Tag: antimicrobial resistance

Pandemic adapted Swedish-Ugandan training on livestock raising with low use of antibiotics

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Written by Kristina Osbjer and Ulf Magnusson at the Department of Clinical Sciences, SLU

Photo: Justine Alinaitwe

The coronavirus pandemic is changing how we work and is providing us with an opportunity to rethink the way we conduct education, sustain research and maintain collaborations. A recent field-training experience in Uganda, combining video recordings, zoom lectures and discussions with local facilitation, has paved the way forward for us within the CGIAR Research Program on Livestock to conduct interactive training in responsible antibiotic use in Ugandan livestock farming communities amidst travel restrictions.

Antimicrobial resistance – the silent pandemic

While the world is preoccupied with fighting COVID-19, antimicrobial resistance is continuing to spread, with serious consequences for health and economies (World Bank, 2017). Antimicrobial resistance (AMR), the ability of microbes to persist and grow in the presence of drugs designed to inhibit or kill them, is accelerated by the excessive and inappropriate use of antimicrobials in humans, animals and crops (FAO, 2020). Low and middle-income countries (LMICs) are predicted to account for most of the increase in antimicrobial use and to carry the largest burden of AMR, but the action and research agenda on AMR has so far been largely driven by the OECD countries (O’Neill J, 2016).

More attention to the conditions of antimicrobial use and resistance in LMICs will be required and was also the focus in a recent webinar arranged by the Livestock Antimicrobial Partnership (LAMP), hosted by SLU Global, where the divergent challenges in curbing AMR in high-income countries as compared to LMICs were discussed (LAMP webinar, 2020).

Sweden as a model to curb Antimicrobial Resistance
Sweden has a long-term experience in producing healthy and productive animals with low antibiotic use. Our unique expertise and lessons learned are internationally recognised and disseminated through online courses (Future learn, 2020) and guidelines (FAO/SLU, 2019 and FAO/SLU, 2020).

A bottom-up approach to influence antimicrobial stewardship in livestock within the CGIAR Research Program on Livestock

SLU is leading the Animal Health Flagship within the CGIAR Research Program on Livestock (CGIAR, 2020). The programme focuses on supporting the development of small-scale livestock farming with the goal ‘more meat, milk and eggs by and for the poor’ primarily targeting Uganda, Ethiopia, Vietnam and Tanzania. SLU contributes to the programme with expertise in herd health and matters related to antibiotic resistance. Such expertise was used also in the training on productive livestock with low use of antibiotics in Uganda. The first round of training was carried out 25-27 November 2020 in Masaka district in collaboration between SLU and colleagues from Ministry of Agriculture, Animal Industries and Fisheries, Makerere University, and local authorities in Masaka. The SLU moderators participated online, whereas the Ugandan facilitators and training participants gathered in Uganda, following the COVID-19 safety measures imposed by the Uganda Government. A mix of veterinarians from the government and the private sector as well as para-veterinarians and some farmers participated in the training that aimed for a two-way learning process to identify feasible measures to reduce the need for antibiotics and use it only when needed in a medically rational way. The local context was emphasised by taking stock of knowledge and current practices in maintaining healthy animals, the role of animal health professionals and farmers in securing animal health and the prevailing application of good animal husbandry, biosecurity and antimicrobial use. This was followed by pre-recorded and online presentations and discussion on the Swedish model and how alternative practices may be adopted in Uganda.  

Sharing ideas helped us learn from each other

The training participants praised the participatory training approach and the opportunity to learn from each other, realising that among themselves they already had much of the knowledge required to become antibiotic-smart. The combined online and onsite training format was successful, yet, required a venue with stable internet connection. Participating farmers and veterinarians concluded that they were equally responsible to limit the prevailing irresponsible use of antibiotics and proposed more sensitisation campaigns, using highly influential people and practical real-life examples to raise the general awareness of AMR. They also asked for follow-up trainings to enable sustainable change of practices. As facilitators, we gained new insights on how antimicrobials are used and accessed in Uganda and tips on how to improve future hybrid and follow-up trainings. We hope that our experience can inspire others to design and implement pandemic-adapted training.

Antibiotics – a tragedy of the commons

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This article was written by Susanna Sternberg Lewerin, Professor in Epizootiology & Disease Control at the Department do Biomedical Sciences & Veterinary public Health, SLU.

Antibiotics kill susceptible bacteria while those who have acquired traits to destroy the drug or protect themselves from it survive and multiply. Resistant bacteria can share their resistance genes with others. Illustration: SLU

Today is the Antibiotic Awareness Day. It is a day to be grateful for these important medicines, and to consider how to best preserve them for the future.

Antibiotics, drugs to combat bacteria, are useful tools in both veterinary and human medicine. They allow us to treat bacterial infections in animals and people, common diseases as well as those that occur due to immunosuppressive treatments such as cancer therapy or following transplant surgery. The problem is that all use of antibiotics kills the susceptible bacteria and leave the field open for those who have  become resistant to the antibiotic. In a successful treatment course, the few remaining (resistant) bacteria can be killed by the host’s immune system and the host, animal or person, is cured. On the other hand, if the majority of the disease-causing bacteria are resistant, the treatment will be ineffective.

To preserve antibiotics as medical tools, we must use them as little as possible, only when needed, in the correct dose so that enough of the drug reaches the body site where the bacteria are causing the disease, and only for the time needed, until the immune system has eliminated the disease-causing bacteria. This is not as easy as it sounds, it takes insight into what diseases cause problems in animals and people in different settings, how to prevent them and how to treat them effectively, with or without antibiotics.

In Sweden, disease prevention is a key feature of veterinary medicine. Good animal husbandry, good biosecurity, vaccination and other strategies to control and prevent disease has been and continues to be a major research focus. We also collaborate in EU projects where different practices, attitudes and societal systems present new challenges that can be addressed by learning from the Swedish experiences (successes as well as failures) and by new ideas and innovations.

In low-income countries, antibiotics are not restricted to prescription from a veterinarian or a doctor but can be bought over-the-counter in drug stores where the products can be of poor quality and the information about how to use them may be lacking or misleading.

Poor farmers sometimes use the volume intended for treatment of one animal to treat several animals (i.e. with a lower dose), rendering the treatment ineffective and paving the way for resistant bacteria without curing the disease. If no veterinarian is involved in determining the cause of the disease, antibiotics may be used to treat diseases that are not caused by bacteria, so that the treatment is a waste of money and, again, promotes the resistant bacteria.

We collaborate with researchers in low-income countries on how to prevent and control animal diseases. We also work on developing systems for monitoring of diseases and antibiotic use, to provide information about what diseases are common and which antibiotics are used effectively. This project also addresses ways to increase the interaction between veterinarians and farmers by video consultations, to facilitate farmers’ access to veterinary advice on disease treatments while improving profitability for both groups. 

It is important to recognise the need for different strategies in different settings, disease prevention and control rely on knowledge of the local situation and its context-specific challenges and opportunities. Still, the worries and hopes of farmers are similar in countries all over the world and serve as incentives for improvement of animal health and production. The long-term goals of our research focus on animal health and welfare, for a sustainable animal production with a sustainable use of antibiotics. We must all contribute to preserving antibiotics for the future. Don’t let it be nobody’s responsibility, it lies with everyone.