How to make noncoherent problems more productive: Towards an AMR management plan for low resource livestock sectors

Abstract

Global policy for managing antimicrobial resistance (AMR) is underpinned by a standardised and coherent global framework for reducing antibiotic use in clinical health, veterinary health, and food production sectors. Within the framework, problematic antibiotic use (a significant driver of AMR) is treated as a knowledge deficit on the part of users and prescribers, which can be remedied by educating them to make better informed treatment decisions. This narrow approach to AMR management conceals the socioeconomic and material drivers of antibiotic decision-making, creating challenges for low resource regions that rely on antibiotic therapies to manage uncertainty and precarity. Thus, there is a need for a global AMR policy that acknowledges the diversity of sociomaterial arrangements and practices that antibiotics form part of, if their use is to be reduced without undermining productivity or the attainment of poverty reduction indicators. Drawing upon research of antibiotic use in West Africa’s livestock sector, this article analyses the interrelation of antibiotics, AMR action plans, and production management strategies in ecologies of livestock breeding practices. We apply the STS-influenced perspective of noncoherence to analyse how seemingly contradictory practices and institutional logics productively coalesce. We argue that observing noncoherent practices increases our understanding of antibiotic use in relation to local breeding conditions that are frequently not of the producers’ making, whilst drawing attention to context-specific possibilities for improving livestock management capacities and reducing reliance on antibiotic therapies in low-resource settings. The article concludes by calling for an AMR global policy that is more responsive to local specificity rather than enforcing universal standardisation.

Investigating risks for human colonisation with extended spectrum beta-lactamase producing E. coli and K. pneumoniae in Malawian households: a one health longitudinal cohort study

“…Antibiotic prescription was limited to oral co-trimoxazole, amoxicillin or metronidazole. These medications are on the international essential medicine lists for treatment of a number of infectious conditions (12)(13)(14), and the use of only a small number of antibiotics is consistent with findings from previous local descriptions from community-focussed ABU research (15). ABU in household animals was limited in our study, despite reports of animal illness.…”

“…ABU is increasing globally, particularly within the commercial livestock production sector, and this has been highlighted by the many authorities as an important driver of AMR (13,14). Moderate levels of human ABU were reported, with under 5s and inhabitants in rural communities having a higher ABU overall.…”

Closing the GAP in Antimicrobial Resistance Policy in Benin and Burkina Faso

“…As we point out above in “Improving awareness of AMR through training and education,” awareness among frontline health care workers, doctors, nurses, veterinarians, and paraveterinarians about reducing the use of antibiotics was deemed to be present, yet antibiotics were used liberally. For example, our observational data and focus group discussions with animal breeders and farmers conferred that in animal husbandry, official dose regimens and recommendations were rarely followed as these would lead to considerable financial losses ( 17 ). While we did not find evidence of antibiotics being used for growth promotion, withdrawal periods after a course of antibiotics were rarely followed to ensure that farmers “break even” and to ensure continued food security for poor populations.…”

“…Local researchers based in universities and civil society organizations were working to test and develop alternatives to antibiotics and to design probiotic feeds and products for use in farming that would support healthier microbiota and reduce conditions under which animal pathogens can spread ( 17 ). These endeavors remained localized and have not generated investment from international funders to support research or to scale up the products nationally or internationally, which would require verifications of safety and efficacy.…”

In critique of anthropocentrism: a more-than-human ethical framework for antimicrobial resistance

“…While clinical diagnosis of bacterial disease in chickens is much less accurate than laboratory diagnosis (Hasan et al 2012), this type of specificity is generally unavailable to breeders in the studied countries who have limited access to laboratories and who often lack the financial resources for clinical diagnosis with veterinary consultants (Cañada 2021). Instead, farmers make their own diagnosis and treatment decisions, either according to their own knowledge and experiences of dealing with previous production diseases, or after consulting with peers (Butcher, Cañada, and Sariola 2021). In the treatment of poultry diseases, diagnosis is often made through observation of the poultry litter and faecal matter, and subsequent treatment usually addresses the entire flock as a single unit, making evident the ecological level of treatment.…”