Antimicrobial resistance: Wicked challenge for livestock farmers in low- and middle-income countries
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The document discusses antimicrobial resistance (AMR) in livestock farming, particularly in low- and middle-income countries (LMICs), highlighting the significant knowledge gaps and misconceptions among farmers about AMR and its transmission. It identifies issues such as the misuse of antibiotics, lack of training for agricultural service providers, and the influence of socio-economic factors affecting both livestock production and AMR awareness. The document emphasizes the need for a multi-faceted approach, including education, policy enforcement, and gender-sensitive strategies, to effectively mitigate AMR risks.
Antimicrobial resistance: Wicked challenge for livestock farmers in low- and middle-income countries
- 1. Antimicrobial resistance: Wicked challenge for livestock farmers in low- and middle-income countries Arshnee Moodley and Delia Grace 5th International Conference on Responsible Antibiotic Use in Animals, 7–9 June 2021
- 2. CGIAR and ILRI: Better lives through livestock! Reduce poverty Improve food and nutrition security Improve natural resources Source: Options for the Livestock Sector in Developing and Emerging Economies to 2030 and Beyond. World Economic Forum White Paper January 2019 Market value of Africa’s animal-source foods to grow to ∼$151 billion by 2050 (from ∼$37bn in 2019) Most livestock products are sold locally and informally
- 3. Disportionate effect in LMICs 2017 2019
- 4. CGIAR AMR Hub mitigating agricultural associated AMR risks www.amr.cgiar.org
- 5. CGIAR AMR Hub • Strength – partnerships (Multi CG centres, external partners incl. governments
- 6. Hub project activities Major activities • AMU, drivers, KAP • AMR Prevalence & Transmission (interfaces) • Cap. Building (lab capability and mentorship) • Interventions incl. pilot studies, economic analyses Minor projects • AMU and AMR in crop systems • Fate and transport of AMR in water bodies • AMR in wildlife and bushmeat • AMR and manure • AMR Policy ILRI alone: 2020-2025, AMR projects equal US$ 6.8 million
- 7. AMR lab at ILRI Kenya • MOU with ICARS and EUCAST • AST knowledge center on the continent • EUCAST trainings (EDL in Växjö and ILRI, Nairobi) Genomics platform
- 8. Fundamentals of reducing AMU and spread of AMR Reduce use • AMU surveillance • Ban/restriction • Education-Awareness compaigns • Evidence based treatment decisions • Treatment guidelines • Vaccines use • Limiting profit of prescribers Reduce transmission • AMR surveillance • Biosecurity • Hygiene/decontamination Challenges in LMICs Corruption Low trust in authority No financial subsidies
- 9. Livestock production in LMICs https://www.flickr.com/photos/ilri/ Nairobi, Kenya Busia, Kenya
- 10. Livestock products slaughtered, transported and sold in informally Manure “management?” https://www.flickr.com/photos/ilri/ Kampala, Uganda Iringa, Tanzania West Bengal, India Iringa, Tanzania Nairobi Kenya Busia, Kenya
- 11. What happens if an animal is sick in a LMIC? https://www.flickr.com/photos/ilri/ Tanzania
- 12. 2021 5/7 commonly used are combination of antibiotics and multivitamins 44-69% of farmers reporting using the two combinations Manufacturer’s indication label “stimulates egg production, increases growth, improves feed conversion”
- 13. BUILD Uganda: Poultry value chain Soroti Wakiso
- 14. KAP survey amongst farmers 73% had little knowledge about AMR 60% didn’t know know that AMR could be transmitted 77% didn’t know that resistant bacteria can be found in meat or eggs 58% believed that AMR in chicken cannot affect clients (consumers) 65% didn’t think good biosecurity measures, hygiene and vaccinations could reduce AMR 65% farmers in Wakiso felt that the Government is to blame for AMR issues 56% didn’t know that AMR was an issue in Uganda 81% believed it was OK to use expired drugs and it did not contribute to AMR 70% don’t receive additional benefits if they observed the the withdraw period https://hdl.handle.net/10568/107443
- 15. KAP survey amongst agrovets 11% had no previous training about poultry 58% did not have any AMR training (68% in Wakiso) 77% did not know that AMR affects chickens in both poor and rich countries 62% thought that AMR does not contribute to treatment failure if a stronger antibiotic In Soroti, 91%, did not believe that good biosecurity, hygiene and vaccinations could reduce infections in poultry 81% believed that the Government is to blame for AMR In Wakiso 81% believed that AMR is not associated with poor prescription practices 42% thought vaccinations does not reduce AMR
- 16. Use of ARVs in livestock production in Uganda Slaughterhouse in Kampala and Lira Blood samples: 27.4 % of test positive
- 17. • 1.4 million people have HIV (2018), and ARVs are available for free • Farmer need to max. profits, max. market share but min. input and shortest turnaround time • Low income country with 40 million people • 41% live below the poverty line, 25% food insecure, 39% have access to drinking water • 58% of households depend on livestock • 92% are subsistence smallholders farmers • Jan-Aug 2019 in 10 districts in Uganda • Are ARVs being used? If so, why? • Can ARV residues be detected in feed, blood or animal tissue destined for human consumption? • Chicken liver, pig muscle and blood
- 18. Are ARVs being use and if so, what are the drivers for use? YES • Mixed in feed or water ($0.2-2/tablet or in-kind) • Drivers of use: • Growth promotion (increase appetite, accelerate growth and weight gain) • Increase milk production (sows) • Prevent or treat Newcastle disease virus, African swine fever virus, mycoplasma infections • lack of good quality feed • Cost of vaccine, lack of access to vaccines or other alternatives to prevent infections • Veterinarian costs too high • ARVs administered by AHSPs as they supported the practice Did we find residues? YES • 9% of samples test positive for 2/4 ARVs in 7/10 districts • Significance? Risk to human health? • Consequence of agricultural misuse and low dose → ARV Resistance
- 19. We can’t regulate our way to reducing AMU and AMR: Regulation is needed but it’s not enough Kenya: prescription only Reality: Without prescriptions Kenya: Agrovets are trained and registered with the KVB Reality: Employ unqualified staff to dispense drugs and advice ~80% of farmers either self diagnose or rely on untrained animal health providers Corruption and low trust in government Limited resources to enforce regulations Policy gaps We can’t train our way to reducing AMU and AMR: Capacity building is useful if incentives are in place Training not just about knowledge transfer - not enough To improve or change behaviour coupled with incentives Willingness to pay: consumers don’t have economic power Need an enabling environment New project: Exploring the use of behavioural “nudges”
- 20. Need for gendered approach to reducing antibiotic use • “farmer” = man in the field or with his livestock • 2/3 of 600 million poor mixed crop-livestock farmers are women • 5-10% of farms in NED, DK, DE are managed by females (Eurostat 2016) • Women do most of the day-to-day farm animal management plus household chores • Gender-blind intensification interventions can inadvertently cause women to lose their business • Gender-dynamics can negatively affect willingness to adopt new vaccines → Increase workload for women • Vaccine delivery systems tend to target men farmers, making it difficult for women to access them e.g. distance to a vaccination point Effective interventions to reduce antibiotic use AND empower rural women livestock farmers?
- 21. Mitigating agricultural associated AMR risks together! Michel Dione, Barbara Wieland, Hu Suk Lee, Delia Grace, Kristina Roesel, Fred Unger, Bernard Bett, Hung Nguyen, Eric Fevre, Ulf Magnusson (SLU)
- 22. THANK YOU
Editor's Notes
- #7: Studies conducted In different value chains
- #12: Often vets are not consulted – too costly → unqualified people offering 82% will self diagnose and administer antibiotics without input/advice 25% of vets will make a diagnosis without seeing the animal 1% will confirm with a laboratory test Farmers calls the vet when infections is severe/close to death especially beyond his/his friends experience Vet-can be based at the agrovet, ambulatory/roaming vet, extension officer/ on the rare occasion vet surgeon in practice. Phone consultation if there is not vet in the vicinity. Vet visit is costly (consul. Fee+transport) and then the cost of treatment The value of the animal also factors in. High value animals e.g. cow would warrant a call to the vet. Self diagnosis- no vets around or too costly Agrovet farm visit only if agrovet is a vet/paraprofessional No back checking with vets for validity No paper prescription-farmers are illterate Unqualified people offering advice- cheaper rates than 82% of farmers will self+diagnose the problem and administer antibiotics without input from animal health person or advice from agrovet/drug store low levels of awareness and knowledge around AMU, AMR risk perceptions and that AMU appears to be far from informed and prudent Apart from treating sick animals and not always respecting the prescribed dosage, most farmers report using antimicrobials for disease prevention in an entire flock and/or as growth promoters In Kenya: 25% of vets will make a diagnosis without seeing the animal, 1% will confirm with a laboratory test, 6-25% will sell a single dose/one time measurement based on farmer’s economy) reuse old prescriptions Wrong use of AM among at least 80% of livestock keepers Cross-over use: including us of ARVs Prescription vs. no prescription sales 37-100% of retailers provide antibiotics without prescription Prohibited sales of antibiotics without a prescription but no mechanisms for monitoring non-compliance Revenues from sale of antibiotics
- #17: Transforming subsistence to commercial (National Povery Eradication Plan)
- #18: Transforming subsistence to commercial (National Povery Eradication Plan)
- #19: e.g. 30 tablets mixed with 100kg maize bran and given continously to pigs “If it can treat HIV it should be able to treat animals diseases” To increase appetite and body weight as seen in HIV patients on ARVs
- #20: need follow up – to reinforce and have a behaviour change
- #21: Meat, milk and eggs are key sources of nutrition for their families