Diagnostic innovation and livestock (DIAL): towards more effective and sustainable applications of antibiotics in livestock farming

The widespread use of antibiotics in livestock farming, in many circumstances, increasingly serves as alternative to the diagnosis, targeted treatment and prevention of disease in individual animals, flocks and herds. Relationships and practices between diagnosis, prescription, treatment and prevention have become stretched to the point of rupture, a rupture thrown into sharp focus by the issue of AMR. Better, smarter, more rapid and more accessible diagnoses, driven by a shift in the behaviours and conditions associated with diagnostic decision making (whether performed in the laboratory or at the point-of-care by veterinarians or farmers) represents a critical step to delivering a more effective and sensible use of antibiotic medicines in animal health. Improvements in diagnostic development and practice, however, and in their relationship to prescription and treatment, require social, governance and technical innovations, understanding the parameters and conditions of which demands urgent research. In this proposed research, we ask: "What needs to be in place to develop better conditions for a diagnostic-led approach to animal care and treatment?"

This interdisciplinary research team will work with and draw from original, empirically driven information, understanding and analysis from diagnostic tool developers and regulators, veterinary practices and professional bodies, farmers and treatment, decision makers, veterinary laboratories, the food industry and government regulatory authorities to develop durable and innovative strategies for facilitating and advancing smarter approaches to the use of antibiotics in agriculture.

We aim to collaboratively generate, evaluate and analyse behaviours and strategies in the practice and governance of animal disease diagnosis, and to show how innovation in the development of diagnostic tools and methods in diagnostic practice along with diagnostic regulation and governance can lead to more sensible use and prescription of antibiotics in animal farming. To do this, we will assess current diagnostic and treatment decision practices in the UK. We will generate understanding of the current development of, market for, and regulation of new and innovative diagnostic tools and technologies. Working with veterinarians, diagnostic developers, farmer and regulators, we will identify pathways and possibilities for improved diagnostic practice and, with partner veterinary practices, will trial new diagnostic tools on a series of farms. We will conduct pilot and capacity-building research in Tanzania, where the relative absence of robust national-level institutions and governance structures for the management of animal disease creates a different context for the coherent stewardship of antibiotic practice and diagnostic use.

We will assess the adaptability and responsiveness of the different production sectors (poultry, pigs and cattle), along with a variety of veterinary structures, to the trialled innovations in diagnosis and diagnostics, and will determine the likely benefits of these innovations for prescription practice, for animal health and for livestock production. We will evaluate the implications these innovations will have for the organisation, cost-effectiveness and efficiency of veterinary practice, as well as for veterinary training. We will identify the changes in behaviour, practice and knowledge necessary to accompany the more widespread adoption of novel and innovative practices that are deemed effective. We will assess the regulatory and governance support necessary to see the adoption and use of innovative diagnostic practices. With our project partners, we will develop detailed strategies for the improved use of diagnostic tools and practices to enable more effective and sensible use of antibiotics in livestock agriculture.

This research addresses the conditions needed to achieve improved veterinary diagnostic practices and treatment decisions through behaviour and practice change, leading to more sensible and sustainable use veterinary medicines. It will provide a detailed assessment of current veterinary (and on-farm) diagnostic practice, and will directly feed this back to interested parties: veterinary practitioners, farmers and the overall animal agricultural industry. Working directly with industry partners to inform and direct the research, the project will deliver reasonable and realistic recommendations regarding the development of viable protocols, standards and practices relating to diagnosis, treatment procedures and interventions. This research will establish and utilise avenues for co-production of science and practice-driven knowledge and information, and will yield insights into how market-driven forms of governance and regulation (such as assurance, certification and benchmarking) and deontological forms (such as professional affiliations and standards) can contribute to achieving changes in the behaviour and practices of diagnosis, prescription and treatment involving antibiotics in livestock agriculture. The impacts will reach across a number of domains and communities.
Diagnostic industry: This research investigates the nature and market of the diagnostic development industry, looking at the regulatory and other barriers and drivers of innovative diagnostic development and their real-world application in the context of achieving more responsible use of antibiotics. Working in the UK, with a pilot study in Tanzania, the project investigates the promising near-future developments in innovative diagnostics and the market and adoption environment for these products. The project involves the triaing of new diagnostic practices to ascertain their likely potential to yield behaviour change in medicine use as well as their economic and organisational implications for diagnostic practice.
Veterinary practices, diagnosticians and diagnostic users: Working closely with veterinary practices and professional veterinary bodies, the research will provide evidence, insights and analysis in the current and innovative use of diagnostics in delivering more responsible medicine use. The project will consider the shifting role and place of diagnostics with respect to disease treatment and prevention, and will contribute to the development of protocols and standards in diagnostic use.
Regulators and governance bodies: The project assesses the impact of the current regulatory environment and governance on the development and use of diagnostics in test development and veterinary medicine, and, by working with key actors in the UK and elsewhere, will inform future governance in this area, such as the role of regulation in incentivising the development of innovative technologies; the development of formularies, limitations on critically important antibiotics, improvements to the prescribing cascade, changes to the licensing of diagnostic tests or certain veterinary medicines.
Farmers and the livestock industries: Current use of diagnostics in veterinary medicine is strongly affected by farmer and veterinary attitudes, behaviour and concerns such as issues of sampling, the time taken for diagnostic results to be available in order to impact upon treatment decisions, the nature of the on-farm environment, as well as information and cost. By working with veterinarians and farmers, exploring their ideas through surveys and interviews, and through the trialing of innovative and novel diagnostic procedures, the project will provide empirical data and analysis allowing re-assessment of the potential for better diagnostics on farms.
Wider public: The analysis and understanding generated by this project will respond to significant public and policy concerns relating to more responsible use of antibiotics, especially in livestock.