French vets let off the hook regarding ‘decoupling’ of critical antibiotics
In France, the proposed legislation on the future of agriculture will be discussed early
2014 by the Members of Parliament. It contains a series of measures aimed at reducing
antibiotic use for the control of antimicrobial resistance. Between October 8th and
November 4th, 2013, the Ministry of Health introduced the ‘decoupling’ of prescription
and dispensing for critical antibiotics, limiting their sales to pharmacies alone. On 4
November, the French government officially withdrew this added proposal, in view of
the announced demonstration and nation-wide strike of the veterinary profession
(“Vétérinaires en colère” – “Vets in anger”) as well as its arguments that showed the
futility and even the counter-productive effect of the measure.
On 4 November, French ministers of Agriculture Stéphane Le Foll and of Health Marisol
Touraine met with the presidents of the Order of veterinarians (statutory body) and other
veterinary bodies, just two days before the announced nation-wide veterinary strike and
demonstrations in front of the Ministry of Health, on 6 November.
During the meeting, veterinary representatives were officially informed of the withdrawal of
the proposal regarding the partial ‘decoupling’ of critical antibiotics. This provision was
added ‘through the backdoor’ by the Ministry of Health after the conclusion of the consensus
procedure with veterinary and agricultural professional bodies. It proposed to ban the
veterinary dispensing of so-called critical antibiotics and to restrict their supply to pharmacies
alone. In only three weeks, the provision won unanimous opposition. Shocked by the lack of
confidence of the government in their profession, veterinarians rapidly rallied to organise a
“day without vets” on 6 November. Nearly all veterinary practices closed on 6 November,
only handling emergencies. Many veterinarians and veterinary students came to demonstrate
in Paris and marched on the Ministry of Health in protest against this measure.
Many arguments were put forward to persuade the government and the Ministry of Health to
withdraw its October decision. At 48 hours before an unprecedented protest demonstration by
French veterinarians, the government decided to replace the decoupling provision by three
other measures, reached in consultation with the profession during the 4 November meeting.
1) A target figure of reduction of the use of critical antibiotics will be set by law. The French
plan EcoAntibio2017 already set an objective of a 25% reduction in antibiotic use. But this
non-binding target is not enshrined in law and is not specific to critical antibiotics.
2) A network of regional veterinarians referent on ‘critical antibiotics’ will be set up
(comparable to referents on a certain disease in animal productions).
3) The use of ‘critical antibiotics’ will be guided by best practices developed under the
auspices of the French Food Safety Agency (Anses). Best practice guidelines are already
being developed in the framework of the EcoAntibio2007 plan by the various veterinary
associations (SNGTV for production animals, Afvac for companion animals, Avef for horses).
This new measure would consist of making the recommendations on critical antibiotics more
binding and of a closer involvement of the Anses in their definition.
According to the French government, the veterinary profession is committed to implement
these three measures. A working group of veterinarians and representatives of the ministries
of Health and Agriculture has already been set up with this objective. It will help to elaborate
the new provisions and to insert them into the legislative proposal that will be tabled on 13
November by the Council of Ministers. It is not clear whether these new provisions will be
ready by November 13, or if they will be added as amendments during consideration by the
Parliament, early 2014.