How we use antimicrobial drugs, like antibiotics, matters. Overuse and misuse are driving antimicrobial resistance (AMR) – an increasingly serious threat to the global health of people, animals and the planet.

AMR happens when microorganisms like bacteria and viruses adapt to tolerate treatment by antimicrobial drugs (such as antibiotics). As these drugs stop working, we risk turning back the clock to a time where easily treatable diseases, such as throat infections, result in death. AMR could also prevent treatment of infections in animals, which would compromise food production, food security and livelihoods. Moreover, AMR is not a problem limited to one country or region. Resistant microorganisms are rapidly spreading across a world increasingly connected through trade and travel.

 The animal production sector is a particularly worrying contributor to the AMR problem. Livestock, poultry and aquaculture production are huge consumers of antimicrobials, and two-thirds of the projected future growth of antimicrobial use is estimated to occur within the animal production sector. Use in pig and poultry production is slated to double. The intensification of animal production due to the increasing demand for products of animal origin is increasing overall use of antimicrobials.

How can we turn things around? What can help us promote the more prudent use of antimicrobials in animal production in order to slow down AMR?

Standard setting bodies, regulatory frameworks and other high-level strategies are essential. However, according to FAO, an equally important part of the answer can be found by understanding the antimicrobial usage of food producers themselves.

This is why, in addition to its high-level work, FAO is engaging in a bottom-up approach to understanding AMR. With the support of the United Kingdom’s Fleming Fund, FAO is studying AMR at local level. This approach begins on the farm and incorporates social science methods to understand how farmer knowledge, attitudes and practices effect antimicrobial use.

“We need to better understand what drives animal production stakeholders to use, sell, prescribe and, most importantly, misuse antimicrobials. Developing this understanding requires open dialogue with all of these important actors,” said Dr. Mark Caudell, Regional Social Science Coordinator and study lead based in FAO's Kenya office.

 As part of the Fleming Fund project, FAO interviewed almost 1000 farmers across five countries in sub-Saharan Africa. This study – the first of its kind – has provided novel insights into how farmers think about AMR and how their behaviours effect AMR trends.

“Here at FAO we have been going into farms, drug shops, and veterinary offices to understand the cultural, economic and historical factors that promote the use of antimicrobial drugs and the spread of AMR. Building upon these factors, we are now deploying behaviour change interventions across Africa to limit the emergence and spread of antimicrobial resistance with the ultimate goal of improving the welfare of people and their animals,” Caudell added.

Deployment of these bottom-up studies across countries and different types of production systems (e.g., poultry, dairy, pigs) will provide the evidence base that is sorely needed. FAO’s bottom-up approach is making it possible to consider the perspectives of livestock farmers first in order to better inform interventions that can limit the emergence and spread of AMR.