To assess the situation in Southeast Asia, whose animal and fish production chains feed the global market, Flavie Goutard, an epidemiologist with CIRAD, worked with peers from the WHO, OIE and FAO on a major study including an analysis of the existing regulatory framework. The data gathered showed that in recent years, the standard of living for people in most Southeast Asian countries has risen considerably. That improvement has been accompanied by dietary changes, resulting in increased demand for animal protein (meat and fish). To satisfy that demand, production has been intensified, as has antibiotic use. As a result, antimicrobial resistance has progressed markedly, compounded by poor regulation of antibiotic sales networks, limited surveillance of their use, and a lack of suitable legal frameworks. Monitoring, working together, raising awareness . According to the researchers, there are several possible ways of boosting the efficacy of health policies:
- setting up integrated surveillance networks to monitor antibiotic use, not only in man, but also in livestock, fish and crop farming;
- strengthening regional partnerships involving the FAO, OIE and WHO, to foster the exchange of information between countries in the region, and multi-sectoral approaches;
- improving adherence to antibiotic use standards by raising awareness among users and applying laws more strictly.
One Health, the most appropriate approach
The authors stress that the One Health approach, which encompasses health and socioeconomic issues relating to humans, animals and the environment, is particularly suitable for fighting a phenomenon as complex as the emergence of antimicrobial resistance. It is already being used in some countries in the region with a view to drafting a range of health policies, and should facilitate global initiatives aimed at fighting antimicrobial resistance, while taking account of country-specific constraints. The WHO-FAO-OIE alliance recommends that countries use this approach, notably to build their antimicrobial resistance monitoring system. A study is under way of the obstacles to and levers for such inter-sectoral approaches, in the form of a thesis being co-supervised by CIRAD in Vietnam. Outside Southeast Asia, a similar study to the one by Flavie Goutard and her peers could also be conducted in sub-Saharan Africa, where the socioeconomic and legal contexts are also largely inappropriate for managing antibiotic use in farming. CIRAD researchers will be looking at these issues in greater detail at a workshop on antimicrobial resistance in Réunion in the week of 9 October 2017. The event is intended to structure current efforts, by involving plant specialists from CIRAD and public health experts from partner organizations.