When antimicrobials, especially antibiotics, were discovered it was a boon to both people and animals. Who knew antimicrobials would lose their efficacy so quickly!
The factors responsible for antimicrobial resistance (AMR) are coming to light from research and it seems that, directly or indirectly, humans are responsible for it. Broadly, these factors can be considered to be poor management, unhygienic environments, poorly trained professionals, irrational antimicrobials use, unethical professional practice, lack of alternatives to antibiotics and a lack of technical innovation.
The issue of AMR is perhaps bigger in Asia than elsewhere because most countries in this region have high population density, high levels of illiteracy and a lack of antimicrobial awareness. A lack of proper understanding of the seriousness of the issue, can lead to people believing what others say and do – even if that leads to wrong or risky behaviour and actions.
In such a situation, it is not fair for the poultry sector to take all the blame for AMR. However, if we do find practices in the poultry sector to be behind the spread of AMR, we need to point out the elements responsible for creating this undesirable and life-threatening problem so we can offer logical solutions.
In short, can we blame our birds for AMR? No!
After all, can they take antibiotics by themselves? This could seem like a joke but the bitter truth is that ultimately humans are responsible for our AMR problems.
In Bangladesh, there is a shortage of field veterinarians to provide farmers with effective veterinary services and so informal providers (like feed dealers) fill the gap. The poultry sector is largely dominated by feed dealers who sell both feed and medicines at the same time. Sales officers working for the pharmaceutical companies as marketing representatives also try to sell medicines, although they too are not veterinarians.
Meanwhile, farmers lack AMR awareness and their attitudes tend to be reactive, rather than preventive. They like to see immediate results. Therefore, they don’t invest in improved farm biosecurity standards. Using their experience, they medicate their birds and only at a last stage of illness, when they cannot check a disease, do they consult with veterinarians.
It is true that in Bangladesh there is a need for informal providers, as the number of field veterinarians cannot meet the great demand from farmers. Further, we cannot imagine a poultry sector without feed dealers because small-scale farmers are provided with loans in a convenient way from the dealers. This chain keeps our farmers under dealers’ control.
Para veterinarian prescribing
The importance of different types of informal providers was revealed in other countries in an international workshop that I attended in Entebbe, Uganda. Hosted by the School of Health Sciences of Makerere University, it considered a common antibiotic stewardship framework for agriculture within a unified One Health strategy. The workshop heard how some countries allow their para veterinarians to set up drug shops and prescribe antibiotics, getting recognition and training from their government.
Many workshop participants mentioned the excellent collaborative work of the public and private sectors in both the human and animal sectors in their countries – the private sector sharing its data with the government.
In Bangladesh, many private companies have facilitated laboratory services for our farmers at a reasonable cost and this is very much appreciated. It serves to increase antibiotic sensitivity and to offer a confirmatory diagnosis. However, apart from these noble attempts, irregular practices are more numerous than any beneficial legal initiatives. The practice of crossover use of antibiotics (the use of human drugs in animals) and the use of the reserve (World Health Organization listed) drugs are becoming difficult to end. Factors specific to the poultry sector need to be addressed properly to take necessary steps against this.
From discussion at the Uganda workshop, it seems there is further scope for public-private partnerships and collaborative activities in our country. It could increase private veterinarians’ involvement in government works and accelerate their actions.
Government could also introduce micro-loans and compensation facilities for our poultry farmers to make them less dependent on feed dealers and more cautious in taking feed dealers’ treatment. Establishing specific guidelines for our informal providers is a must to reduce the irrational practice of antibiotics overuse.
There is also a crisis of human health involvement in Bangladesh to cooperate in reducing AMR. The collaboration of animal and human health services is a must to tackle it.
We need to work to save our poultry sector. This means not only finding faults but also creating more opportunities for people in the sector as poultry is a much-needed cheap and available source of protein in Bangladesh.