The UK Antimicrobial Resistance Strategy 2013–18: A Qualitative Study of International and Domestic Policy and Action Related to Livestock and the Food Chain

Abstract

Antimicrobial resistance (AMR) is an increasingly important challenge within global health, and growing action is being taken by countries across the world. The UK Government established a national AMR Strategy in 2013, encompassing human and animal health. An evaluation of the implementation of the Strategy was commissioned, to feed into a refresh of the Strategy in 2018. This article addresses the implementation of the parts of the Strategy related to food sourced from animals. It is based on 15 semi-structured interviews with policy officials and professionals from UK and international agencies. Four themes comprise the findings from thematic analysis. (1) The UK's advocacy and leadership at the global level to encourage international action, which was praised. However, the UK's actions were limited in permeating complex international food supply chains. (2) Integrating a One Health approach, adopted in the Strategy, which had successfully facilitated bringing together human and animal health sectors, but still lacked input from environmental agencies and integration of the role of environmental factors in understanding and tackling AMR. (3) Changes in antimicrobial use and attempts to reduce AMR brought about by the Strategy, including the disparity in variations of actions and progress between livestock sectors, the pros and cons of antimicrobial usage reduction targets—felt to be best when adapted for each livestock species sector, the preference for voluntary sector-led approaches to reduction in antimicrobial use, and the need for changes in production systems and animal husbandry. (4) The challenges relating to costs, drivers and incentives identified to reduce antimicrobial use, and how research, data and surveillance systems support continued action. In particular, the need for adequate investment and financial incentives to enable changes in production and husbandry to take a more preventative approach, the importance of working with different actors throughout the food chain in each livestock sector, and the need for adequate and consistent surveillance data to measure antimicrobial use and continued research to understand AMR. The findings have implications for how to implement further changes at both farm and policy level, how to implement harmonized surveillance whilst maintaining sectoral autonomy, the need for a whole food chain approach, and greater integration of research, actions and actors working on environmental factors of AMR.