Chicken or Egg: Drivers for Antimicrobial Resistance in Poultry in India (DARPI)

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The aim of this study is to first to map antimicrobial use (AMU) and the antimicrobial resistance (AMR) that is driven by inappropriate use, across the entire poultry meat supply chain from farm to table in India. The study provides [1] a unique opportunity to map AMU, [2] to understand entry points for development of AMR and [3] the contribution by inappropriate AMU in poultry, and [4] suggests potential solutions to address the huge AMR burden in India.AMR is a major global health risk, particularly in developing countries, threatening human and animal health. Contributing to this problem is the inappropriate use of antimicrobials in people and livestock production. India has a high burden of infectious disease, and bacteria from human clinical infections are becoming increasingly difficult to treat, with fewer treatment options available. Studies suggest that livestock may commonly carry resistant bacteria in their gut, with poultry and poultry meat also identified as a source of such bacteria. However, there is a complete lack of data on the scale of the problem, or on what antimicrobials are being used in poultry meat production, how they are used, and how this contributes to the carriage of AMR bacteria that may be a threat to human and animal health.Poultry meat is one of the main protein sources in Indian and is the fastest growing livestock sector. Increasingly, poultry meat in India is produced through more intensive integrated or semi-integrated farming systems where antimicrobials are used for various purposes, including for growth promotion, to prevent and treat disease. To date there have been no comprehensive studies on AMU or AMR through the poultry meat supply chain. Our interdisciplinary project aims to address these data gaps by studying the poultry meat food supply in its entirety to determine: behaviours that drive AMU and how these contribute to the selection and transmission of AMR, to inform better use; to design with farmers and other stakeholders interventions to reduce AMU/AMR, which are cost-effective and easy to implement; determine the economic impact from changing AMU practices, or using alternatives. The project will involve working closely with the poultry industry, policy makers and other stakeholders throughout to ensure the findings have impact.This project is timely in providing crucial data to inform antimicrobial stewardship: the trajectory of the Indian poultry industry is shifting towards intensive farming and AMU is predicted to rise substantially. Therefore, this is an opportunity to intervene through working closely with stakeholders to provide alternative strategies for sustainable AMU. The project also offers other benefits, with a strong social science component providing unique insights into behaviours driving AMU, as well as service design enabling visualization of AMU and AMR, and co-design strategies. Indian researchers will be trained in these methods, building capacity for social science in Indian agricultural and veterinary research that will have value long after the conclusion of this project. The study will be the first to map AMU and AMR in the entire poultry meat supply chain from farm to table in India. The study provides a unique opportunity to map AMU, understand entry points for development of AMR and the contribution by inappropriate AMU in poultry, and suggest potential solutions to address the huge AMR burden in India.