Selecting Efficient Farm-level Antimicrobial Stewardship Interventions from a One Health perspective

Lead Research Organisation: London School of Hygiene & Tropical Medicine
Department Name: Epidemiology and Population Health

Abstract

It is often suggested that interventions to prevent the development and transmission of antimicrobial resistance (AMR) should be targeted at the livestock sector. The potential costs to agriculture are often argued as "worth it" for the long-term human (and animal) health benefits. However, a quantification of the relative benefits and costs for each system is lacking.

Through shared learning across partners and secondary use of existing data, we plan on answering the question 'What farm-level antimicrobial usage (AMU) interventions are most efficient at the national-level, given different scenarios of human health, AMU and AMR, for England, Denmark and Senegal?', defining efficiency as the optimisation of resource use, given a set budget and a set of desired outcomes.

We will use statistical, mathematical and economic modelling to construct a compartmental model that can assess (i) the interplay between animal, environment and human transmission of AMR, and (ii) the interplay between costs and benefits across One Health. We will analyse the impact of previously implemented intervention to inform modelling of future interventions under different AMR scenarios. Settings, costs and benefits will be specifically defined via expert elicitation through a stakeholder-led 'knowledge hub'.

This work will not only provide explicit impact estimates and ranking for a range of farm-level AMU interventions, it will also provide insight into uncertainty, highlighting where future research could be most valuable in understanding AMR intervention efficiency from a One Health perspective.

Technical Summary

It is often postulated that interventions to prevent the development and transmission of antimicrobial resistance (AMR) should be targeted at the livestock sector. The potential costs to agriculture are often argued as "worth it" for the long-term human (and animal) health benefits. However, a quantification of the relative benefits and costs for each system is lacking.

Through shared learning across partners and secondary use of existing data, we plan on answering the question 'What farm-level antimicrobial usage (AMU) interventions are most efficient at the national-level, given different scenarios of human health, AMU and AMR, for England, Denmark and Senegal?', defining efficiency as the optimisation of resource use, given a set budget and a set of desired outcomes.

We will use statistical data analysis, transmission dynamic mathematical modelling and microeconomic economic modelling to construct a unified model that can assess (i) the interplay between animal, environment and human transmission of AMR, and (ii) the interplay between costs and benefits across One Health. The statistical data analysis will analyse the impact of previously implemented interventions to inform modelling of future interventions under different AMR scenarios. Settings, costs and benefits will be specifically defined via expert elicitation through a stakeholder-led 'knowledge hub'.

This work will not only provide explicit impact estimates and ranking for a range of farm-level AMU interventions, it will also provide insight into uncertainty, highlighting where future research could be most valuable in understanding AMR intervention efficiency from a One Health perspective.
 
Description ILRI / University of Copenhagen 
Organisation International Livestock Research Institute (ILRI)
Country Kenya 
Sector Charity/Non Profit 
PI Contribution New research collaborations and generation of data / analysis
Collaborator Contribution Bringing data and perspectives to the One Health AMR partnership
Impact New data analysis and links to policy networks and impact
Start Year 2022
 
Description Knowledge Hub meetings 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Knowledge Hub meeting to gain input on model structures: what interventions should we model? what scenarios are realistic and what should we focus on in terms of pathogens / drugs.
Year(s) Of Engagement Activity 2023