Member profile
Dr. Chioma Achi
Organization:
University of Cambridge
Country:
United Kingdom
Field(s) of expertise:
I am working on:
I am currently working on the genomic diversity of antimicrobial resistance in Salmonella isolates recovered from people and animals. My other research interests are on food safety, zoonoses, and One-Health.
Dr. Chioma Achi
Thanks, Irene and James.
With regards to the best approach of communicating resistance in other microbes, I do agree that the collective term "antimicrobials" should be used in all campaigns. The emphasis has always been on antibiotics and bacteria and not much on the other bugs (except for scientists and researchers who are working specifically in these areas). The message should be clear that any medicine that is used for whatever type of infection or disease should be used only when absolutely needed in order to prevent bacteria from developing resistance to them.
One thing I also found interesting from my engagement with farmers is the use of the "cocktail" of drugs. Here, you have a sachet of medicine labeled "anti-stressor" or "multivitamin" but which in actual fact has a certain amount of antimicrobials incorporated into it. Some farmers would innocently use these without knowing the full content. The cocktails are often administered as growth promoters hence exposing bacteria to minute amounts of the antimicrobials that lead to resistance.
As Irene said, feed producers should be included in the list of priority stakeholders. I do understand that in a bid to compete for the market, producers are somewhat under pressure to ensure that farmers get optimum productivity when they use their products and hence might be compelled to incorporate certain levels of antimicrobials in the feeds. This again is the reason we need serious engagement. The people need to understand the consequences of their actions and take responsibility for propagating and doing right when it comes to AMR stewardship.
The message should also be very clear on AMU, "the intent is not to stop complete use of antimicrobials because they are essential and do save lives but to use them only when absolutely necessary so we do not run out of them".
Even though we need technocrats and people in other sectors to pass on the right message, from my experience of working with farmers, they are more likely to do the right thing when they understand the implications of their actions and when you present to them alternatives. For instance, if you say they shouldn't use antimicrobials, then one must be willing to invest in training them on good biosecurity and husbandry measures and other prevention strategies. As long as this new alternative results in increased profit, less cost and improved productivity, they will most likely go with it.
Dr. Chioma Achi
I am pleased to be part of this forum and I look forward to discussing with you all and learning from your contributions. It is my first time here, so pardon me if I do not exactly follow the format, I will learn as time progresses.
Early this year, we organized a public engagement program with farmers in Nigeria and we had some good interaction. We conducted one-on-one interviews with farmers upon arrival. This was to enable us to gauge prior knowledge of AMR. About half of the farmers that attended the program said they had not heard about antimicrobial resistance while some who had previously heard of the term AMR but did not completely get the message. My take on the questions raised for this discussion are:
1. The message on AMR is often presented as an abstract term and gives the impression of an impending threat (e.g. 10 million people will die by the year 2050 from AMR infections).
There is a need to make communications on AMR relatable to the “ordinary person” in order to drive the message home and make it easier to understand. The threat of AMR needs to be strongly emphasized and communicated as a problem that is already with us.
In our previous programs, we noticed more engagement when real-life experiences of the impact that AMR has on human health, livestock productivity, and food safety were shared. We also noticed increased interest when we analyzed the economic cost of using antimicrobials versus increased productivity in relation to prevention strategies of infections, improved biosecurity measures, and sanitation. Farmers want to hear how they can save costs whilst improving productivity.
Key stakeholders in the fight against AMR such as farmers who directly use antimicrobials are somewhat ignored in communications regarding AMR and inappropriate AMU in Africa. It is not enough to place posters in strategic places and share pamphlets on AMR without appropriate engagement. We do not need to assume that people will assume what the posters say. Often times, passing a message on behavioral change does not directly translate to change in behavior. Other strategies like active engagement need to be put in place to enable people to understand the meaning behind the message.
3. To get AMR into the news and list of hot topics, countries need to invest in recording and communicating the number of lives lost per year due to AMR, quantifying AMR in terms of economic losses and magnitude of the threat. Proactive key stakeholders involvement is important and it might be needful to have in-country ambassadors for AMR, these could be highly respected people in the society who will be committed to this cause.
4. Properly coordinated, clear and concise messages on AMR in various dialects can be passed through local radio and television networks as well as national stations. Grassroot engagements often in collaboration with various associations could also be useful. Disseminating this information across board will also prompt consumer awareness in demanding for antimicrobial-free (organic) products.
5. Farmers are critical stakeholders and should be given priority. They do need to understand the need for responsible AMU if there has to be behavior change in terms of administering antimicrobials only when needed, not putting pressure on Veterinarians or extension workers for antimicrobials, and taking ownership to ensure the health of the nation in terms of food safety. There is a need to also involve Veterinarians, Lab diagnosticians, government bodies and the media.
6. The National Communication Commissions, National CDCs, various ministries of Health, Agriculture, and Animal Health should be involved at national level while the African Union, African CDC, AU-IBAR need to take a strong stand in leading continental advocacy activities and awareness on AMR and AMU. FAO and WHO regional offices are already doing excellent work in this area and should continue with this.
I look forward to an engaging discussion.