Antimicrobial use in African agriculture and its implications
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Presentation by Delia Grace, Johanna Lindahl, Hung Nguyen‐Viet, Fred Unger and Tim Robinson at a national information sharing workshop on antibiotic use, management and potential risk of antibiotic resistance, Hanoi, Vietnam, 20 September 2016.
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Antimicrobial use in African agriculture and its implications
- 1. Antimicrobial use in African agriculture and its implications Delia Grace, Johanna Lindahl, Hung Nguyen-Viet, Fred Unger and Tim Robinson International Livestock Research Institute, Nairobi, Kenya National information sharing workshop on antibiotic use, management and potential risk of antibiotic resistance National Institute of Veterinary Research, Hanoi, Vietnam 20 September 2016
- 2. International Livestock Research Institute •a member of the CGIAR Consortium, ILRI conducts livestock, food and environmental research to help alleviate poverty and improve food security, health & nutrition, while protecting the natural resource base. Mali Nigeria Mozambique Kenya Ethiopia India China Laos Vietnam Thailand
- 3. International Livestock Research Institute • Founded in 1974 • Budget: nearly US$90 million • Staff: 700: 130 Senior scientists from 39 countries: >half from developing countries • 34% of internationally recruited staff are women --and 50% of the senior leadership team • Main campuses in Kenya and Ethiopia, and offices in 17 other countries around the world (including Hanoi)
- 4. Antimicrobial resistance • AMR infections currently claim at least 50,000 lives each year across Europe and the USA alone ….. with many hundreds of thousands more dying in other areas of the world • In 15 European countries more than 10% of bloodstream Staphylococcus aureus infections are caused by methicillin-resistant strains (MRSA) ….. closer to 50% in several of these Source: O’Neill (2014) The O’Neill Report (2014)
- 5. Livestock trending up, fish slower, pulses down 0 10 20 30 40 50 60 70 1961 1963 1965 1967 1969 1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 Protein(gramspercapitaperday) Livestock Aquatic Pulses
- 6. Antimicrobial resistance Source: Van Boeckel et al. (2015) Global antimicrobial consumption in livestock (mg per 10km pixel)
- 7. Antimicrobial use in livestock • Total consumption in the livestock sector in 2010 estimated at 63,151 tons • Global antimicrobial consumption will rise by 67% by 2030 • It will nearly double in BRICS • Poultry>pork: e.g. in Asia, chicken by 129%, pork 124% by 2030
- 8. 8 Africa: dozens of vets, tens of millions livestock
- 11. • Africa: every year one in two young animals and one in five adult animals die, mostly of preventable disease • Better access to antimicrobials and other veterinary drugs and services could reduce losses Young Adult Cattle 22% 6% Shoat 28% 11% Poultry 70% 30% Otte & Chilonda, IAEA Annual mortality of African livestock But access to antimicrobials also important to improve animal health
- 13. AM use in LMIC and its impacts • Little information on AM use • Some countries massively over-use • Large problem of antimicrobial under-use • Almost no evidence on impacts on human or animal disease
- 14. Global antimicrobial use in food animals Source: Grace,. 2015 • Total consumption in the livestock sector in 2000s estimated at 400,000 tonnes (vs. 64,000 tonnes from models) China, USA, Thailand France, Iran, S Africa Norway, Kenya Sweden 1 10 100 1,000 10,000 100,000 1,000,000 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 Antibiotics (tn) 0 100 200 300 400 500 600 700 800 900 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 Antibiotic grams/VLU China, Thailand USA, Philippines, S Africa Sw, Nor, Kenya
- 15. Kampala pork butcheries: Salmonella Heilmann & Ndoboli, 2015. All isolates were confirmed Salmonella at FUB using species primer
- 16. Drug sensitivity tests • So far 25 of the 60 isolates tested (agar diffusion test) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% SA PRL PTZ AMC CZ AP FOX KF CPM CAZ CXM CTX AK MEM CIP IMI T GM C LEV OFX SXT R I S
- 17. Way forward • Some LMIC use AM high rates in certain sectors, others at very low rates • Very difficult to regulate use in the developing and emerging economies • Poorest should be privileged ➜ Global problem: Concerted action ➜ Emotion high, reason low problem: Strengthen evidence base ➜ Goldilocks challenge: Address the “too little” as well as “too much problem”
- 18. Acknowledgements • The research featured in this presentation was funded by DFID, ACIAR, the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) and others 18
Editor's Notes
- Several hotspots
- BRI
- The point is there are hundreds of millions of livestock, tens of millions of farmers but only dozens of vets so vets can’t oversee the animal health needs so you get a mass or other providers and they often misuse drugs
- It is an example of incentives. Of how people will use drugs incorrectly – so not necessarily just retrovirals but other medicine too
- ECF and Newcastle Disease are examples where the disease is the biggest constraint in the system. Several studies have shown that where these are controlled populations and/or offtake can double. The table summarises a number of studies in a systematic review of mortality in African traditional systems, by age group
- Our analysis suggest 3 groups with different needs: worried well in rich countries who are most concerned with AMR and are funding initiatives; hot spots of rapid intensification like China and Vietnam where lots of drug use and misuse; cold spots like tribal areas and much of Africa where major problem is lack of access to animal health
- It will nearly double in BRICS (Brazil, Russia, India, China, and South Africa) countries China’s livestock industry by itself could soon be consuming almost one third of world’s available antibiotics. to a country – didn’t want to put all country names because of sensitivity the y axis is tonnes of AM used in agriculture: it is a log scale