Exploring the barriers and incentives towards effective surveillance for antimicrobial and anthelmintic usage (AMHU) in beef cattle and sheep in Great Britain

Arnold, Jean-Christophe; Whatford, Louise; Gabain, Isobel; Tak, Mehroosh; Van Winden, Steven; Barling, David; Haesler, Barbara

Abstract

Antimicrobial and anthelmintic usage (AMHU) in livestock production has increased over the last 50+ years. Microbial and helminthic exposure to such drugs is understood to have contributed to increased resistance to treatment, causing significant economic impact in the human and animal health sectors. Surveillance of
AMHU is an important part of a mitigation-policy cycle for antimicrobial and anthelmintic resistance (AMHR). It is used to guide decisions on treatment, identify populations at risk, understand the epidemiology of AMHR and inform the development and evaluation of strategies and interventions. In this study, we aimed to explore potential barriers and incentives towards enhancing AMHU surveillance in beef cattle and sheep sub-sectors using a PESTLE - Political, Economic, Sociological, Technological, Legal and Environmental factors – analysis.

The United Kingdom (UK) currently collects antimicrobial usage (AMU) data for the purpose of national surveillance, with sales data from the pharmaceutical industry and sub-sector-specific usage data. Increased efforts have been made towards capturing AMU data to understand which are high users and to observe usage trends. Sub-sector-specific AMU surveillance coverage is the largest in poultry, pig, aquaculture, and gamebird sub-sectors who are currently achieving 90% and above (RUMA 2020; VMD 2020).

However, AMU surveillance coverage remains low in the GB beef sub-sector (9.6% of GB slaughtered beef (VMD 2020)) and appears largely absent in the sheep sub-sector. Furthermore, no anthelmintic usage (AHU) data is captured for national surveillance despite the high economic burden of parasitism on grazing livestock, strong efforts by industry-led organisations towards promoting responsible AHU, and evidence of mounting levels of anthelmintic resistance (AHR) (Hennessey et al. 2020). Increased AMU data capture in the beef sub-sector is required to increase representativeness, determine usage level, and observe trends. In sheep, enhanced data capture will help to understand the sub-sector’s contribution to total AMU in livestock,
and to set targets for reducing AMU. Surveillance of AHU seems particularly relevant in sheep and beef cattle systems, as they are often raised in extensive, grass-based systems and are at higher risk of helminth infection.

Workshops and one-to-one interviews were conducted with 26 stakeholders directly and indirectly implicated in AMU and potential AHU surveillance in the beef cattle and sheep sub-sectors. Workshops and interviews were held in February and March 2021 to discuss these issues from the perspective of stakeholders’ roles in the system. In the workshops, barriers, and incentives for enhancing AMU and implementing AHU surveillance in beef and sheep were discussed considering political, economic, sociocultural,
technological, legal, and environmental factors. Additionally, interviews on the same topics were conducted with stakeholders who were unable to attend workshops. Summary notes from workshops and interviews were analysed thematically in an iterative process among the study authors and emerging themes were identified. These were supplemented by knowledge from the literature and used to define recommendations.

Key themes that emerged were the following:
• The heterogeneity of the beef cattle and sheep sub-sectors poses challenges towards the collection and collation of AMU data for national surveillance.
• The apparent lack of human health implications of AHR limits political will towards implementing AHU surveillance.
• Quality and compatibility issues of collected AMU data are barriers towards its use for the purpose of national surveillance.
• Voluntary mechanisms of collecting AMU data are the preferred route (at least in a first instance) in comparison to firmer legal or regulatory requirements for farmers to report AMU data. Firmer requirements may include the following:
o Accreditation schemes can provide economic incentives to farmers to report AMHU data if medicine reporting were integrated into standards
o Outcome-based payments have potential to be an opportunity for improved AMU surveillance, such as the proposed Animal Health and Welfare Pathway grant scheme in England, through a requirement for farmers to report AMU data.
• The ability to benchmark medicine usage on-farm can be an incentive for farmers to report data into the Medicine Hub for cattle and sheep (recently launched by the Agriculture and Horticulture
Development Board, AHDB). AMU data can be of greater value to farmers when contextualised alongside additionally collected farm data, for example, on animal health and welfare, timing of
administration and other measures of productivity.
• The farmer-veterinarian relationship is considered of importance to enhance AMU data capture by encouraging greater accuracy of medicine recording and communicating the benefits of reporting
AMU data to farmers (for benchmarking).

There is optimism that the AHDB Medicine Hub for cattle and sheep can be successful in being the central repository for AMU data. Potential strategies for improving AMU data capture in beef and sheep can factor the Hub as the repository for reporting AMU data. In its capacity to record medicine data generally, it can additionally serve as a source of AHU data.
• Anthelmintic drugs are predominantly sold and supplied by non-veterinary outlets. As such, alongside sales data from the pharmaceutical industry and on-farm AHU recording, such nonveterinary sources of anthelmintics potentially serve as a target for AHU data capture.

From our findings, we present 15 recommendations on AMHU data capture and use of AMHU knowledge that span recording and reporting, cooperation and collaboration, co-design and agency, and effective linking and use of data and the information generated.

Citation

Arnold, J., Whatford, L., Gabain, I., Tak, M., Van Winden, S., Barling, D., & Haesler, B. (2021). Exploring the barriers and incentives towards effective surveillance for antimicrobial and anthelmintic usage (AMHU) in beef cattle and sheep in Great Britain. RVC Research Online: not applicable

• Report Type: Research Report
• Online Publication Date: May 12, 2021
• Publication Date: May 12, 2021
• Deposit Date: May 13, 2021
• Publicly Available Date: May 14, 2021
• Pages: 1-39
• DOI: https://doi.org/10.34840/3r19-fc05
• Keywords: Antimicrobial use; anthelmintic use; surveillance; beef; sheep; UK
• Public URL: https://rvc-repository.worktribe.com/output/1548721