India ban shows need for ‘proactive’ antibiotic policy, RVC-led study claims

The decision to end use of an antibiotic on Indian livestock could provide a framework for similar regulatory decisions elsewhere, a new study has suggested.

But RVC researchers have warned policymakers must adopt a “proactive” approach to help combat resistance based on their analysis of India’s 2019 ban on colistin.

The college collaborated with institutions in West Bengal, Gujarat and Tamil Nadu for the paper, published in Preventive Veterinary Medicine.

Key factors

It identified five key contributing factors to be considered when developing future antibiotic policies:

• Key-focusing events
• Consistent narratives
• Worthwhile endeavour
• Precedent for change
• Lack of substantial opposition

Resistant gene

Colistin has long been used to treat livestock since its discovery in 1947 and was deemed by the WHO as “critically important” for human health in 2011.

The paper noted that two major antibiotic events preceded the ban – the discovery of a mobile colistin-resistant gene in bacteria from a pig in China in 2016, and evidence of colistin resistance in bacteria found in Indian food samples the following year.

It said low levels of colistin resistance in humans, below 10% prior to the ban, had indicated it would be beneficial to preserve its effectiveness in humans by pursuing legislation, while a lack of opposition from the poultry sector based on alternative treatments limited obstacles to its passage.

‘Much-needed’

Two other antibiotics commonly used to treat livestock in India, fluoroquinolones and macrolides, were identified as potentially more challenging to regulate than colistin.

But lead author and RVC researcher Mat Hennessey said: “Given that other antibiotics deemed critically important for human health are still being used in livestock on a large scale, we urge states and stakeholders to consider how to act proactively to develop further meaningful antibiotic policy.

“The factors we identify in our review provide a useful framework for this much-needed action.”