Antimicrobial Resistance, homeopathy and the Soil Association

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Robyn Lowehttps://www.facebook.com/veterinaryvoicesuk
Robyn J Lowe BSc Hons, Dip AVN (Small Animal), Dip HE CVN is a small animal Registered Veterinary Nurse (RVN) who regularly writes articles for academic journals and publications for animal owners. Robyn has a passion for evidence-based medicine, volunteers for Canine Arthritis Management, runs the Veterinary Voices Public Page, and campaigns on mental health and animal welfare issues.

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The Soil Association was one of the founders of the global organic movement and developed some of the world’s first organic standards. Their intent is to protect producers, consumers and the soil by endorsing ‘nature-friendly’ farming methods and practices.

The Soil Association aims to develop high standards for food, farming, health and beauty, and textiles, as well as to protect forestry. They work across Europe to influence legislation, and through their work with the International Federation of Organic Agriculture Movements (IFOAM), they aim to support organic farming methods internationally.

In a way, this parallel focus on animal welfare, human health, and safeguarding the environment encapsulates the idea of ‘one health’; an approach that recognises that our health is closely connected to the health of animals and our shared environment. The COVID-19 pandemic has shown us just how devastating diseases can be, and with our lives interlinked with animals, livestock, and the environment, and with an ever-increasing population with its growing demand on resources, the Soil Association are incredibly aware of the importance to protect from both from disease, and from antibiotic overuse.

Antimicrobial Resistance

The World Health Organization states that antimicrobial resistance (AMR) is a global health and development threat, requiring urgent multisectoral action. Of course, antibiotic overuse and resistant bacteria are not just issues in human healthcare – many farming practices involve the use of antibiotic treatments.

Antimicrobial resistant organisms are found in people, animals, food, plants and the environment (in water, soil and air). They can spread from person to person, or between people and animals, including from food of animal origin.

The WHO states that the main drivers of antimicrobial resistance include the misuse and overuse of antimicrobials; lack of access to clean water, sanitation and hygiene for both humans and animals; poor infection and disease prevention and control in health-care facilities and farms; poor access to quality, affordable medicines, vaccines and diagnostics; lack of awareness and knowledge; and lack of enforcement of legislation.   

While in the UK we restrict prescribed treatments for the management of disease, some countries (particularly the USA) allow farmers to give livestock a low dose of antibiotics to prevent illnesses and even to promote growth. The EU banned such use of antibiotics in 2006.

Furthermore, as well as using antibiotics only when needed, there are a number of things the agricultural sector can do to reduce disease risk in their animals – which ultimately can lead to even less disease and antibiotic usage.

Antibiotics Stewardship

In 2017, farm animals accounted for around 30% of all antibiotics used in the UK. Despite this, agricultural use in the UK is among the lowest in Europe – although historically, dairy, beef and sheep sectors have struggled to provide evidence of their levels of use.

Currently, dairy farms are well on course to meet targets for reduction in antibiotic use. A report tracking usage on dairy farms across the British herd from 2017 to 2020 found that the use of injectable Highest Priority Critically Important Antibiotics (HPCIAs) has fallen by 96%. Overall, sales of antibiotics for use in livestock have reduced by 55% since 2014 to the lowest ever recorded level.

Antimicrobials and Soil Association

Organic farming aims to maintain animal health through prevention of disease and minimising the use of veterinary medicines. Overall, this is a laudable aim, as veterinary professionals always strive for prevention over cure. There are a number of factors which play into the health and welfare of our farm animals, and there are dietary, healthcare and husbandry measures that can all help reduce the instance of disease.

The basis that disease management must be based on preventative measures is sound. The Soil Association allows famers to draw up a health plan to show how they will build health and reduce disease, where their preventative measures include:

  • Breed and strain selection
  • Husbandry management practices
  • High quality feed and exercise
  • Appropriate stocking density
  • Adequate and appropriate housing maintained in hygienic conditions
  • Biosecurity measures
  • Grazing and range management
  • Stockmanship
  • Welfare assessments
  • Breeding and culling management

My concern

While this all seems enormously positive and sensible, the concern here lies in the wording of the Soil Association’s position. The SA states that a farmer “must be able to demonstrate that [they] are treating animals affected by disease, injury or ill-health quickly and effectively” and “that the use and application of treatments should be given under professional guidance”.

This sentiment will be mirrored by veterinary professionals, who want to ensure that livestock have access to quick and effective treatment, to alleviate unnecessary pain and suffering.

But here is the snag, and where the removal of a single word could improve guidance substantially, to bring it into line with evidence-based medicine, and to mirror the values of the Soil Associate to treat livestock with effective treatment. The guidance goes on to say:

When treating you must use phytotherapeutic and homeopathic products and the trace elements, vitamins and minerals listed in standard in preference to chemically-synthesised allopathic veterinary treatment or antibiotics, provided that their healing effect works for the animal species and the condition you are treating.

The inclusion of homeopathic products in this statement is hugely problematic. Homeopathy is a “treatment” based on the use of highly diluted substances, which practitioners claim can cause the body to heal itself. There is sufficient body of evidence to support the conclusion that homeopathy has no medicinal properties, and works no better than a placebo.

There is no reliable evidence from research in humans that homeopathy is effective for treating health conditions, and such is the case within the veterinary field too: studies of a robust nature reported that homeopathy was not more effective than placebo. Overall, there is weak evidence in favour of homeopathic remedies, but (as expected) strong evidence for specific effects of conventional evidence-based interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.

In their standards, the Soil Association clearly state:

[the farm] must be able to demonstrate that they are treating animals affected by disease, injury or ill-health quickly and effectively

Here, I believe the standards are self-contradictory – we cannot have quick and effective treatment while promoting the use of homeopathy in preference to conventional veterinary treatment.

The aims of the Soil Association are commendable, and based on the concerns of many within the human medicine, veterinary medicine and agricultural sector, to ensure the health and welfare of livestock, as well the protection of the wider health of our society and environment. However, the inclusion of homeopathy in the guidance fundamentally undermines their aims – to treat effectively, but treat first with a substance known to be no more effective than placebo? This is hopelessly contradictory.

For the Soil Association to live up to their laudable aims, they need to update their standards to remove any endorsement of homeopathy, and align instead with the most current and up to date evidence base.

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