The work of the VMEC Animals and humans in the spotlight

The VMEC (Veterinary Medicines Expert Committee) is the counterpart to the HMEC (Human Medicines Expert Committee). Chair Barbara Knutti talks about her vocation for veterinary medicine, the variety of the job and the greatest challenges faced by the committee. We visited her at her home in the village of Corcelles in the canton of Vaud.

In the middle of nowhere

Corcelles is located in the northern corner of Vaud, on the border of the enclave on the south bank of Lake Murten. Agriculture predominates in the Broye valley. Animals are everywhere and at home in this village idyll. Slightly off the beaten track and almost under a road bridge live Barbara Knutti and her husband. On our arrival, the vet is still fussing around her dog Loki. "He's only 5 months old and very playful – I'm still training him", she smiles. Originally from Biel/Bienne, she grew up with animals ("My father was a hunter") and feels very much at home in the Broye countryside. "We're close to everything that makes live worth living; the people here celebrate the live-and-let-live principle – that's fine by us", she relates in a relaxed manner. In Corcelles Barbara Knutti has managed a veterinary practice for the past 20 years. "At one point, four vets were working for me – now that my husband has retired, I'm cutting down on my workload and once again running my business as a one-woman operation."

Animals and love

Barbara Knutti did not become a vet by chance. "I knew that's what I wanted to be when I was six years old", she smiles. Today, she specialises in the field of gynaecology, and has continued her professional development accordingly. "Each year I attend international congresses – in 2020 subjects ranged from the reproduction of snakes, via poultry to hippopotami. I was particularly interested in the retrieval of egg cells from horses and cattle." One of the most important discoveries made by Barbara Knutti: "In veterinary medicine, it's not just about the animal – the human aspect also has to be considered. We always work on behalf of the animal owner. When dealing with livestock, this means that our work affects the economic situation of the owner. With a pet, it's the emotional value that the animal has for the owner that's important. And ultimately we have an ethical obligation to the animal. A love of animals on its own is not enough to become a vet." For Knutti, her job is a vocation: "I've experienced a lot and had insights into many things. Both empathy and detachment are required at the same time. That's what really fascinates me." And "Veterinary medicines are my bread and butter – I think that we should all approach the use of drugs very responsibly."

Focused and wide-ranging

The VMEC is an expert committee comprised of professionals with know-how from as many specialist areas as possible. Each member is appointed for a four-year term of office. It has to comply with the legal requirements and to cover all specialist areas. “That includes, for example, some very unusual subjects such as the anaesthesia of rodents or poultry, specific bacteria or the life cycles of parasites", explains the VMEC Chair.

Comprehensive and detailed

Each year, the VMEC usually receives around ten applications that need to be reviewed. Barbara Knutti cites an example to illustrate exactly what's involved. "This was a product for equine joints that we had already authorised. The new application requested an additional intravenous form for the treatment of horses before competitions", she recounts. The VMEC now had to clarify whether this posed a tolerability risk and establish just how effective it was. "In the end, we had to conduct a risk/benefit assessment and determine whether it made sense to authorise the revised product. A clinical improvement after intravenous administration was observed in the studies, although it could not be confirmed that the active substance accumulates in the joints. We considered the new delivery form to be safe – primarily because no side effects occurred." The product was eventually authorised after extensive investigation of the intravenous administration.

Subjects and committees

The VMEC experts meet from three to five times a year to scrutinise the dossiers of certain products submitted for authorisation. It also addresses subjects such as European legislation, concept papers or general documents that need to be harmonised in the overall context with the European Medicines Agency (EMA). "We want to be in line with the European directives. For example, in light of the latest studies on the risks to humans we have completely eliminated an antibiotic that we had been using for years – much like in the EU." Equally importantly: "Of course, we review what our colleagues in Europe and the USA publish, but ultimately we ourselves always decide what we will, or will not, recommend for authorisation", explains the VMEC Chair.
To take one example: We in Switzerland have stricter legislation relating to animal protection and animal husbandry, which restricts or prohibits the use of certain products. Or we require the use of antibiotics to be monitored, which may prompt a company to withdraw an authorisation application because the cost of monitoring would be too great compared to the relatively small Swiss market. For each application, the VMEC issues a recommendation for the attention of Swissmedic. Swissmedic then makes the actual decision on authorisation.

Challenges and potential

As the VMEC Chair, Barbara Knutti also serves as the link to Swissmedic. She contributes her extensive veterinary experience, ideally with examples from practice. "We have to resolve the potential conflicts between animal health and food production, make the right decisions and keep an eye on the big picture. Since joining this committee, I have changed and, in particular, widened, my personal perspective: I now use medicines much more consciously and think about whether they are needed and whether I'm using them correctly. I now know just how much knowledge lies behind them and what factors are crucial", says the VMEC Chair in summing up her work. At the same time, she looks to the future: "We need to focus even more on combining our broad knowledge. As a committee, we operate in a very straightforward manner and are able to make quick decisions and reach a consensus. The most important need is to continue this dialogue – for the good of veterinary medicine."

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