Environmental and Economic Impacts of Improved Antibiotics Stewardship in Poultry Systems

To address AMR, there is consensus on the need to reduce antimicrobial use (AMU) in food animal production. Intensive poultry production is characterised by high AMU and associated environmental risks to human health through direct and indirect (environmental) transmission - e.g. from livestock waste. As in other LMIC countries there are emerging challenges in designing regulatory structures and priorities based on robust evidence of effectiveness and cost of different voluntary and mandatory interventions across different parts of the supply chain. This proposal offers five linked interdisciplinary work packages exploring different elements related to drivers of AMU, pathways to resistance, and economic costs of alternative mitigation measures and their effectiveness in terms of reducing AMR risks. The project adopts novel perspectives in terms of the development of antimicrobial stewardship across all industry actors (e.g. breeders, feeding, pharmaceutical, veterinarians, farmers, retailers). We also use a theoretical framework (a marginal abatement cost curve) to represent relative cost-effectiveness of mitigation measures. Further project elements will share experience on research and training methods and science-policy translation between countries.
Activities:
WP1 Supply/value chain characterisation: To define stewardship in terms of supply chain relationships and to model value chains in economic terms, development of farm scale economic models to test costs of interventions. Identification of different mitigation measures to reduce AMU, modelling propensity to adopt alternative AMU practices.
WP2 AMR prevalence of AMR in target farms/systems: In selected groups of farms to identify /confirm AMR hotspots prevalence and pathways in farms & supply chains using bacteriological and metagenomic approaches to evaluate the consequences and relationship between AMR and different productive performances, considering resource consumption and residue generation, with the aim to model and characterise each group regarding its environmental impact (GHG emissions, pollution risk to in soil and water, and potential consequences).
WP3 Characterising AMU reduction interventions: Evaluating the effectiveness of alternative mitigation measures identified in WP1.
WP4 Cost-benefit analysis and scenarios: Development of a marginal abatement cost curve showing relative cost-effectiveness of alternative interventions targeting AMU.
WP5 Decision support for industry policy, scenarios & integration: Developing industry support tool and supply chain guidance on AM stewardship plan across poultry industry stakeholders for promotion of adoption of CE measures. Evaluating potential regulatory interventions targeting AMU.
The project seeks to understand and co-design cost-effective interventions across all supply chain actors that have a role on the stewardship of AMs, and can potentially influence on-farm behaviours, directly or indirectly. There is a need to understand how the action of the different actors might be combined to reduce AM use in production. The project will develop economic and behavioural methodologies as a basis for informing Argentinian field studies that seek to understand AMU drivers. It will test various responses (behavioural interventions), and evaluate the pathways to impacts; i.e. how these interventions and reduced use might actually reduce AMR, and what the broader economic costs and benefits of such scenarios might be. Much of the project will involve raising awareness of the role of economics among scientists, industry, regulators, and other policy makers, with a series of research, and policy meetings and joint events in both countries. It will also develop a consistent framework for representing the costs and benefits of measures to modify antimicrobial use in agriculture. This in turn will offer lessons for the development of LMIC strategies for managing antimicrobial use in poultry production.

There is a need to regulate use of antimicrobial medicines in food animal production. Focusing poultry supply chains, this project adopts a One Health approach to understand and quantify the environmental and economic impacts (costs and benefits) of modified antimicrobial use and to co-design system interventions that are feasible, acceptable and cost-effective for producers. We take a whole supply/value chain perspective, using economic and social research methods to understand the role of all actors and transfer of value from breeding to retail, to define these interventions. . We will also quantify the abundance and diversity of AMR along this chain, supported by in vivo and in vitro studies. Samples will be collected and microbiological and metagenomic data will be analysed in collaboration with University of Edinburgh, as part of postdoctoral training/exchanges. Our interdisciplinary research will inform rational use and the development of decision support tools to inform production (e.g. on farm). We will develop the notion of antimicrobial stewardship as an industry (voluntary) approach, but we also consider other mandatory and market-based policy scenarios for measure compliance. Our methodologies will consider industry-wide effects and will be appropriate for use in other LMIC contexts for data collection and prioritisation of poultry sector antimicrobial use (AMU) interventions. This project suggest a marginal abatement cost framework as an integrative element for other projects funded under this call.

We identify the following beneficiary groups:

Public:
The ultimate long-term impact targeted by this project is to reduce AMR through improved global stewardship of antimicrobial drugs in poultry production worldwide. This change will contribute to the maintenance of a global common pool resource (antimicrobials) and hence the beneficiaries are the global population - i.e. the general public depending on efficacy of antimicrobials to control bacterial diseases in humans and animals. The project will deliver increased awareness of the complex interplay between supply chain actors in terms of delivering stewardship of valuable drugs, and will provide an integrated tool/system to promote rational AMU in the context of cost-effective poultry/livestock production. It also points to the need to the best way to collect limited data in LMICs.

Livestock industry:
Livestock farmers, meat processors and retailers are obliged to produce meat and eggs that are safe and in a manner that does not adversely affect animal welfare, the environment or public health. The stewardship of antimicrobials is a major challenge facing the industry and public attitudes towards current farming practices. This project will clarify the different costs and benefits of AMU, and addresses the behavioural barriers to change in this sector by studying the role of different supply chain actors and will propose interventions that can be used to drive down AMU within the industry.

Vets:
Vets are notionally part of our AMU stewardship "supply chain" and will be beneficiaries of additional training in the control of AMR, following the guides developed by the research team. This evidence will be of use to veterinary and medical stakeholders seeking to implement a One Health approach to AMR. Note that this project is addressing an area that is characterized by significant data gaps.

One Health stakeholders:
AMR has been described as the quintessential One Health challenge requiring an improved understanding of antimicrobial use in animal and human medicine. We have noted numerous national and international strategies addressing AMR, but none of these provides a convincing framework for assessing economics (cost-effectiveness) and behavioral change in supply chains. We expect our results to be of interest to several international organizations including OIE, WHO, FAO and OECD.

Educators:
Further direct beneficiaries are educators especially in the veterinary sector who seeking tools and techniques for developing veterinary curricula to include effective behavioral interventions and social science methods in general. We are aiming to develop these tools for delivery in veterinary training (i.e. continuing professional development) worldwide.
Public health regulators:
Beyond the long-term behavioral objective, the project seeks to understand the effectiveness of other policy instruments (e.g. tradable antimicrobial credits). Information on the potential effectiveness of these instruments will be of benefit to health regulators in all countries seeking the most cost-effective policy approach to regulating antimicrobial use.

Academics:
Academics will benefit from this research in terms of development of joint interdisciplinary publications, gaining demonstrable interdisciplinary experience and in terms of training opportunities for younger postdoctoral project partners.

UKRI/CONICET:
AMR offers a variety of challenges that cannot be addressed without an understanding of the social and economic drivers of antimicrobial use in human and animal systems and the environment. The research councils will benefit from developing an example of truly cross-disciplinary research in this One Health area. UKRI is seeking to develop the area of biosocial science and we suggest that this project will contribute significantly in framing the relevant scientific and policy questions linking social drivers with biological outcomes.