Understanding the veterinary antibiotics supply chain to address antimicrobial resistance in Lao PDR: Roles and interactions of involved stakeholders

Poupaud Mariline, Putthana Vannaphone, Patriarchi Alessandro, Caro Domingo, Agunos A., Tansakul N., Goutard Flavie. 2021. Understanding the veterinary antibiotics supply chain to address antimicrobial resistance in Lao PDR: Roles and interactions of involved stakeholders. Acta Tropica, 220:105943, 13 p.

https://doi.org/10.1016/j.actatropica.2021.105943

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Quartile : Q2, Sujet : PARASITOLOGY / Quartile : Q2, Sujet : TROPICAL MEDICINE

Résumé : In response to the global call to mitigate risks associated with antimicrobial resistance (AMR), new regulations on the access and use of veterinary antibiotics are currently being developed by the Lao government. This study aims to explore how the implementation of these new regulations might effectively reduce and adapt the sale, distribution and use of veterinary antibiotics in Lao PDR. To this end, we used the theory of change, framing the AMR issue within the context of the stakeholders involved in the veterinary antibiotics supply chain. Qualitative and quantitative methods were used to collect data, based on questionnaires (n=36 antibiotic suppliers, n=96 chicken farmers, n=96 pig farmers), and participatory tools such as a workshop (n=10 participants), semi-structured interviews (n=20), and focus group discussions (n=7 participants). The stakeholders' understanding of the AMR issue and potential challenges related to the implementation of new regulations regarding access and use of antibiotics, were also investigated. We mapped the veterinary antibiotic supply chain in Lao PDR, and analysed the roles and interactions of its stakeholders. Twenty-three stakeholders representing the private and the public sectors were identified. Many informal and formal links connected these stakeholder within this supply chain. The lack of veterinarian-farmer interaction and the evolving nature of the veterinary antibiotics supply chain accentuated the challenges of achieving behaviour change through regulations. Most of the antibiotics found on farms were categorized by the World Health Organisation's as critically important antibiotics used in human medicine. We argue that AMR risk mitigation strategy requires dialogue and engagement between private and public sectors stakeholders, involved in the importation, distribution, sale and use of veterinary antibiotics. This study further highlighted that AMR is a complex adaptive challenge requiring multi-sectoral approach. We believed that a sustainable approach to reduce and adapt veterinary antibiotics use should be prepared in collaboration with stakeholders from private and public sectors identified in this study, in addition to the new regulations. This collaboration should start with the co-construction of a common understanding of AMR issue and of the objectives of new regulations.

Mots-clés Agrovoc : antibiotique, partie intéressée, résistance aux antimicrobiens, médecine vétérinaire, législation sanitaire, réglementation, chaîne d'approvisionnement, santé animale, analyse des parties prenantes

Mots-clés géographiques Agrovoc : République démocratique populaire lao

Mots-clés libres : Antimicrobial resistance, Stakeholder mapping, Veterinary drugs, Policy regulations, Supply chain, Public and private sector collaboration, National action plan

Classification Agris : L75 - Pharmacologie et toxicologie
E70 - Commerce, commercialisation et distribution

Champ stratégique Cirad : CTS 4 (2019-) - Santé des plantes, des animaux et des écosystèmes

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