratory and several Collaborating Centres, as well as by an Ad hoc Group of international experts, including experts from WHO and FAO.


Resolution adopted by the World Assembly of Delegates

83rd General Session, May 2015
Resolution No. 26
: Combating antimicrobial resistance and promoting the prudent use of antimicrobial agents in animals

84th General Session, May 2016
Resolution No. 36
: Combating Antimicrobial Resistance through a One Health Approach: Actions and WOAH Strategy

85th General Session, May 2017
Resolution No. 38
: Global action to alleviate the threat of antimicrobial resistance: progress and opportunities for future activities under the ‘One health’ initiative

86th General Session, May 2018
Resolution No. 21
: List of antimicrobial agents of veterinary importance

87th General Session, May 2019
Resolution No. 14
: WOAH’s Engagement in the One Health Global Effort to Control Antimicrobial Resistance


WOAH Global Conferences

The Responsible and Prudent Use of Antimicrobial Agents for Animals

“International Solidarity in the Fight Against Antimicrobial Resistance”
(WOAH Headquarters, Paris, 13-15 March 2013)


Antimicrobial Resistance and Prudent Use of Antimicrobial Agents

Putting Standards into Practice
Marrakesh (Morocco), 29-31 October 2018


Related link


WOAH Manual of diagnostic tests and vaccines for Terrestrial Animals

  • Chapter 2.1.1. Laboratory methodologies for bacterial antimicrobial susceptibility testing

The WOAH promotes the responsible and prudent use of antimicrobial agents in terrestrial and aquatic animals, so as to preserve their therapeutic efficacy and prolong their use in both animals and humans.

It has developed a wide range of international standards and guidelines in this field. These provide a framework for responsible and prudent use of antimicrobial products in animals and for the surveillance and monitoring of the quantities used:

Terrestrial Animal Health Code

Chapter 6.7. Introduction to the recommendations for controlling antimicrobial resistance

Chapter 6.8. Harmonisation of national antimicrobial resistance surveillance and monitoring programmes

Chapter 6.9. Monitoring of the quantities and usage patterns of antimicrobials agents used in food producing animals

Chapter 6.10. Responsible and prudent use of antimicrobial agents in veterinary medicine

Chapter 6.11. Risk analysis for antimicrobial resistance arising from the use of antimicrobials in animals

Aquatic Animal Health Code

Chapter 6.1. Introduction to the recommendations for controlling antimicrobial resistance

Chapter 6.2. Principles for responsible and prudent use of antimicrobial agents in aquatic animals

Chapter 6.3. Monitoring of the quantities and usage patterns of antimicrobial agents used in aquatic animals

Chapter 6.4. Development and harmonisation of national antimicrobial resistance surveillance and monitoring programmes for aquatic animals

Chapter 6.5. Risk analysis for antimicrobial resistance arising from the use of antimicrobial agents in aquatic animals


Furthermore, the WOAH developed a list of antimicrobial agents of veterinary importance, in parallel with the existing WHO list for human medicine.


The WOAH has also developed standards and guidelines to provide methodologies to appropriately address the risk of the emergence or spread of resistant bacteria that result from the use of antimicrobial agents in food-producing animals:


Manual of Diagnostic Tests and Vaccines for Terrestrial Animals

Chapter 2.1.1.
Laboratory methodologies for bacterial antimicrobial susceptibility testing


These Standards have been adopted by WOAH’s 182 Members and are regularly reviewed and updated, in line with the latest scientific findings.

All WOAH Standards and Guidelines on the topic are also gathered in the following book:

Limiting the emergence of antimicrobial resistance requires a global, harmonised and intersectoral approach that enables the coordination of medical, animal health and environmental policies. Indeed, people and animals share the same bacteria, since 60% of infectious animal diseases are transmissible to humans. This is the foundation of the ‘One Health’ concept.

It is in this context that the WOAH cooperates with many other international organisations, such as WHO[1], FAO[2], Codex alimentarius, the WTO[3] and, more recently, INTERPOL, all of whom are key partners in sharing information, developing recommendations and preventing the traffic in counterfeit products.


The Tripartite

Since 2010, the WOAH has committed itself to a Tripartite Alliance with WHO and FAO. In 2017, their second strategic document was released and a Memorandum of Understanding (MOU) was formally signed in June 2018 by the organisations to reaffirm their commitment, establishing respective responsibilities for these three organisations in combating diseases that have major health and economic impacts, particularly zoonoses. Antimicrobial resistance is one of the Tripartite’s three priority issues.

The Tripartite alliance agrees to collaborate on:

  • Supporting the continued implementation of the Global Action Plan on AMR;
  • Engaging with countries to reinforce national and regional human health, animal health and food safety services;
  • Improving inter-agency collaboration in foresight analysis, risk assessment, preparedness building and joint responses to emerging, reemerging and neglected infectious diseases at the animal-human-ecosystems interface;
  • Addressing food safety challenges requiring a multi-sector approach in the context of reinforcing food security;
  • Promoting coordinated research and development to achieve a common understanding of the highest priority zoonotic diseases and the research and development needed to prevent, detect, and control them; and
  • Developing a Voluntary Code of Conduct to reinforce the implementation of international standards on responsible and prudent use of antimicrobials.

Global Action Plan on Antimicrobial Resistance

The WOAH recently played a significant role in developing the WHO Global Action Plan on Antimicrobial Resistance(GAP), adopted in 2015 and aimed at ensuring our long-term capability to treat infectious diseases with effective and high-quality antimicrobials. The Member Countries of the WOAH pledged their support to this plan of action through a Resolution, unanimously adopted in May 2015.  
Within the framework of key activities which should be implemented over the next five to ten years, this GAP highlights the importance of the WOAH intergovernmental standards and supports the establishment of a worldwide database on the use of antimicrobial agents in animals by the WOAH.

Monitoring and Evaluation of the Global Action Plan on AMR

To collaboratively monitor and evaluate the global GAP indicators to inform on strategic decision-making the tripartite developed the dynamic Monitoring and Evaluation (M&E) Framework to assess the progress of country governments, the Tripartite organisations and other national and international partners in fulfilling their roles and responsibilities to impact change to combat the threat of antimicrobial resistance.


The United Nations Secretary General Report

The September 2016 Political Declaration of the High-level Meeting on Antimicrobial Resistance (Resolution A/RES/71/3) called for the establishment of the ad-hoc Interagency Coordination Group on Antimicrobial Resistance (IACG), in consultation with the Tripartite (FAO, WOAH, WHO). The IACG’s mandate was to provide practical guidance for approaches needed to ensure sustained effective global action to address antimicrobial resistance, and to report back to the UN Secretary-General.

On 29 April 2019, the IACG Secretariat handed off the Recommendations Report to the Secretary-General of the UN. A united effort for the Tripartite, the report contains critical recommendations to combat drug-resistant infections and demanding immediate, coordinated and ambitious action to avert a potentially disastrous drug-resistance crisis. Furthermore, the WOAH World Assembly of Delegates strengthened its commitment to the Tripartite at the 87th General Session by passing Resolution No. 14 to a Joint Tripartite Secretariat and AMR Multi-Partner Trust Fund for rapid implementation of recommendations.


Surveillance of bacterial resistance and the use of antimicrobial agents in animals 

In many countries today, including developed countries, antimicrobial agents are widely available, directly or indirectly, with virtually no restrictions. Of the 135 countries recently assessed by the WOAH, many have not yet passed relevant legislation to ensure appropriate conditions for the importation, manufacturing, distribution and use of veterinary products, including antimicrobial agents. As a result, these products circulate freely, like ordinary goods, and are often adulterated. 

Moreover, as there is no harmonised surveillance system for the use and circulation of antimicrobial agents in animals worldwide.  Collecting such information would enable countries to better control the quality and effectiveness of the products in use. It is in this context that the WOAH has been mandated by its Member Countries to collect the missing information and establish a worldwide database to monitor the use of antimicrobial agents in animals. This database, which will eventually be linked to  the Worldwide Animal Health Information System WAHIS, will make it easier to analyse and control the source of imported medicines, improving their traceability by WOAH Member Countries.


Taking action against antimicrobial resistance, key component of the action plan for the Global Health Security Agenda (GHSA)

The WOAH participates in the world Steering Committee of the GHSA, launched in 2014, as an advisor. The GHSA programme is a joint endeavour between the United States of America and more than 40 other nations, in addition to international organisations, such as WHO, the WOAH and FAO. With tackling antimicrobial resistance among its primary objectives, this programme aims to accelerate progress towards a world that is better protected from infectious disease threats and to promote world health security as an international priority.


Alliance Tripartite


Regional Project


[1] World Health Organization 

[2] Food and Agriculture Organization of the United Nations

[3] World Customs Organization

Success against antimicrobial resistance can only be achieved when the public, veterinary and environmental health authorities put these global strategies into place at the national level.

For national animal health services, implementing the WOAH’s intergovernmental standards involves:

  • the presence of adequate legislation on the use of antimicrobials
  • a veterinary profession which is well trained and supervised by law
  • the allocation of the necessary resources to strengthen Veterinary Services so that they can exercise the appropriate controls

Ensuring the circulation of antibiotics under appropriate legislation

Antibiotics are not a harmless product which should be freely available for sale and use. Their sale should be legally supervised and the distribution of counterfeit products severely suppressed


Fostering excellence in the veterinary profession

The veterinary profession, in both its public and private sectors, has a crucial role to play in confronting antimicrobial resistance, particularly in overseeing the prescription and delivery of antimicrobial products.

For this reason, the WOAH has also developed guidelines on the Veterinary Education Core Curriculum, covering the basic essentials of a well-organised profession which is reliant on well-trained and properly supervised professionals.

Moreover, the WOAH advocates an appropriate legislative framework to ensure professional ethics and good governance of Veterinary Services within the veterinary profession. With this in mind, the Organisation is developing intergovernmental standards and programmes related to the functioning and constitution of national and regional Statutory Veterinary Bodies, which have the necessary legal powers to oversee degrees, ethics, professional excellence and the exclusion of those whose conduct is inappropriate.

In the face of antimicrobial resistance, veterinarians are part of the solution.


Capacity-building programmes for national Veterinary Services

International solidarity is crucial in helping developing and emerging countries to achieve the legislation, infrastructure and human and financial resources needed to implement and comply with the WOAH standards.

As a result, the WOAH provides continuing support to Veterinary Services; in particular, by means of the PVS Pathway (evaluation of Performance of Veterinary Services).

Furthermore, the WOAH has created a network of National Focal Points, appointed by their governments, to develop or update legislation related to the production, importation, distribution and use of veterinary products, and, among other things, to establish the monitoring of antibiotic consumption. These National Focal Points provide technical support to their WOAH National Delegates. To date, three series of seminars have been organised in the five regions of the WOAH and the fourth series is under way.

We each have a role to play against antimicrobial resistance.

This page gives you access to various background materials on the problem of antimicrobial resistance. These elements are free-access, please don’t hesitate to use them and pass them on.

World Antimicrobial Awareness Week


World Antimicrobial Awareness Week 2021

Spread awareness, stop resistance

Discover


The goal of this week is to raise awareness of the health risks posed by antimicrobial resistance and to promote good practice in this area of concern, to limit the emergence and spread of resistance throughout the world.


New resources


Informative documents


Publications


Editorials