The Governance of UK Dairy Antibiotic Use: Industry-Led Policy in Action

Consumer Preferences and Attitudes towards Antibiotic Use in Food Animals

Antimicrobial resistance (AMR) is one of the major challenges faced by society, with the real threat of the failure of many medical procedures. Antibiotics are also used in livestock production and provide a potential pathway to increasing AMR. The central challenge involves ensuring animal health and welfare while securing the long-term effectiveness of antibiotics. This paper reports the results of a survey of 5693 respondents from the customer panels of four major UK supermarkets regarding preferences and attitudes towards antibiotic use in food animals, and their perspectives on how the balance between animal welfare and human benefit can be achieved. The results of these surveys are consistent with those from other countries that found that consumers generally have limited knowledge about antibiotic use in agriculture and AMR, with around 50% responding "don't know" to many questions. There was agreement about the benefits of antibiotics outweighing harm, with 40% agreeing that, overall, the use of antibiotics to treat disease in farm animals delivers more benefit than harm. However, 44% neither agreed nor disagreed, indicating a high level of uncertainty and a situation that is potentially unstable. The seriousness of the AMR challenge is such that continued action for the more discriminating use of antibiotics must continue.

Reducing antimicrobial use in chicken production in Vietnam: Exploring the systemic dimension of change

Antibiotic use in livestock production is one of the drivers of antibiotic resistance and a shift towards better and reduced antibiotic usage is urgently required. In Vietnam, where there are frequent reports of the misuse and overuse of antibiotics, little attention has been paid to farmers who have successfully changed their practices. This qualitative study aims to understand the transition process of Vietnamese chicken farmers toward reduced antibiotic usage. We conducted semi-structured interviews with 18 chicken farmers, 13 drug sellers, and 5 traders using participatory tools and a socio-anthropological approach. We explored the farmers' histories, current and past antibiotic usage, methods used to reduce antibiotic use, and motivations and barriers to changing practices. Through the thematic analysis of the farmers' transcripts, we identified technical, economic, and social factors that influence change. Out of eighteen farmers, we identified ten farmers who had already reduced antibiotic usage. The main motivations included producing quality chickens (tasty and safe) while reducing farm expenditures. Barriers were related to poor biosecurity in the area, market failures, and the farmers' lack of knowledge. Innovation led to overcome these obstacles included the local development of handmade probiotics and the organization of farmer cooperatives to overcome economic difficulties and guarantee product outlets. Knowledge was increased by workshops organized at the communal level and the influence of competent veterinarians in the area. We showed that the transition process was influenced by several components of the system rather than by any individual alone. Our study demonstrated that local initiatives to reduce antibiotic use in Vietnamese chicken production do exist. As changes depend on the system in which stakeholders are embedded, systemic lock-ins must be removed to allow practices to change. The promotion of locally-developed solutions should be further encouraged.

Factors influencing Scottish dairy farmers' antibiotic use

BACKGROUND

Good stewardship of antibiotics can reduce the development and impact of antimicrobial resistance (AMR); therefore, understanding farmers' antibiotic use is of interest to stakeholders. To date, few qualitative studies have looked at farmers' antibiotic use on dairy farms in the UK.

METHODS

Semi-structured interviews were used to explore 15 Scottish dairy farmers' antibiotic use behaviours and the factors influencing their antibiotic use on farms.

RESULTS

Using an inductive process, the results from the interviews were analysed, and four key themes were extracted: use of antibiotics, awareness of AMR, determinants of antibiotic use and future aspirations.

LIMITATIONS

Some of the farmers interviewed were wary about discussing their antibiotic use, which could mean that some contentious issues were not discussed. The farmers also all belonged to a single milk-buying group, which may limit the generalisability of the findings.

CONCLUSIONS

The quantities of antibiotics used were felt to be driven by the disease prevalence on farms, cows being indoors more, increasing herd sizes resulting in increased stocking densities, retention of poorer cows and substandard housing. Farmer knowledge of antibiotics varied, and not all farmers interviewed were aware of AMR. The farm veterinarian, the press and peers were found to be the main sources of antibiotic information.

Antimicrobial usage and resistance in scottish dairy herds: a survey of farmers' knowledge, behaviours and attitudes

Antimicrobial resistance (AMR) poses a major threat to global health. Understanding how antimicrobials are used on dairy farms and stakeholder beliefs relating to their use is essential to ensure responsible antimicrobial usage (AMU) to tackle the emergence of AMR. This study explored Scottish dairy farmers' knowledge about the meaning of AMR and antimicrobial activity, behaviour and practices related to farm AMU and attitudes towards AMR mitigation. An online survey was designed based on the findings of two focus groups and was completed by 61 respondents (7.3% of the total population of Scottish dairy farmers). Knowledge of antimicrobials and AMR was variable, and almost half of the participants believed that antimicrobials could have anti-inflammatory or analgesic activity. Veterinarians' opinions and advice about AMU were ranked significantly more important than other social referents or advisors. The majority of farmers (90%) reported having implemented practices to reduce reliance on antimicrobials (e.g., selective dry cow therapy, AMU treatment protocols) and having reduced farm AMU over recent years. Feeding waste milk to calves is still widespread, being reported by up to 30% of respondents. The main factors described to hinder responsible farm AMU were limited facilities (e.g., lack of isolation pens for sick animals) and knowledge of appropriate AMU recommendations, followed by time and financial constraints. Most farmers (89%) agreed that it is important to reduce AMU on dairy farms, but fewer (52%) acknowledged that AMU on UK dairy farms is currently too high, suggesting a mismatch between their intention to reduce antimicrobials and AMU behaviour. These results indicate that dairy farmers are aware of AMR, and their self-reported farm AMU has been reduced. However, some do not clearly comprehend the activity of antimicrobials and their correct usage. More work is needed to improve dairy farmers' knowledge of appropriate AMU and intentions to combat AMR. Farmers would benefit from more regular AMU discussions and advice from herd veterinarians, as they were described as highly trusted information resources. Training on how to reduce AMU should involve all farm staff administering antimicrobials and should be tailored to farm-specific barriers, such as limited facilities and workforce shortages.

Lessons learned for animal health governance from bovine viral diarrhea eradication schemes in Scotland and Ireland

This paper explores lessons learned for animal health governance from bovine viral diarrhea (BVD) eradication schemes in Scotland and Ireland, drawing on qualitative key stakeholder interviews. Bovine viral diarrhea is an endemic cattle disease that causes animal health and welfare problems, as well as financial losses to farmers. Initial voluntary industry-led schemes to eradicate BVD were introduced in both countries in the 2010s, followed by compulsory phases involving legislation. The paper uses a theoretical framework of co-productive governance to analyze stakeholder views on how well the design and execution of the eradication schemes worked and what can be learned to inform future directions of animal health governance. The term “co-productive governance” comes from the field of environmental governance and was developed to describe how science and politics influence each other in a context where governance is carried out by multiple actors working collaboratively. The results of key stakeholder interviews are analyzed using the concepts of vision, context, knowledge, and process. In relation to vision, the results show the importance of creating a clear narrative about the goal of disease eradication schemes, which may incorporate or replace existing vet or farmer “narratives” about a disease. With regard to context, it is difficult to engage all actors in biosecurity governance, when initiatives are developed with the legacy of existing relationships and tensions. In relation to knowledge, the results showed the importance but political complexity of basing decisions on scientific research. One of the lessons learned was the benefit of involving industry stakeholders in setting scientific questions to inform the design of the scheme. Additionally, with reference to the process, while interviewees were enthusiastic about future prospects for industry and government working together to achieve biosecurity goals co-productive governance is not a panacea for enrolling all actors in biosecurity goals. The results also highlighted that farmers and other actors might object to an eradication scheme, whether it is run by government or private industry. Thus, it is useful to keep questions about who benefits in what way from biosecurity governance open.

Understanding antibiotic use: practices, structures and networks

In this article, we consider how social sciences can help us to understand the rising use of antibiotics globally. Drawing on ethnography as a way to research how we are in the world, we explore scholarship that situates antibiotic use in relation to interactions of pathogens, humans, animals and the environment in the context of globalization, changes in agriculture and urbanization. We group this research into three areas: practices, structures and networks. Much of the public health and related social research concerning antimicrobial resistance has focused on antibiotic use as a practice, with research characterizing how antibiotics are used by patients, farmers, fishermen, drug sellers, clinicians and others. Researchers have also positioned antibiotic use as emergent of political-economic structures, shedding light on how working and living conditions, quality of care, hygiene and sanitation foster reliance on antibiotics. A growing body of research sees antibiotics as embedded in networks that, in addition to social and institutional networks, comprise physical, technical and historical connections such as guidelines, supply chains and reporting systems. Taken together, this research emphasizes the multiple ways that antibiotics have become built into daily life. Wider issues, which may be invisible without explication through ethnographic approaches, need to be considered when addressing antibiotic use. Adopting the complementary vantage points of practices, networks and structures can support the diversification of our responses to AMR.

Understanding Antibiotic Use in Companion Animals: A Literature Review Identifying Avenues for Future Efforts

Addressing antibiotic use is essential to tackle antimicrobial resistance, a major human and animal health challenge. This review seeks to inform stewardship efforts in companion animals by collating research insights regarding antibiotic use in this group and identifying overlooked avenues for future research and stewardship efforts. The development of population-based methods has established that antibiotics are frequently used in companion animal care. Research insights are also contributing toward an in-depth comprehension of the contexts to antibiotic use. Qualitative approaches, for example, have enabled a nuanced understanding in four key areas: interactions with owners, clinical and financial risk management, time pressures, and clinic dynamics. This review identifies that much of the existing research frames antibiotic use as the result of choices made by the individuals at the interface of their use. Future research and policy endeavours could look beyond the moment of prescribing to consider the societal structures and networks in which companion animal antibiotic use is entangled. A diversification in research approaches and frameworks through which antibiotic use is understood will facilitate the identification of additional targets for stewardship initiatives beyond providing information and awareness campaigns.

The antimicrobial landscape as outlined by Danish dairy farmers

Limiting antimicrobial use (AMU) in dairy farming is an important step toward reducing antimicrobial resistance (AMR). Therefore, it is relevant to understand dairy farmers' choices and the potential for change in relation to AMU, even in countries with low usage. Furthermore, there is an increasing recognition of the need to focus on both the individual farmer's behavior as well as the context surrounding and influencing the farmer's decisions in relation to AMU if the goal is further reduction. To date, no studies have taken into account both the individual farmer and their context in both conventional and organic dairy farms under Danish conditions. For this study, 15 Danish dairy farmers were interviewed using qualitative semi-structured research interviews, and the notion of landscape was used to describe the context of their AMU. We found that AMR was considered a distant element of the farmers' antimicrobial landscape. Daily challenges such as acutely diseased animals and poor housing conditions seemed more urgent and overruled the threat of AMR. We also found that interviewed farmers had differing opinions on farm management, partly shaped by changes in legislation and ways of farming over time. At one end of the scale, some organic farmers had rethought the current way of farming; keeping robust animals in a natural setting was expected to prevent disease. They were positive about legislation, and the numerous restrictions on AMU over time were thought to contribute to ensuring quality for consumers. At the other end of the scale, some conventional farmers perceived disease as something that should be controlled through treatment, and the currently eased legislation and intensification of farming have legitimatized AMU for this purpose, leading to an expectation among these farmers of certain rights to handle medicines themselves. These contrasting views might lead to inspiration and competition in terms of reducing AMU, as the farmers appeared to value the opinions of other farmers, and they were found to continuously assess each other. Through such ongoing assessment, pioneers of AMU reduction-whether organic or conventional-might motivate their colleagues to change their AMU. Future research should address the potential of experience- and attitude-sharing among farmers as motivation to reduce AMU.