What’s the worry about antibiotics? Andy Stringer reports

Ethiopia relies on livestock. They are crucial to the livelihoods of the majority of the country’s population and to the country’s economy. However, infectious diseases impact the health of livestock in Ethiopia, making antimicrobials vital in combating these diseases. Antimicrobial resistance (AMR) is recognised as a significant threat to global health. Estimates have highlighted that drug resistant infections will cause 10 million extra deaths a year and cost the global economy up to $100 trillion by 2050. The highest mortality due to AMR will be found on the African continent.

The landmark report on AMR, authored by Lord O’Neil, identified a number of important interventions, including the need for a global public awareness campaign, and reducing the unnecessary use of antibiotics in agriculture. Our project, funded by the Soulsby Fellowship, is based in central Ethiopia, specifically in the Ada district of Oromia regional state, and aims to tackle this grand global challenge.

Selection of veterinary pharmaceuticals for sale through an informal seller in central Ethiopia
Selection of veterinary pharmaceuticals for sale through an informal seller in central Ethiopia. Photo: Keli Gerken

The project involves focus group discussions with both animal health professionals and livestock owners to explore themes surrounding antimicrobial use and prescribing behaviors. Previous studies have identified a lack of knowledge by livestock owners regarding antibiotics. Considerable issues surrounding the availability, accessibility and affordability of antibiotics, and drive inappropriate usage practices. Certain antibiotics are purchased by traders and then decanted into previously used, smaller drug bottles, for resale.

Small ruminant being injected with antibiotic by an Ethiopian Animal Health Assistant
Small ruminant being injected with antibiotic by an Ethiopian Animal Health Assistant. Photo: Keli Gerken

Primary veterinary healthcare in Ethiopia is delivered by numerous different animal healthcare professionals. Veterinarians, diploma-holding Animal Health Assistants, Animal Technicians, Community Animal Health Workers and private drug sellers. Across these formal and informal providers there is a greatly varying degree of knowledge, attitudes and behavioral practices to the appropriate usage of antibiotics. To date, there is scant information on the motivations for prescribing antibiotics. This information is vital in any future program designed to address inappropriate usage.

Our project has identified the study location, the study participants, and is currently piloting the methodologies that will be used in the focus group discussions. It is anticipated that the data collection phase will begin, and be completed, in February. The aim of our project is to ascertain a better understanding of behavioral determinants and human motivations for prescribing and using antimicrobials. This information will facilitate the design and development of culturally appropriate interventions focused on mitigating AMR, helping both animal and human populations.