Foro Global sobre Seguridad Alimentaria y Nutrición (Foro FSN)

1) Quel est le plus grand défi de communication lié à la Résistance aux Antimicrobiens (RAM) et l’utilisation inappropriée d’antimicrobiens (UMA) en Afrique ?

Le grand défi de communication lié à la Résistance aux Antimicrobiens (RAM) et l’utilisation inappropriée d’antimicrobiens (UMA) en Afrique est la participation des experts de la communication audio-visuelle et digitale. Seuls ces professionnels de la communication sont outillés pour véhiculer le message. C’est le principe de « ONE HEALTH » où toutes les spécialités qui rentrent dans la ligne de la santé animale, environnementale et humaine, la sociologie, la communication, l’économie, le droit, doivent jouer son rôle pour atteindre l’objectif commun.

2) Quelle est la meilleure approche pour communiquer sur d’autres antimicrobiens (antifongiques, antiparasitaires, antiviraux, pesticides), et pas seulement sur les antibiotiques ? Etant donné que les virus, les champignons et les parasites peuvent également être résistants aux médicaments couramment utilisés pour traiter et avoir un impact sur la santé et les systèmes alimentaires, comment pouvons-nous communiquer sur ces problèmes en plus des bactéries résistantes aux antibiotiques ?

D’abord, la législation doit être réformée afin réglementer l’accès à ces antimicrobiens ; il faut créer une agence continentale de gestion et de mise sur marché africain avec des représentations dans chaque région d’Afrique. La meilleure approche pour communiquer est de produire des vidéos en dessin animé et des films documentaires en plusieurs langues africaines et de les diffuser par les  acteurs de « ONE HEALTH ». Il ne faut pas oublier de se servir des réalités d’Afrique pour éviter que certains pensent que les RAM n’existent qu’ailleurs.

3) Comment intégrer plus souvent le sujet de la RAM dans les médias ? Comment assurer la visibilité de la RAM parmi les autres « sujets d’actualités » ?

Pour intégrer plus souvent le sujet de la RAM dans les médias, il faut former professionnels du média et les dirigeants africains sur l’impact de l’UMA et de la RAM sur la santé publique, tout en leur faisant savoir que personne n’est à l’abri car les erreurs d’une seule personne peut mettre la vie des milliers de personnes et plus en danger. Quant à la visibilité de la RAM parmi les autres « sujets d’actualités », il faut parrainer certains groupements ou personnes afin qu’ils inondent les médias sociaux.

4) Quels canaux, méthodes ou mécanismes de communication les mieux adaptés et les plus susceptibles d’avoir un impact sur le terrain dans les pays africains ?

N’oublions pas que plus de la moitié des africains sont sur les réseaux sociaux, il faut se servir de ces médias sociaux pour véhiculer le message. Il faut aussi recruter des volontaires engagés de tous horizons, spécialités et couches sociales et les mettre en mission comme des relais.

5) Quel groupe de partie prenante devrait, selon vous, être considéré comme prioritaire pour la diffusion de messages ciblés visant à sensibiliser à l’UMA et à la RAM ?

L’approche « ONE HEALTH » doit être privilégié. Nous savons que 60% des maladies infectieuses humaines sont d’origine animale et 70% de ces zoonoses proviennent des animaux sauvages ; lors du traitement de ces maladies infectieuses, les antimicrobiens sont utilisés à tort ; donc les professionnels de la santé animale et environnementale doivent être en première ligne et à leur côté ceux de la communication.

6) Aux niveaux national, régional et continental, qui devrait, à votre avis, prendre la direction et la responsabilité des activités de sensibilisation et de plaidoyer sur l’UMA et la RAM ?

Au niveau national, il faut un comité « ONE HEALTH » avec pour président de direction le représentant de la FAO et son vice un professionnel de la santé animale ou environnementale.

Aux niveaux régional et continental, la direction et la responsabilité doit revenir au représentant de FAO régional et continental.

1. What is the biggest communication challenge related to AMR and inappropriate antimicrobial usage (AMU) in Africa?

AMR is often considered as a “foreign” challenge and people in Africa seem not to be able to relate to it and governments do not consider it a priority. So, communication should be targeted such that people could see that AMR is a present danger and that they could be involved in solving the challenge.

2. What is the best approach to communicate about other antimicrobials (antifungal, antiparasitic, antiviral, pesticides), and not only antibiotics? As viruses, fungi and parasites can also be resistant to medicines commonly used to treat them, and impacting health and food systems, how do we communicate about these issues in addition to antibiotic resistant bacteria?

Communication should reflect the fact that indiscriminate use of medicines for humans and animals should be discouraged. Also, growth promoting products for livestock and any other treatments should only be used when prescribed by appropriate professionals and as prescribed.

3. How can we get the topic of AMR included more often in the media? How do we ensure the visibility of AMR amongst other “hot topics”?

Dedicated time for discussing AMR issues with compelling audio-visual aids and locally generated and relevant data in print and electronic media.

4. What communication channels, methods or mechanisms are more suitable and will have the greatest impact at field level in African countries?

Agriculture extension workers should be trained to deliver accurate AMR information in their routine activities. Physical contact with end-users (livestock farmers, food producers, sellers/market groups and the general society). Academics should be trained to be AMR Champions and engage with their local communities through farm visits, market visits, radio and television interviews. Professional groups (doctors, nurses, pharmacists, veterinarians) should enlighten their members on AMR issues so that they can limit excessive AMU and ensure proper antimicrobial stewardship.

5. Which group of stakeholders do you think should be considered as priority for targeted key messages aiming at raising awareness on excessive AMU and AMR?

a. Those prescribing antibiotics: doctors, nurses,

b. End-users: livestock farmers, veterinarians, doctors and primary healthcare providers

6. At national, regional and continental levels, who to do think should take leadership and responsibility for awareness and advocacy activities on AMU and AMR?

Multidisciplinary AMU and AMR committees should be constituted at national, regional and continental levels and the teams should direct the awareness and advocacy.

1. One of the biggest challenges related to AMR and inappropiate antmicrobial usage (AMU) in Africa is the lack of adequtae and informed  provision of education to precsribers, commercial pharmacies and medicine stores operators and the community dwellers on the danger of self-medication, self- diagnosis and the resulting adverse effects of poor health seeking behavior by the population.

2.Firstly, AMR prevention and control strategy should be looked at from a multisectorial point of view. Additionally, AMR focal Points of various countries must put proper coordination mechanism that will bring together relevant sectors to discussion the threats of AMR and misuse of antmicrobial agent; in so doing, a clear understanding of  the composition of antimicrobials agents will be communicated to representatives of these sectors. Finally, a strategy can be put into place to creat awareness ,educate and train health care workers, vets  and the population on various antimicrobial agents ( viral, fungal parasite pesticides etc,) on the use of these agents.

3.Considering AMR as new in the health sectors, a program on awareness for schools and communities should be set up to discussion AMR related issues with the authorities and the community leaders through the school science health program and community forum.   Media coverage and scheduled radio talk show with school health program and community leaders  will also help in communicating and informing the entire population on AMR and AMU. This can be talyor to other learning institutions and communities  with continuous financial support.

4.Communication channels: working with school health programs, community focus group forum, development of social media platform with health teaching insttutions,  and coordinating with the administration to incorporate AMR in their curricula, the media and also working with  sectors other then health on relevant AMR issues, civial society group.

5.Group of Stakeholders: Community dwellers, students (junior and senior high students)  Prescribers in both human and animal health sectors, Pharmacists and Physicians, medicine regulatory authiority, Associations of commercial and medicine stores and civial society organizations, health teaching institutions.

6.At national, regional and continental: AMR Coordinators, AMR Technical working groups (TWGs), Donors /Organizations  supporting  the implementation of AMR activities,county governments, public health institutions and sectors involved with AMR related activity.

Thanks for the oppiortunity given me to make my comtributions.

Pharmacist Diana K. Gahn-Smith

AMR National Focal Point, Liberia

2. What is the best approach to communicate about other antimicrobials (antifungal, antiparasitic, antiviral, pesticides), and not only antibiotics? As viruses, fungi and parasites can also be resistant to medicines commonly used to treat them, and impacting health and food systems, how do we communicate about these issues in addition to antibiotic resistant bacteria?

I think the best approach is to communicate about these medicines as one component, and advocate for using the term of antimicrobials instead of communicating about them separately. This would put them at the same level of importance and save time, efforts and other resources.

 3. How can we get the topic of AMR included more often in the media? How do we ensure the visibility of AMR amongst other “hot topics”?

Collaborate with government and private media outlets such as national televisions, radio and newspapers and encourage them to continuously address and adopt AMR 's subject among other issues  they tackle. This can be accomplished by continuous monetary and non-monetary compensation, appropriate and up-to - date AMR information and data provision for these media channels. 

 5.Which group of stakeholders do you think should be considered as priority for targeted key messages aiming at raising awareness on excessive AMU and AMR? 

Prescribers (Physicians, Pharmacists, Veterinarians), Nurses, Pharmacy Technicians, Veterinary Technicians.

Consumers (patients, farmers, food-animal producers) 

6. At national, regional and continental levels, who to do think should take leadership and responsibility for awareness and advocacy activities on AMU and AMR

At the national level: Ministries of health/ Agriculture/Animal Resources/Environment

At the regional and continental level: WHO, FAO, OIE, UNEP/ Africa regions, and CDC Africa.

QUESTION: At national, regional, and continental levels, who do you think should take leadership and responsibility for awareness and advocacy activities on AMU and AMR?

RESPONSE: Communication on AMU and AMR is typically disjointed between the different institutions that deal with the agriculture sector, especially in the LDCs of Sub-Saharan Africa. Recall that in most SSA countries, there are separate ministries for Agriculture Livestock, Fisheries, Forestry, etc., with very little synergy amongst them. This will also mean the potential to convey conflicting information. There is, therefore, need to undertake the following to improve  communication:

(a) Creation of an Inter-ministerial task force on communication (involving all ministries associated with Agriculture, Health, Communication)  with respect to AMU and AMR to harmonize the message; (b) make use of both government-owned public national broadcasting organizations, whether radio or TV,  which are cost-effective and fulfills the mandate of social responsibility; (c) increased involvement of the leadership of farmer umbrella organizations or associations at the national or regional levels.

Synergy amongst these institutions will significantly contribute to timely, effective and in-depth communication of issues of AMU and AMR in the LDCs of SSA.

• What is the biggest communication challenge related to AMR and inappropriate antimicrobial usage (AMU) in Africa?

The inadequacy or lack of information on antimicrobials available and used as well as detailed study and publications of the trends of AMR in Africa is the biggest communication challenge related to AMR. This has caused many to people, groups and companies to import and/or use these antimicrobials at will. Subsequently, stakeholders get disinterested in conversations related to AMR since they don’t see the empirical evidence of the claim being made for AMR in their countries and the continent at large. Medical, pharmaceutical, veterinary sectors administer, prescribe or sell antimicrobials but do not provide data on which antimicrobials were against which pathogens or diseases. It is common knowledge that an antimicrobial may be used to treat several pathogens or diseases without even identifying the underlying cause of the disease. This is the foundation cause of the slow progress on winning the war against AMR in Africa.

• What is the best approach to communicate about other antimicrobials (antifungal, antiparasitic, antiviral, pesticides), and not only antibiotics? As viruses, fungi and parasites can also be resistant to medicines commonly used to treat them, and impacting health and food systems, how do we communicate about these issues in addition to antibiotic resistant bacteria?

Targeted education using available means including but not limited to the media (both online and print), workshops, flyers, technology (the use of apps) is the best approach to communicate issues on AMR. First, the audience needs to be known as this will influence how to send the AMR message. Targeting the general public is good but a better approach is to target cohorts within the general populace, for example, schools, churches, mosques, marketplaces, farmers, industries etc. Having identified these cohorts, the best means of communication like physically delivering an address or using the media or workshops or posters etc can be used in the most preferred language that can be understood by the audience. The use of technology by creating videos, animations, games, posts, competitions serves as a great way to communicating the impact of resistance to medicine, health and food systems.

• How can we get the topic of AMR included more often in the media? How do we ensure the visibility of AMR amongst other “hot topics”?

To begin with, various stakeholders must liaise with different media houses (whether online or print) to talk about health or food related topics and therein make time to talk about AMR during some of these times. Aside from the International Day against AMR, stakeholders within the various African countries must come together under the umbrella of One Health and set aside period to celebrate and educate the masses on AMR. Examples can be cited of situations where antimicrobials were administered but failed to give the needed relief and the public can be called in to join in with their personal experience. This interaction with the public opens room for stakeholders to know the relevant topics to address therefore, educating the public and generally winning the war on AMR.

• What communication channels, methods or mechanisms are more suitable and will have the greatest impact at field level in African countries?

Workshops are the best method of communication at the field level in African countries. Most of these people in the field don’t really have time to use technological gadgets even if they have because of the workload on them. So, getting them to be physically present and educating or training them to have the firsthand experience compared to reading it is the best method.

• Which group of stakeholders do you think should be considered as priority for targeted key messages aiming at raising awareness on excessive AMU and AMR?

Medical doctors, pharmacist and veterinarians form the stakeholder groups that should be given priority in addressing issues on AMU and AMR. They are the groups who are constantly administering, prescribing or selling antimicrobials. Though they are probably the cause of AMR, they are the same group with the relevant knowledge of AMU, hence, can communicate matters on AMU and AMR with certainty.

• At national, regional and continental levels, who to do think should take leadership and responsibility for awareness and advocacy activities on AMU and AMR

AMU and AMR are not a one sector effort. It is multisectoral! It is therefore important that One Health committees or groups with various focus areas including AMR be set up at all the three levels to champion the cause.

English translation below

Chers collègues,

J’espère que ce courrier vous trouvera tous en bonne santé malgré la pandémie du COVID-19. Dans le cadre des discussions et des échanger d’idées sur l'amélioration des communications contre la RAM en Afrique, j’ai le plaisir de partager avec vous mes commentaires ci-dessous par ordre des questions.

1.En matière de communication, quel est le plus grand défi lié à la RAM et à l'utilisation inappropriée des antimicrobiens (UAM) en Afrique ?

Le plus grand défi en matière de communication est la méconnaissance ou la connaissance très limitée de la définition, l’ampleur et les conséquences de la RAM par les acteurs de la communications et l’absence de réglementation pour lutter contre le fléau.

2.Quelle est la meilleure approche pour communiquer sur les autres antimicrobiens (antifongiques, antiparasitaires, antiviraux, pesticides), et sans se limiter aux antibiotiques ? Comme les virus, les champignons et les parasites peuvent également résister aux médicaments couramment utilisés pour les traiter, et avoir un impact sur la santé et les systèmes alimentaires, comment communiquer sur ces questions en plus des bactéries résistantes aux antibiotiques ?

La meilleure approche pour communiquer sur les autres antimicrobiens est la collaboration multi et intersectorielle coordonnée allant de l’élaboration à la mise en œuvre d’un plan de communication qui favorise l’intégration des antifongiques, antiparasitaires, antiviraux et pesticides dans les messages clés et indique un slogan de plaidoyer choisi sur la base des données probantes.

3.Que pouvons-nous faire pour que le thème de la RAM soit plus souvent abordé dans les médias ? Comment assurer la visibilité de la RAM par rapport à d'autres « sujets sensibles » ?

Pour que la RAM soit abordée régulièrement dans les médias et qu’une visibilité soit assurée par rapport à d’autres sujets sensibles, il faut :

A. Disposer d’un plan de plaidoyer capable d’informer, de sensibiliser et d’impliquer les médias et les organisations de la société civile dans la lutte contre la RAM. Un slogan est requis pour orienter les actions.

B. Mettre en place une gouvernance comprenant la constitution et la coordination d’une coalition des OSC œuvrant dans le secteur de la santé notamment la lutte contre la RAM

C. Signer une convention de partenariat avec quelques médias cibles et des organisations de la société civile dans le domaine de la lutte contre la RAM.

D. Mettre en place un réseau (national, régional et continental) des communicateurs et assurer le partage ou la mise à jour de son information sur la lutte contre la RAM.

4.Quels sont les canaux, méthodes ou mécanismes de communication les mieux adaptés et les plus susceptibles d'avoir un impact sur le terrain dans les pays africains ?

Les canaux de communication susceptibles d’avoir un impact dans les pays africains sont :

• Les évènements traditionnels (Conférence, stands) ;
• La presse écrite (journaux, magazine, revues)

Les méthodes ou mécanismes de communication les plus impactant sont :

• La radio (radio communautaire surtout dont les heures d’écoute sont bien synchronisées par les communautés rurales) ;
• L’affichage ;
• La communication événementielle ;
• La télévision.

Il faudra donner une place de choix aux communicateurs traditionnels (musiciens, comédiens, griots etc…) dont l’information et la sensibilisation sur la RAM sont des préalables à leur intégration et leur implication.

5.Quel groupe de parties prenantes devrait, selon vous, être considéré comme prioritaire pour la diffusion de messages clés ciblés visant à sensibiliser à l'utilisation inappropriée des antimicrobiens et à la RAM ?

Par ordre de priorité on devrait considérer les parties prenantes suivantes :

A. le personnel de la santé humaine, animale, végétale et environnementale notamment les prescripteurs

B. Les médias et les Organisations de la Société Civile.

C. Les élus locaux pour intégrer la lutte contre la RAM dans leur plan de développement local ;

D. L’assemblée nationale pour faciliter la compréhension et l’adoption des textes règlementaires si nécessaires ;

E. Les leaders d’opinion pour engager et faire participer la communauté dans la lutte contre la RAM.

6. Aux niveaux national, régional et continental, qui devrait, à votre avis, prendre la direction et la responsabilité des activités de sensibilisation et de plaidoyer sur l'utilisation inappropriée des antimicrobiens et la RAM ?

La direction et la responsabilité des activités de sensibilisation et de plaidoyer sur l'utilisation inappropriée des antimicrobiens et la RAM doivent être confiées respectivement à :

1. Au niveau national : Le ministère de la santé publique ou l’institution nationale de la gouvernance de la RAM s’il en existe appuyé par le bureau pays de l’OMS ;
2. Au niveau régional : Le volet santé de l’organisation sous régionale appuyé par le bureau régional de l’OMS pour l’Afrique et CDC ;
3. Au niveau continental : L’Union Africaine appuyée par le bureau régional de l’OMS pour l’Afrique et CDC.

Recevez mes meilleures salutations.

Par Dr Michel SAGNO, PharmD MSc

Expert Consultant

Chef de l’Unité Suivi-Evaluation

Programme National de lutte contre les

Maladies Tropicales Négligées

BP 585 Conakry

Ministère de la Santé Publique

République de Guinée

Dear colleagues,

I hope this letter finds you all in good health despite the COVID-19 pandemic. As part of the discussions and the exchange of ideas on improving communications against AMR in Africa, I am pleased to share with you my comments below in order of questions.

1) What is the biggest communication challenge related to AMR and inappropriate antimicrobial usage (AMU) in Africa?

The biggest communication challenge is the lack of awareness or very limited knowledge of the definition, extent and consequences of AMR by those involved in communications and the lack of regulations to combat the scourge.

2) What is the best approach to communicate about other antimicrobials (antifungal, antiparasitic, antiviral, pesticides), and not only antibiotics? As viruses, fungi and parasites can also be resistant to medicines commonly used to treat them, and impacting health and food systems, how do we communicate about these issues in addition to antibiotic resistant bacteria?

The best approach to communicate on other antimicrobials is a coordinated multi and intersectoral collaboration ranging from the development to the implementation of a communication plan that promotes the integration of antifungals, antiparasitics, antivirals and pesticides in key messages and indicates an advocacy slogan based on evidence.

3) How can we get the topic of AMR included more often in the media? How do we ensure the visibility of AMR amongst other “hot topics”?

In order for AMR to be discussed regularly in the media and to ensure visibility in relation to other sensitive subjects, it is necessary:

A. Have an advocacy plan capable of informing, raising awareness and involving the media and civil society organizations in the fight against AMR. A slogan is required to guide actions.

B. Establish governance including the constitution and coordination of a coalition of CSOs working in the health sector including the fight against AMR

C. Sign a partnership agreement with some target media and civil society organizations in the field of AMR control.

D. Establish a network (national, regional and continental) of communicators and ensure the sharing or updating of its information on the fight against AMR.

4) What communication channels, methods or mechanisms are more suitable and will have the greatest impact at field level in African countries?

The communication channels likely to have an impact in African countries are:

• Traditional events (conference, stands);
• The written press (newspapers, magazines, magazines)

The most impacting communication methods or mechanisms are:

• Radio (especially community radio whose listening hours are well synchronized by rural communities);
• Billboarding;
• Event communication;
• Television.

It will be necessary to give traditional communicators (musicians, actors, griots, etc.) information and ensure their awareness about AMR as prerequisites for their involvement.

5) Which group of stakeholders do you think should be considered as priority for targeted key messages aiming at raising awareness on excessive AMU and AMR?

In order of priority, the following stakeholders should be considered:

A. human, animal, plant and environmental health personnel, in particular those who can prescribe antimicrobials.

B. The media and civil society organizations.

C. Local elected representatives to integrate the fight against AMR into their local development plan;

D. The National Assembly to facilitate the understanding and adoption of regulatory texts if necessary;

E. Opinion leaders to engage and involve the community in the fight against AMR.

6) At national, regional and continental levels, who to do think should take leadership and responsibility for awareness and advocacy activities on AMU and AMR?

The direction and responsibility for advocacy activities on the inappropriate use of antimicrobials and AMR should be entrusted to:

1. At the national level: The Ministry of Public Health or the national institution of governance of AMR if supported by the WHO country office;

2. At the regional level: The health component of the sub-regional organization supported by the WHO regional office for Africa and CDC;

3. At continental level: The African Union supported by the WHO regional office for Africa and CDC.

Is the Purpose of Communication Just to do something or to Get Something Useful Done by those who can do so?

Some may dismiss this question as an irresponsible one when the world is facing the crisis of resistance to antimicrobials (RAM). In our previous contribution, we have explained why we suggest the use of the abbreviation RAM rather than the so-called AMR. However, we are aware that it took a long time for many to accept that the earth went around the sun even after it has been accepted even by the church. Today, ‘experts’ of every ilk are analogous to the ‘infallible’ clergy of the past.

It is with some regret we note that the two critical questions posed above have been completely ignored by the contributors. Perhaps, this may be due to the fact that they have no time to read what the others have said before them.  It is unfortunate, but one has only a little hope in changing this common tendency. So, we shall now try to point out the importance of the questions we have raised here.

Let us assume that the FAO should communicate to the public ‘about RAM’. What do the contributors expect to happen then?

• After these communications using electronic personal interchange platforms and other methods they have proposed, what do they expect to happen?
• Remember what they want to communicate is that there is a problem; how do they expect their audiences to respond to the crisis when those emphatically advocated methods do not tell the people what to do?
• They have underlined that the public knows very little about the problem and have even proposed story telling as means of ‘getting the message across?’ But they do not include in their message telling people what useful things the public can do.
• Then how can one expect people to respond in any useful way?
• Is it not amply clear that the authorities will have to undertake the correct steps to deal with the problem? And to do so, they require a different set of information viz., the nature of the problem and how best to solve it.
• Public may not understand the scientific basis of what to do and it would be too much to expect it in any country regardless of its technological advances.

Those who have read this contribution this far, will now begin to see how one may do a great deal without contributing anything to solve a problem. True, it will cost a considerable amount of time and money which might give some a sense of having done something. But is that something useful? It is clear that it would have no effect on the problem of RAM.

In our previous contribution, we have included all types of living pathogen ranging from liver flukes and tape worms, protozoans, fungi, bacteria and viruses. However, we did not think that it would be relevant to give an exhaustive list of pathogens in each category.  A longer list of bacteria was given to illustrate some of those pathogens that could thrive in nature when the conditions are favourable to them, hence, they cannot be eliminated from earth.

Those and some others will be spread throughout the world carried from land to land by trade and travel just as the Corona virus did. Therefore, it is a global problem that requires a concerted international effort. No country or a continent can solve this global crisis by its own actions. We have explained what international steps may be useful, and individual nations ought to contribute to that endeavour if we really wish to deal with this daunting challenge.

Therefore, we will reiterate here in general terms what communication could do at global and national levels. Its content is communicated to a specific target audience in order to encourage its members to undertake appropriate action to solve the problem. These audiences fall into two groups; those who have the authority to undertake appropriate action against RAM and those who can compel the former to act. Those in the first group are the authorities both global and national while the latter group embraces the general public.

Thus we propose the following two sets of communication, each directed at a particular audience with respect to what each of them are willing and able to do in real life:

• To international and national authorities; an aptly worded description of the problem and what they should do as well as the urgent need of rapid action.
• To general public; a simpler version of the problem, what they should encourage the authorities to do, what they can do about their own personal hygiene and the need for quick action.

What precisely each audience ought to do has been fully described in our previous contribution and will not be repeated here. We shall not speculate on the ability of the electronic personal exchange platforms which has been named by some previous contributors. The complexity of the problem of RAM and what each group ought to do can hardly be compressed into a few lines of electronic text. Therefore, we are sceptical about its efficacy. But, one could always hope for the impossible i.e., reason and fundamental scientific principals may win over reductive eye-candy.

Best wishes!

Lal Manavado.

What is the biggest communication challenge related to AMR and inappropriate antimicrobial usage (AMU) in Africa?

The biggest communication challenge has been the lack of interest by most stakeholders in this area. On the level of farmers, they are interested in their profit margin and any thing they will do to protect that is wellcome. We have seen that in many areas of agricultural practices from chemical usage to the misuse of antibiotics. From farming to fishing despite the education. We could not ignore the effect of poverty in all this. Ignorance is also barrier to communication as most farmers have little knowledge of the effect of usage on the lives of consumers as they haven't seen or experienced any person who have suffered such. The area of health promotion and agriculture extention is another barrier as we see or hear very little of such communication in our media or extension worker circles. Very few civil society groups are advocating on such in africa basically because of lack of funding as most Civil society groups are not funded by state and therefore could only shift their attention on issues they could secure funding. 

What is the best approach to communicate about other antimicrobials (antifungal, antiparasitic, antiviral, pesticides), and not only antibiotics? As viruses, fungi and parasites can also be resistant to medicines commonly used to treat them, and impacting health and food systems, how do we communicate about these issues in addition to antibiotic resistant bacteria?

The issues most be communicated following all forms of social marketing skills. The inclusion of such matter in basic and second cycle school curicular will bring the needed attention to the growing youth who invariably will be a mouth piece in their communities. Broader stakeholder engagement are needed here considering the nature of the subject and its multiple causality. Stakeholder mapping and development of a national framework for action on this issue and its communication is of neccesity. 

How can we get the topic of AMR included more often in the media? How do we ensure the visibility of AMR amongst other “hot topics”?

We could get the topic included often in the media when CSO are engaged to wage a media campiagn and advocacy on the subject. Observing the celebration of AMR day and supporting community, district, regional forums on the subject. Active health promotion of the subject would also be of essence

What communication channels, methods or mechanisms are more suitable and will have the greatest impact at field level in African countries?

The use of the electronic media most especially the radio and television, community radios, engaging churches, the use of organisations with community volunteers for house to house campaigns woud be a good initiative. Red cross for example in the past in Ghana have help in many of such leads in addressing guinea worm eradication, maternal and  child health and many others and they could be of valuable service.

Which group of stakeholders do you think should be considered as priority for targeted key messages aiming at raising awareness on excessive AMU and AMR?

Farmers, both animal and crop, community leadership, educational service, the health promotion sector, civil society groups and policy makers

At national, regional and continental levels, who to do think should take leadership and responsibility for awareness and advocacy activities on AMU and AMR

If there are nutrition councils or commission in various nations they could be the best to lead this however, the three sectors which are most effected could lead the process. Health, Agriculture could play a lead role. 

Dear Forum participants,

Thank you for your valuable ideas and suggestions in this forum. With the team, we have been following the advice and recommendations that you have been giving, and they are providing us with significant insight and inspiration.

One of the key points that a number of people mentioned was to keep AMR messages simple and clear. Some pointed out that there is a low level of understanding, or resistance, to believe the extent of the negative impacts of AMR. In order to convey this in a clearer way, it has been suggested that we use real-life stories of individuals affected by AMR – stories about their journeys – to help make AMR a more relatable subject to ordinary people.

Participants also mentioned the opportunity to use of both traditional and modern media. Social media was identified as an effective tool to reach out to the younger generation of farmers and health workers, and to enable messages to connect with food consumers. Traditional media, especially radio programming, was suggested as an effective way to reach people in rural areas. Adapting messages to local languages was also recommended by multiple people as well.

“Engagement” was also a key word that many people used. Engagement not only supports effective communicating, but it also builds a sense of ownership about AMR issues that we all face. After all, AMR is everyone’s business. People suggested that efforts should be made to engage religious leaders, educators, political leaders, health care providers, medical workers, veterinarians, lab diagnosticians, government agencies, media reporters… and so many more.

These were just a few of the contributions that participants shared in the online forum thus far. As we extend the deadline till 30 June 2020, we look forward to your valuable contributions and ideas. Please keep the great ideas coming, and further challenge our approaches and thinking with your fantastic ideas and suggestions. Many thanks to all consultation participants for your time and effort.

Kind regards,

Scott Newman

Senior Animal Health and Production Officer and

FAO Secretariat to the Africa Tripartite One Health Regional Coordination Group

FAO Regional Office for Africa