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For effective awareness raising on prudent use of antimicrobials, dairy farmers need regular education and veterinary experts need tools and strategies to educate farmers on prudent use of antimicrobials, a new research study says. Antimicrobial resistance (AMR) is a global public health threat and the indiscriminate use of antibiotics in the animal health sector contributes to increasing rates of AMR. In India, studies involving dairy farmers have found knowledge levels regarding antibiotics and AMR to be very low. The study, published in Frontiers in Public Health, was conducted in September to December of 2018 in some parts of Haryana, Assam, Karnataka, and West Bengal to assess different methods to raise awareness and knowledge about AMR and antibiotic use among dairy farmers, veterinarians and veterinary assistants (paraveterinarians). The study had two parts: an intervention meeting (September–October 2018) which consisted of focus group discussions (FGD) with farmers, key informant interviews (KII) with veterinary professionals along with distribution of information packages, and then a follow-up survey (November–December 2018). The villages were randomly allocated to either one of the four intervention approaches (1-FGD/KII and information package on AMR; 2-FGD/KI and information on animal health; 3- FGD/KII and information package on animal health plus information on AMR; or 4- only the FGD/KII). A follow-up survey was done to assess the effect of interventions. A total of 274 dairy farmers and 51 veterinary professionals (21 veterinarians and 30 paravets) participated in the follow-up survey. Many of the farmers and veterinary professionals who participated in the follow-up survey had been part of the intervention meetings. The average knowledge score of farmers was 7.8. It was found that the knowledge score was higher amongst farmers who had participated in the intervention meetings, had received intervention approach 2 or approach 3 , and amongst female farmers compared to male. The veterinary professionals had good knowledge but lacked interest in training the farmers about antimicrobial resistance. The study showed that a higher percentage of farmers and veterinary professionals who attended the intervention meeting had improved knowledge. Citation Sharma, G., Mutua, F., Deka, R.P., Shome, R., Bandyopadhyay, S., Shome, B.R., Kumar, N.G., Grace, D., Dey, T.K. and Lindahl, J. 2022. Comparing the effectiveness of different approaches to raise awareness about antimicrobial resistance in farmers and veterinarians of India. Frontiers in Public Health 10: 837594. 

Written by Elliot Carleton On November 18, the first day of World Antimicrobial Awareness Week, the CGIAR Antimicrobial Resistance (AMR) Hub hosted a virtual seminar addressing antimicrobial awareness. Launched in 2019 and led by ILRI, the AMR Hub is a global research and development partnership for reducing agricultural-related AMR in low- and middle-income countries. Moderated by Ekta Patel, a scientist and communications manager at ILRI, the seminar began with opening remarks from ILRI director general Jimmy Smith. ‘Climate change and COVID-19 have seemingly knocked AMR off the global agenda’, said Smith. However, AMR is not a problem the world can afford to overlook. Without urgent action, AMR could cause 10 million deaths annually by 2050 along with a 3.8 per cent reduction in global GDP. Faced with these challenges, the AMR Hub has been working with ILRI and other CGIAR partners, including the International Food Policy Research Institute (IFPRI), WorldFish and the International Water Management Institute (IWMI), on research projects to address AMR's connection to livestock, fish and water, which are among the most significant contributors to global AMR. The Hub can be expanded to include other CGIAR centres in the future. Despite this recent progress, 'there is still a lot of work to be done', said Smith. Scientists do not yet have accurate data on aggregate antibiotic use. Although we know the impact of AMR is significant, this complicates attempts to pinpoint AMR's overall impact on the developing world. As a result, many developing countries have not recognized the urgency of the crisis, leaving them vulnerable to AMR's potentially devastating effects on both human and animal health, not to mention the economy. For this reason, further research is needed to build evidence of AMR’s impact on developing countries and support innovations that can help farmers provide animal care without relying on antibiotics. It is also necessary to ‘build capacity in developing countries, design and enforce standards on antibiotic use, and expand advocacy for AMR solutions’, said Smith. The AMR Hub will be at the centre of this work going forward. Smith was followed by Elwyn Grainger-Jones, managing director for the new CGIAR institutional strategy and systems division. Grainger-Jones noted that just like with climate change 15 years ago, efforts to address AMR are hindered by the need for more data and a lack of urgency to address the crisis in many countries. However, the CGIAR can learn from its experience with climate change by recognizing the ‘need to invest early and build recognition that agriculture is both part of the problem and part of the solution to AMR’, said Grainger-Jones. Anders Dalsgaard, a veterinarian and microbiologist who helped establish the International Centre for Antimicrobial Resistance Solutions (ICARS), spoke next on the ‘opportunities for collaboration between the CGIAR AMR Hub and ICARS’. One avenue for collaboration is on antimicrobial susceptibility testing, which ‘will allow African stakeholders and researchers access to training, identification and testing of bacterial isolates’, said Dalsgaard, which are necessary to document AMR’s impact. Dalsgaard also urged people to shift their perspective on AMR mitigation, saying that ‘prevention and control of AMR should not just be seen as costs because investments will save both lives and money’. Arshnee Moodley, an ILRI scientist and CGIAR AMR Hub leader, was next to speak. She highlighted the importance of the Hub's global partnerships with both CGIAR centres and national governments. ‘AMR is a One Health issue, and the partnerships at the centre of the hub can allow us to take the One Health approach required to address AMR’, said Moodley. Moodley also expressed the need to address livestock's contributions to AMR. Two-thirds of all antibiotic use is in livestock as antibiotics are widely available and affordable for farmers. Addressing this problem can be difficult given the differences in livestock systems around the world, so the hub is working to develop solutions that are cost-effective and sustainable as well as 'locally relevant and context specific', said Moodley. Other key comments were raised by Jerome Delamare-Deboutteville of WorldFish and Javier Mateo-Sagasta of IWMI. Delamare-Deboutteville highlighted the role aquatic food systems have in contributing to global AMR, saying that ‘67 different antibiotics are used in 11 major aquaculture producing countries’. To address these concerns, WorldFish is currently leading a variety of projects to ‘build our understanding of AMR in aquatic food systems’. Water environments more generally also contribute to global AMR. Resistant bacteria can make their way into water through waste runoff. When this happens, ‘water bodies become a conveyor of antibiotic resistance, and then populations downstream are exposed’, said Mateo-Sagasta. For this reason, IWMI is working ‘to develop models that can predict the concentration of resistant bacteria in water bodies to understand the health risks and test the effectiveness of solutions’. Although the seminar covered a wide variety of topics relating to AMR, in her concluding remarks, Arshnee Moodely affirmed what was perhaps the seminar’s central theme: that ‘the AMR Hub epitomizes what we want the One CGIAR to do’—bring a variety of partners together and combine expertise to tackle the world’s greatest challenges. As the CGIAR moves into its next phase, the AMR Hub will continue building the partnerships necessary to address global AMR. As Dieter Schillinger, deputy director general of biosciences at ILRI, said at the end of the seminar, 'AMR must be attacked from all angles—nobody can be left out'. For more information, visit the CGIAR AMR Hub or learn about the Hub’s research activities. Methicillin-Resistant Staphylococcus aureus (MRSA) Bacteria (photo credit: NIAID)

Written by Ekta Patel Access to quality veterinary drugs is a significant challenge for smallholder livestock keepers in low- and middle-income countries. Moreover, livestock producers who have access to over-the-counter animal drugs, including antimicrobials, often misuse them in food producing animals, which can produce drug residues in food products such as milk, meat and eggs, and pose a health risk to consumers. This among other reasons has led to growing risks of antimicrobial resistance in the public health sectors of these countries.  Antimicrobial resistance is one of the world’s most rapidly emerging health threats and data suggest that it will be the number one cause of death by 2050. Antibiotics play a pivotal role in animal agriculture and have been used as prophylactics (used when animals are stressed in the treatment of illness) or as therapeutics (to manage the health and welfare of sick animals). They have also been used to improve growth and productivity by giving animals antibiotics through feed or water.  In Uganda, the private sector has greatly contributed to the delivery of animal health services, which are regulated by the government. However, the lack of budgetary resources has hindered the implementation of regulations and policies that govern the delivery of veterinary drugs.  Scientists from the International Livestock Research Institute (ILRI), Makerere University, and Institute of Virology and Immunology have assessed the use of antimicrobials in smallholder livestock systems in Uganda. Their findings, which are published in the Journal of Frontiers in Veterinary Science show that antibiotics and anti-helminthics are readily available over-the-counter to livestock keepers in the country and antibiotics sales contribute a third of the profit for veterinary drug stockists.  The researchers evaluated Uganda’s veterinary drug supply chain, constraints faced by actors, assess knowledge, practices, and awareness of veterinary drug suppliers on drug use and management in Lira and Mukono in the northern and central region of the country, respectively. They documented the constraints faced by the actors of the drug supply chain, which include lack of knowledge on veterinary drug policies of the country, low level of education especially drug retailers, poor handling of drugs at purchase and administration.  Potential drivers of misuse of antibiotics in the country include low level of education of actors who deal with drugs such as drug retailers and veterinary practitioners, poor handling of drugs at purchase, and self-medication by livestock farmers resulting in inadequate treatments regimens to livestock. Low enforcement of policy and regulations and lack of awareness of stakeholders about policies that regulate use of drugs were also listed as contributing to misuse of drugs such as antibiotics.  The authors advocate future interventions to reduce misuse of drugs in small-scale livestock production systems should target capacity building and improvement of the business of veterinary drug input suppliers and strong policy advocacy.   For more information read the full article here  Learn more about antimicrobial resistance through the CGIAR AMR Hub Photo credit: AVCD health services project, Syat Onle, operations manager at his agrvet shop in Garissa town, Kenya (ILRI/Dhanji). 

Written by Ekta Patel Antimicrobial resistance (AMR) is a global challenge, where drugs relied on to treat infections in humans, animals and plants will no longer be effective. Globally, drug resistant diseases already account for over 700,000 human deaths every year and the status of AMR in Africa is limited due to the lack of surveillance. Qualitative interviews with farmers in Africa demonstrate a lack of knowledge on both AMR and the importance of prudent antimicrobial use. The World Health Organization has declared AMR as one of the top 10 global public health threats facing humanity and states that misuse and overuse of AMR are the main drivers in the development of drug-resistant pathogens. Last week, the OIE - Global Leaders Group on AMR called all countries to significantly reduce the levels of antimicrobial drugs used in global food systems, including the use of medically important drugs to promote growth in healthy animals.  A perspective by Christian Ducrot et al. (2021) published in the Journal of Emerging Infectious Disease evaluates the challenges faced by farmers in Africa. The perspective acknowledges that Africa reports lowest usage of antimicrobials in the world, however, the prevalence of antimicrobial resistance in foodborne pathogens isolated from animals and animal products remains high.  Ducrot, the lead author of the paper and deputy head of the animal health division at the French National Research Institute for Agriculture, Food and Environment says that ‘a major challenge is in implementing policies that would enable reduction of antimicrobial use on animals.’ He added that effective application of policies is dependent on minimizing adverse health and socio-economic impacts on the livelihoods of farmers in low and middle-income countries. The authors, who are from the International Livestock Research Institute (ILRI) and French research organisations namely, The French Agricultural Research Centre for International Development (CIRAD), French National Research Institute for Agriculture, Food and Environment (INRAE), and Institute of Research and Development (IRD), advocate for policies that consider specific farmer needs, including improved access to veterinary drugs, and improved regulation of their use.  For more information: Ducrot C, Hobeika A, Lienhardt C, Wieland B, Dehays C, Delabouglise A, et al. (2021). Antimicrobial resistance in Africa—how to relieve the burden on family farmers. Emerg Infect Dis.  OIE- Global Leaders Group on AMR Joint Press Release. 24 August 2021.