Ethiopia and a Global One Health Challenge

Welcome to this first blog post! I graduated with a veterinary degree from the University of Liverpool in 2005 and immediately spent time volunteering for a veterinary charity in Morocco. This experience provided me with an appreciation of the important role animals have in the livelihoods of communities in Africa. This was my first exposure to One Health – the recognition that the health of animals and the health of humans are intrinsically linked.

After arriving back from Morocco, l spent time completing an equine internship, and in equine ambulatory practice, before returning to the University of Liverpool in 2007 to study for a PhD. My PhD was based in Ethiopia and focused on evaluating the efficacy of knowledge-transfer interventions for communicating animal health messages to rural farmers. My PhD also marked the start of my long time association and deep affection for Ethiopia.

In 2010, l joined the British charity SPANA (Society for the Protection of Animals Aboard) as Director of Veterinary Programs, where l was responsible for managing SPANA’s global veterinary programs, specifically aimed at improving the health and welfare of working animals. These animals supported many of the world’s poorest people, the so-called ‘bottom billion,’ whose livelihoods were intrinsically linked to the health and productivity of the animals they owned. In 2015, l moved to the USA, and took up the position of Director – Global Health Education and Clinical Assistant Professor at the College of Veterinary Medicine, North Carolina State University (

The Soulsby Fellowship provided by The Soulsby Foundation ( allows me to further develop my strong commitment to One Health as an epidemiologist focused on the interface of health and livelihoods in sub Saharan Africa, particularly in Ethiopia. Ethiopia is a wonderful country, with great history and culture, and amazing opportunities ahead. Ethiopia is also a country that faces considerable challenges. The country has the second largest human population in Africa (over 100 million people), with the majority of the population classed as subsistence farmers living in rural areas. Ethiopia has the largest population of livestock in Africa, with agriculture contributing to over a third of the country’s Gross Domestic Product.

Infectious diseases impact the health of livestock in Ethiopia, making antimicrobials vital in combating these diseases. However, there is increasing consensus that it is desirable to reduce antimicrobial use in agriculture. Antimicrobial resistance (AMR) is recognized as a crosscutting threat to global health. The increasing impact and geographical distribution of AMR threatens to undermine decades of progress in effective prevention and control of infectious diseases. One estimate states that drug resistant infections will cause 10 million extra deaths a year and cost the global economy up to $100 trillion by 2050, with the highest mortality rate from AMR found on the African continent.

The research project funded by the Soulsby Fellowship will explore antimicrobial use in central Ethiopia. A qualitative approach utilizing focus groups and interviews will be used to explore themes surrounding antimicrobial use and prescribing behaviors by animal health professionals and livestock owners. This work will build on the existing work being conducted by my research group, the Health and Livelihoods (HEAL) Group (, in collaboration with co-investigators at the Aklilu Lemma Institute of Pathobiology, Addis Ababa University.

Previous work has identified that nearly one-third of rural villagers reported being ill in the last month and that nearly two-thirds owned animals that were ill in the last 12 months. Of these villagers, nearly two-thirds did not know the purpose of antibiotics and could not name the disease they took antibiotics to treat. Addressing the rising threat of AMR requires a holistic and multisectoral approach – a One Health approach.

Thanks to the Soulsby Foundation, this project will be able to promote the importance of a One Health approach in addressing the truly global challenge posed by AMR by providing a better understanding of behavioral determinants and human motivations for prescribing and using antimicrobials. The outcomes will allow us to design and implement culturally appropriate and effective interventions focused on mitigating AMR, helping both animal and human populations.

Andrew Stringer BVSc PhD