Cyfarfod Chwarterol 1 Grŵp Iechyd Anifeiliaid Cymru ar Ymwrthedd Gwrthficrobaidd: 12 Rhagfyr 2024

Sarah Carr* ” (SC) Vet & Farmer/Animal Health & Welfare Framework Group Representative
Rob Smith* (RS) Iechyd Da
Gwen Rees* (GR) Aberystwyth University/Arwain DGC
Hywel Morgan* (HM) Farmer
Thomas Bletcher* (TB) Farmer
Claire Jones* “ (CJ) Farmer
Jennifer Dow (JD) Veterinary Medicines Directorate (VMD)
Meryl Davies (MD) Public Health Wales (PHW)
Catrin Moore* (CM) Microbiology Society
Gavin Watkins* (GW) OCVO, Welsh Government
Dewi Hughes (DH) Arwain DGC
Simon Rolfe (SR) HSS, Welsh Government
Richard Pizzey (RP) OCVO, Welsh Government
Sian Timms (ST) OCVO, Welsh Government

Apologies:

Ifan Lloyd* (IL) Iechyd Da/Arwain DGC
Chris Teale* (CT) Animal and Plant Health Agency (APHA)
Kitty Healey* (KH) Veterinary Medicines Directorate (VMD)

Facilitator(s):

Kirsty Falcus“ (KF) OCVO, Welsh Government.

Key

* = DG Board Member
“ = Attended online

The meeting started at 10:00, GW thanked all for attending. Apologies were noted.

• The group is set up to deliver the new UK five-year plan for AMR (Antimicrobial Resistance) starting in 2024.
• The group reports to the Animal Health and Welfare Framework Group and the Welsh Government’s AMR Delivery Oversight Group.
• The structure includes a link between Sarah Carr as a representative of the Wales Animal Health and Welfare Framework Group and the AMR delivery group.
• The terms of reference for the group are similar to the previous Wales Animal and Environment AMR delivery group, with minor changes.
• The group will finalize and agree on the terms of reference via email in the new year, ready to be finalised and agreed during the next meeting in March 2025.
• Conflict of interest declarations were shared in advance by Kirsty and need to be completed by all members.
• The group will meet quarterly, with three virtual meetings and one annual face-to-face meeting.

Action: Group members to review terms of reference and provide comments before next meeting.

• UK and Wales Governance Structure:
  • The AMR governance is part of a 20-year vision with multi-year action plans, emphasizing a unified UK strategy with devolved policy implementation.
  • The Wales AMR Delivery Oversight Group is chaired by Sioned Rees, who is the SRO for the AMR program.
  • The group reports to the One Health Sub-Group, chaired by Richard Irvine, ensuring senior veterinary and human health policy involvement.
• Delivery Groups:
  • There are three main delivery groups: Animal Health, Human Health, and One Health Research and Surveillance.
  • The environment aspect has been moved from the Animal Health Delivery Group to the One Health Research and Surveillance Delivery Group.
• Challenges and Flexibility:
  • The governance structure is open to review and changes to ensure effectiveness and alignment with the UK structure.
  • There are ongoing efforts to improve engagement from environmental policy colleagues.
• Alignment with UK Structure:
  • The UK AMR Programme Strategy Board oversees the implementation programs for England, Scotland, Wales, and Northern Ireland.
  • The structure aims to ensure that the UK strategy is inclusive and considers devolved administrations' input.
• Funding and Resources:
  • There is no centralized budget for AMR in Wales; funding is sourced from various programs like the Rural Development Programme and its replacement, the Rural Investment Scheme.
  • Efforts are ongoing to secure a more dedicated and long-term AMR budget.
• Research and Surveillance:
  • The One Health Research and Surveillance Delivery Group exists on paper but lacks resources to manage and run it effectively.
  • There is a need for better integration of research efforts and surveillance data to support AMR initiatives. 

• Purpose and Scope:
  • The UK NAP (2024-2029) supports the next five years of the 20-year vision for controlling and mitigating AMR, published in 2019.
  • It is a comprehensive document with 85 pages, aiming to take a One Health approach to AMR.
• Key Themes:
  • Reducing the Need for and Unintentional Exposure to Antimicrobials: Focuses on infection prevention, management, and biosecurity strategies.
  • Optimising the Use of Antimicrobials: Ensures appropriate use of antimicrobials across human and animal health sectors.
  • Investing in Innovation, Supply, and Access: Promotes research and development of new antimicrobials, diagnostics, and alternative treatments.
  • Being a Good Global Partner: Engages in international collaborations and efforts to combat AMR globally.
• Commitments:
  • The plan includes around 30 commitments across various categories such as infection prevention, informed interventions, built environment, waste management, and public engagement.
  • Each commitment is marked with icons indicating whether it pertains to human health, animal health, or the environment.
• Implementation in Wales:
  • Wales aims to align its AMR efforts with the UK NAP while addressing specific needs and strengths within the region.
  • The Welsh Government contributed to the development of the UK NAP and is working on its own delivery plan for the animal health sector. 

• Meeting broke off into discussion groups, group notes are detailed below.

1. Reducing the need for, and unintentional exposure to antibiotics

• Needs more resources to help with surveillance for both vets and farmers.
• Improved farm sampling and testing as well as pen side testing.
• Develop calculator to determine cost and productivity impacts to support engagement.
• Public engagement to be more joined up between animal and human health – some messaging and branding.
• Educate the next generation; schools’ colleges, university, Young Farmers Club (YFC).
• Increase data from surveillance systems.
• Continuation of biosecurity app.
• Existing guidance Arwain DGC (indirect)
• Priority, concentrate on prevention.
• Engage with public, concentrating on animal owners.
• Vets are key to knowledge transfer with owners.
• Sustainable Farming Scheme (SFS), farmer support, increase knowledge in veterinary workforce.
• Education settings, vet undergrad/postgrad, farmers agri colleges, schools, one health.
• ACTION: Should there be a YFC Rep on Animal Health Delivery Group? Chair of YFC on the rural affairs committee.
• Winter fair, Antimicrobial Stewardship (AMS), 24/11/25, last day of WAAW.

2. Optimising the use of antimicrobials

• Develop on farm diagnostics.
• Continue Veterinary Prescribing Champions (VPC), Code of Conduct (CoC) and guidelines.
• Develop VPC leads to help apply CoC.
• Work with milk buyers/processors.
• Help vets and farmers to comply with new Veterinary Medicines regulations particularly selective dry cow therapy.
• Continue Farm Assured Welsh Livestock (FAWL)/Red Tractor/Arla
• SFS to policy to support agricultural sector.
• Optimising use maybe not a priority but focus on similar aspects.
• Engaging with farmers.
• Requires a long-term budget to do well.
• FAWL, one health, public engagement.
• Antibiotic training, needlestick/wound management.
• SFS, AMS into existing training/CPD.
• Cross cutting, partnership, coproduction of guidelines.

3. Investing in innovation

• Continue incentives to adopt tech/approaches to reduce AMU.
• Improve understanding.
• Continue AMU calculator to develop and incorporate good practice resistance.
• Strengthened priority but can we expand.
• Money for pilots?
• Arwain FAVSNET.
• Priority AHWP, Welsh version is coming.
• Surveillance, strengthened, what does this mean? What are the gaps? How can we make it useful?
• FAVSNET work, surveillance on antibiotic use and diseases.

4. Being a good global partner

• Showcasing what Wales/Arwain have achieved, what good looks like.
• Not a priority.
• Increase engagement with colleges and YFC. Make the next generation aware.
• ACTION: Invite someone from education umbrella organisation to talk to group. Probably UK level accreditation.
• ACTION: Extension of e-bug to further education in agriculture.
• Quality assurance for further education, UK wide accreditation body.
• ACTION: Review education action point and consider how this could be further acted upon. Pick up conversations with City & Guilds before next meeting. (KF)

• Overview:
  • Arwain is a Welsh Government-funded initiative focused on AMR in animals and the environment. It is a collaborative, multidisciplinary program involving farmers, vets, researchers, and industry experts.
• Key Activities:
  • Dissemination of Responsible Antimicrobial Use: Engaging with stakeholders, including farmers and vets, to promote responsible antimicrobial use.
  • Veterinary Prescribing Champions (VPCs): A network of over 50 motivated vets acting as change agents to promote best practices in antimicrobial use.
  • Innovation and Technology: Implementing technologies such as automated weighing systems, smart boluses, and motion detectors to improve livestock health and reduce antibiotic use.
  • Sample Collection and Analysis: Collecting samples from farms across Wales to study AMR pathways and inform interventions.
• Engagement and Outreach:
  • Events and Clinics: Hosting events and clinics to engage directly with farmers and vets, providing education and support.
  • Pledges and Public Engagement: Encouraging farmers to pledge responsible antimicrobial use and engaging with the public at events like the Winter Fair.
• Impact and Coverage:
  • Arwain has achieved significant engagement across Wales, with ongoing efforts to reach 100% coverage of large animal veterinary practices.
  • The initiative has been well-received, with increasing engagement and meaningful conversations with stakeholders.
• Collaborative Approach:
  • The program emphasizes a bottom-up approach, with guidelines and codes of conduct developed by vets for vets, ensuring greater acceptance and implementation of best practices. 

• UK VARSS Report:
  • The Veterinary Antimicrobial Resistance Sales and Surveillance (VARSS) report for 2023 was published in November.
  • Key findings include stable sales of antibiotics for food-producing animals, with a 59% decrease since 2014.
  • Sales of highest priority critically important antibiotics have decreased by 84% since 2014, now accounting for less than 0.5% of total sales.
• Medicine Hub Data Collection:
  • The Medicine Hub collects data on antimicrobial usage in the ruminant sector.
  • Current engagement levels are low, with only 30% data coverage for dairy, 10% for sheep, and less than 10% for beef.
  • Welsh data is overrepresented, thanks to efforts in Wales, accounting for 84% of sheep data and 80% of dairy data.  
• World AMR Awareness Week:
  • The VMD participated in World AMR Awareness Week in November, producing blogs, videos, and articles to raise awareness.
  • Activities included a blog on work supported by students in Zambia and a video featuring VMD representatives discussing AMR.
• International Engagement:
  • The UN General Assembly High-Level Meeting on AMR took place in November, resulting in 45 commitments around antibiotic stewardship and regulation.
  • Efforts are ongoing to develop global guidance on antimicrobial resistance in plants and to establish an independent panel for evidence-based action on global resistance, similar to the IPCC for climate change.
• National Audit Office Audit:
  • The National Audit Office is conducting an audit on AMR, focusing on England but including animals and the environment.
  • The audit aims to create a holistic picture of AMR efforts and is expected to publish findings in early 2025.  

• Project Overview:
  • The Microbiology Society is supporting a five-year project called "Knocking Out AMR," co-chaired by Catrin and Tina Joshi. The project focuses on therapeutics, vaccines, diagnostics, and surveillance to address AMR.
• Workshops and Engagement:
  • In January 2023, the society hosted eight workshops with over 120 experts from industry, government, non-profits, and funding bodies. These workshops used a complex systems approach to identify solutions for minimizing AMR.
  • The workshops produced detailed maps outlining barriers and solutions for accessible and affordable therapeutics, vaccines, diagnostics, and surveillance.
• Policy and Outreach:
  • The society has been actively involved in policy engagement, including participation in the UN General Assembly High-Level Meeting on AMR.
  • The society aims to provide a neutral platform for discussions, convening meetings, and facilitating communication between researchers, industry, and policymakers.
• Publications and Resources:
  • The society publishes research papers, with over 300 AMR-related papers published in the past year.
  • They offer grants for early career researchers and host events such as the annual meeting and focused meetings on specific topics like vaccines.
• Global Engagement:
  • The society's Champions scheme engages early career researchers globally, providing resources and support for AMR-related events and initiatives.
• Future Plans:
  • Upcoming events include a meeting on vaccines in February and the annual meeting in Liverpool in April, which will feature presentations from transdisciplinary AMR networks. 

GW thanked everyone for attending and explained to those attending in person that they were invited to stay for further networking if they wished.

With no further business, the meeting finished at 14:30 with optional networking until 15:00.