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Dr Leslie SIMS

Dr Leslie SIMS

Dr Leslie SIMS

Director and lead consultant, ANDI Ltd, Hong Kong and Asia Pacific Veterinary Information Services, Australia

Dr Les Sims is a veterinary consultant and former Assistant Director of the Department of Agriculture, Fisheries and Conservation. He has over 40 years’ experience working as a veterinary diagnostician and animal disease manager both in government and as a private consultant. He has been working at the human-animal interface for much of his career, long before it was referred to as “One Health”.

He is currently leading a group developing recommendations on monitoring systems for antimicrobial use and resistance for animal production farms (pigs, chickens and aquaculture) for Hong Kong. He was a lead consultant in production of Viet Nam’s One Health plan for 2016 – 2020, highlighting antimicrobial resistance as one of the core areas, and a technical advisor for an IDRC funded research programme on antimicrobial resistance in South East Asia. He was a leading technical advisor for the international company Yum! (parent company of KFC and Pizza Hut) in development of their policies on antimicrobial resistance.

Dr Sims has spent much of the past 20 years shaping and working on policies for control and prevention of avian influenza since it emerged as a potential pandemic threat and public health issue of global concern, on which billions of dollars have been invested. During this time he worked for and with the major international agencies providing the response, especially FAO and the World Bank, and was a member of a team that performed a review of the UN system influenza coordination (UNSIC), the group led by Dr David Nabarro. He sees many parallels between the responses to avian influenza and AMR, including areas that had or will likely have limited success. We risk making the same mistakes with AMR that were made when avian influenza was elevated to an issue of global concern. Ways to reduce this risk will be explored in his presentation.

Session 5: From action plan to actions (2)

[5.4] Antimicrobial resistance in food animals in Asia - can it be reversed?

Plans for containing antimicrobial resistance in food animals are based largely on improving disease management and antimicrobial stewardship. In some cases, dramatic falls in resistance have followed reductions in use of selected antimicrobials in animals. In other cases, resistance has either remained steady or reduced slowly, even in countries that apply global best practices for antimicrobial use in food animals, such as Denmark and the Netherlands. Resistance patterns in farmed animals in Asia reflect indiscriminate use of antimicrobials in the past. Baseline levels of resistance for most antimicrobials are much higher than those in high income European countries. Another health crisis attracted global attention in 2006 when zoonotic avian influenza H5N1 viruses infected poultry in over 60 countries. This resulted in heightened concerns regarding human pandemic preparedness and a multibillion dollar global investment to prepare for and contain these viruses. Today, these viruses are still endemic in a number of countries and pandemic preparedness remains weak. Several factors that resulted in endemic infection are relevant to programmes for antimicrobial resistance, including weak veterinary services and complex, poorly biosecure production chains. These factors will interfere with antimicrobial stewardship which, even when well managed, may not produce the reductions in resistance required. In 10 years, levels of resistance in Asian farm animals will likely be similar to today – an unacceptable result. Some reduction in resistance to critically important antimicrobials may occur but requires finding appropriate alternatives for farmers to use. Progress in reducing the One Health (human and environmental) effects of antimicrobial resistance will therefore require investment in alternative approaches, including identifying ways to contain AMR organisms/genes to farms. Options include improved methods for livestock waste treatment and examination of novel ways to manipulate the intestinal microbiome in animals prior to leaving farms so as to reduce the number of resistant bacteria.