It is estimated that the share of global antibiotics consumption in food animals for China will increase from 23% in 2010 to 30% in 2030 ( 2). A study estimated that China consumes approximately 162,000 tons of antibiotics in 2013, of which 52% were used in agriculture ( 11). Hence, optimizing antibiotic use in animal agriculture is critical for tackling AMR from a One Health perspective ( 6).Ĭhina is one of the leading consumers of global agricultural antibiotics. The chance of human exposure to resistant pathogens will increase through direct and indirect contact with contaminated food animals, animal products, water, soil, sludge, and manure ( 10). Food animals and the contaminated environments in agricultural settings can serve as reservoirs of antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs) ( 9). Misuse and overuse of antibiotics in animal agriculture can increase the risk of human exposure to AMR through the food chain and environmental pathways ( 7, 8). Global antimicrobial use in the agriculture sector is expected to increase due to accelerating demand for animal-source nutrition, especially in low- and middle-income countries (LMICs) ( 4).ĪMR has been recognized as a One Health issue due to increasing evidence of the development and transmission of AMR through human-animal-environmental interactions ( 5, 6). Antimicrobials are commonly used in livestock farming to prevent infections and as growth promoting agents ( 3), which can aggravate the problem of AMR selection. Globally, animal agriculture accounts for over half of all antibiotic consumption ( 2). Although resistance to antimicrobials is a natural phenomenon, the widespread use of antibiotics has been creating selective pressure and accelerating the screening of drug-resistant strains ( 1). Considering the extensive links of AMR exposure under the One Health framework, efforts to integrate smallholders in antibiotic governance are required to address the AMR burden systematically in China.ĪMR is one of the most serious global public health threats. We also found that smallholders resort to human antibiotics for the treatment of backyard animals because of economic constraints and lack of access to professional veterinary services.ĭiscussion: More attention needs to be devoted to the local structural needs of farmers to reduce antibiotic misuse. Results: Findings revealed that although the governance of antibiotic use has made progress, especially in controlling irrational antibiotic use in commercial farms, smallholders are under-regulated due to a lack of resources and assumptions about their marginal role as food safety governance targets. Interview transcripts were analyzed in NVivo12 using a thematic approach. Methods: 33 semi-structured interviews were conducted with government agriculture officials, veterinary drug sellers, farmers and smallholders in two contrasting areas of rural Zhejiang and Jiangsu provinces, China. This study describes the practices of antimicrobial management in eastern China and current scenarios of antibiotic use in commercial farms and smallholder backyard farming. While the Chinese government has been tightening its regulations to control antimicrobial resistance (AMR) from animal sources in recent years, the extent of antimicrobial oversight and the practices of antibiotic use in animal agriculture in China has not yet been explored. Introduction: China is one of the largest consumers of agricultural antibiotics in the world. 3Division of Health Economics, Policy and Management, School of Public Health, The University of Hong Kong, Hong Kong, China.2Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, School of Public Health, Fudan University, Shanghai, China.1Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.Binjuan Liu 1 †, Wei Wang 2 †, Ziru Deng 2,3, Cong Ma 2, Na Wang 2, Chaowei Fu 2, Helen Lambert 1 * and Fei Yan 2 *
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