The Situation in Denmark

The Situation in Denmark
and the Danish Approach and Experiences
Tim Petersen
Special Vet. advisor, business developer and project manager
DVM, GDBA
Division for Animal Welfare and Veterinary Medicine

2
Menu
• Denmark in Numbers in Short
• The Yellow Card Initiative
• Results so far
• Other Important Initiatives on
Antimicrobials

3
21+ million pigs
slaughtered 2010.
6+ mill. piglets
exported 2010.
Pig Population
app. 12.5 mill.
Human
Population 5 mill.
Denmark in Numbers

4
Use of Antibiotics in Animal Production in Denmark
Tonnes (active component)
250
200
150
100
50
0
1990
1992
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
Therapeutic AGPs
2004
2005
2006
2007
2008
2009
2010

5
100
50
0
Contribution of Pig Consumption
24 24 23
Veterinary use
of antibiotics in tons
2001 - 2010
Pigs Other species
22 22 26 25 25
72 72 79 90 90 88 94 93 104 100
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
26
18

6
The Yellow Card Initiative

7
Monitoring of use of Veterinary Medicines
VetStat
Veterinary Prescription Medicine Data Input
Since 2001
Vet
Pharmacy
10% 85% 5%
VETSTAT
Feed
plant

8
Monitoring of use of Veterinary Medicines
VetStat PIGS
Veterinary Prescription Medicine Data Input
Vet
Pharmacy
< 1% > 97 % 2 %
VETSTAT
Feed
plant

9
Farmer
Slaughter houses
Markets
Export facilities
Central Husbandry Register
Animal data input
CHR

10
• Data:
The Concept in short
• Amount of antibiotics used on farm in a specific age
group in ADD (from VetStat)
• Number of pigs days for that specific animal group
(from CHR)
• The Yellow Card Level
• Based on 9 months average
• Amount antibiotics used / Number of pig days

11
9 months rolling avg.
(ADD/100 animals per day)
National mean
Yellow Card Threshold
The Threshold Levels
Finishers
(30 – 120 kg)
4
8
Weaners
(7 – 30 kg)
14
28
Targeting 5 – 10 % of all pig farms
Sows
(>120 kg)
2,6
5,2

12
The Yellow Card – In Short!
Yellow Card Increased Supervision Red Card
Second
Opinion
9 mth. 5 mth. Until below the threshold
www.dvfa.dk > Animal Health > The Yellow Card Initiative on Antibiotics

13
Risk Communication
Tools to Assist the Farmer/Vet

14
Tools to Assist the Farmer/Vet �

15
Tools to Assist the Farmer/Vet �

16
K g a c tiv e d ru g p e r 1 0 0 0 s w in e
2,40
2,20
2,00
1,80
1,60
1,40
1,20
1,00
1
05
2
05
3
05
4
05
1
06
2
06
3
06
4
06
Antibiotics 2005 - 2011
per 1000 swine
Yellow card reduction 30 % since 1.Jan 2010
Same level 3rd quarter 2011 as 5 years ago
1
07
2
07
3
07
4
07
1
08
2
08
3
08
4
08
1
09
2
09
3
09
4
09
1
10
2
10
3
10
4
10
1
11
30%
2
11
3
11

17
14500
14000
13500
13000
12500
12000
11500
11000
10500
Pig Population in Denmark
Pigs in Denmark
(X1000)
10000
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Data from Statistics Denmark

18
What Should the Farmer Do To Meet the
Expectations?
• Non-antimicrobial Preventive measures
– Ensure adequate facilities for the production of
pigs
– Improve on vaccination strategies
– Improve on management, feeding and watering
– Improve on breeding and aquisition of pigs
– Improve production hygiene

19
25
20
15
10
5
0
Effect of Strategies
Prevention of Disease - Vaccination
Vaccinations per 1000 swine
Antal_vac._pr.1000 svin

20
Kg aktivt stof pr 1000 svin
Effect of Strategies – Administration Routes
1,2
1
0,8
0,6
0,4
0,2
0
1. kv 2008
2. kv 2008
3. kv 2008
Injection- and oral treatment per 1000 svin
2008 to 2011 3kv
4. kv 2008
1 kv 2009
2 kv 2009
3 kv 2009
4 kv 2009
1. kv 2010
2. kv 2010
3. kv 2010
4. kv 2010
1. kv 2011
2. kv 2011
3. kv 2011
Injek_pr_1000_svin
Vand_med_1000_svin
Foder_med_1000_svin

21
Yellow Card Discussion
Large decrease in usage could be attributable to:
• INCREASED AWARENESS ON VET AND FARMER LEVEL
• GOOD RISK COMMUNICATION VIA GRAPHS IN VETSTAT
AND/OR
• Poorly managed herds with low productivity and high usage of AM close business
• AND/OR
Stop of previous over-treatment
Present under-treatment – DVFA will do inspections
Effect of new (treatment) guidelines
Improved motivation for non-antimicrobial strategies
– Increased use of vaccination strategies
– Increased diagnosis quality and testing frequency
– Improved management reducing disease prevalence etc.

22 22
Fluoroquinolones 2002
Strategic use – lab tests
Action plan 2007
Cephalosporin focus
Supervision all vets
2010
Swine industry 1. July
Cephalosporin ban
Evidence based
treatment guidelines
Effect of strategies on CIA
Cephalosporines (3rd og 4th gen.) and
Fluoroquinolones for production animals
Kg aktivt stof
140
120
100
80
60
40
20
0
Source: DTU
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Svin, Cephalosporin, syst.
Kvæg, Cephalosporin, syst.
Kvæg,Cephalosporin, intram.
Svin, Fluorkinolon, syst.

23
So – What Does Denmark Do?
• Monitoring of use of veterinary medicine
• Monitoring of antimicrobial resistance
• One-on-One relationship between farmer and vet
• Focus on prevention through professional veterinary advise
• Restricting use of Critical Important Antibiotics
• Restricting use of antibiotics in general
• Focused risk communication on both CIA and AM in general

24
Thank you for your attention!
Questions?
tipe@fvst.dk