| Study methodology to characterize antimicrobial use |
Where there are limited resources, we must focus antimicrobial use and resistance work on parts of the livestock sector with high potential for animal to human transmission of AMR. This requires knowledge of the livestock food system and capacities of the private sector to manage and implement change. Methods to obtain accurate, specific antimicrobial use data in livestock should be assessed with the analysis of the relative costs and benefits of obtaining such data. The poultry and pig sector have cycles within and between years that influence profitability and, in turn, the economic value of AMU. Therefore, meaningful antimicrobial use and resistance economic research should be carried out over a number of production cycles.
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| Antimicrobial use |
The main antimicrobials used are penicillins, tetracyclines, and sulphonamides. Critically important antimicrobials are also frequently used. Feed labelling is sometimes misleading and does not list nutritional information or ingredients including antimicrobials added. Therefore, farmers may not know what is contained in commercially-purchased feed.
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| The economics of antimicrobial use |
The costs of antimicrobials in the production systems are small in total and very small in relation to other costs. There is evidence that antimicrobial use in small-scale poultry production systems improves feed conversion ratios and improves overall production. The pig industry is susceptible to economic instability with falling prices placing farmers under increasing pressures to minimize costs. The poultry industry is also susceptible to economic and market stability, with day-old chick price and availability a constant concern and increasing pressure on commercial feed prices as human food demand increases. Small changes in feed prices have big impacts of cycle profitability.
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| Antimicrobial use and resistance policy for livestock |
During the period of the study, Indonesia, Thailand, and Vietnam have embraced and implemented policies on antimicrobial use control in livestock and AMR surveillance. Thailand appears to have the most intensive, modern, and regulated livestock systems with regard to antimicrobial use and more developed policies and implementation such as HP-CIAs requiring and prescription, when compared with Indonesia and Vietnam. Thailand has quantified antimicrobial sales using the ESVAC methodology. There is potential for this methodology and approach to be adopted by other LMICs and could be applied to data already collected and supplied to OIE. Policy to regulate antimicrobial use should be stepwise with prescription only being the ultimate goal. At present, of the case study countries, Thailand appears to be further along the journey in developing antimicrobial use and resistance policy for livestock than Indonesia or Vietnam.
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