AMR as a Global and One Health Issue: the Challenge to Adapt a Global Strategy in Two Low‐ and Middle‐income Countries, Mozambique and Vietnam

Abstract

SummaryAntimicrobial resistance (AMR) is framed by international organisations as a global threat requiring a One Health (OH) approach. This raises challenges for adapting a global strategy to national contexts and sectorial policies. In the agricultural sector, another challenge is to avoid stigmatization of farmers’ behaviours and to pay more attention to other stakeholders and systemic drivers of antibiotic (AB) use. We examine the case of two low‐ and middle‐income countries (LMICs): Mozambique and Vietnam, with different levels of veterinary AB consumption (respectively lower and higher than the world average), accessibility to alternatives to veterinary AB (non‐existent in Mozambique) and veterinary medicines and services (very unequal in Mozambique), and opportunities to value higher‐standard products on domestic markets (emerging in Vietnam). The differences between these two LMICs challenges current ‘one size fits all’ strategies. We recommend embedding better national AMR strategies into sectorial agricultural policies and country‐specific contexts (i.e. by considering the functioning of the drugs markets and livestock value chains; resistance to other veterinary medicines, such as trypanocide), and to address the observed contradictions with national agricultural policies which, in order to face the growing consumption of animal products, encourage the development of livestock systems that are technically and economically dependent on the use of AB.