Diagnostic innovation and livestock (DIAL): towards more effective and sustainable applications of antibiotics in livestock farming

在许多情况下，抗生素在畜牧业中的广泛使用越来越多地成为诊断、针对性治疗和预防个别动物、畜群和牛群疾病的替代方法。诊断、处方、治疗和预防之间的关系和实践已经到了破裂的地步，这种破裂因AMR问题而成为人们关注的焦点。更好、更智能、更快速和更容易获得的诊断，在与诊断决策相关的行为和条件的变化(无论是在实验室还是在兽医或农民的护理点进行)的推动下，是在动物健康中更有效和更明智地使用抗生素药物的关键一步。然而，改进诊断的发展和实践，以及改进它们与处方和治疗的关系，需要社会、治理和技术创新，了解这些参数和条件需要迫切研究。在这项拟议的研究中，我们问：“需要什么才能为以诊断为导向的动物护理和治疗方法创造更好的条件？”这个跨学科研究团队将与诊断工具开发商和监管者、兽医实践和专业团体、农民和治疗、决策者、兽医实验室、食品行业和政府监管机构合作，并从原始的、经验驱动的信息、理解和分析中获取信息，以开发持久和创新的战略，促进和推进在农业中使用抗生素的更智能方法。我们的目标是合作产生、评估和分析动物疾病诊断实践和治理中的行为和战略，并展示在诊断实践中开发诊断工具和方法以及诊断监管和治理方面的创新如何能够在动物养殖业中更合理地使用和处方抗生素。为此，我们将评估英国目前的诊断和治疗决策实践。我们将促进对新的和创新的诊断工具和技术的当前发展、市场和监管的理解。我们将与兽医、诊断开发人员、农民和监管机构合作，确定改进诊断实践的途径和可能性，并将与合作伙伴兽医实践一起，在一系列农场试验新的诊断工具。我们将在坦桑尼亚进行试点和能力建设研究，那里相对缺乏强有力的国家级机构和治理结构来管理动物疾病，为抗生素实践和诊断使用的协调管理创造了不同的背景。我们将评估不同生产部门(家禽、猪和牛)以及各种兽医结构对诊断和诊断学试验创新的适应性和响应性，并将确定这些创新对处方实践、动物健康和畜牧业生产的可能好处。我们将评估这些创新对兽医实践的组织、成本效益和效率以及对兽医培训的影响。我们将确定行为、实践和知识方面的变化，以便更广泛地采用被认为有效的新的和创新的做法。我们将评估必要的监管和治理支持，以确保采用和使用创新的诊断做法。我们将与我们的项目伙伴一起制定详细的战略，以改进诊断工具和实践的使用，以便在畜牧业中更有效和合理地使用抗生素。

The widespread use of antibiotics in livestock farming, in many circumstances, increasingly serves as alternative to the diagnosis, targeted treatment and prevention of disease in individual animals, flocks and herds. Relationships and practices between diagnosis, prescription, treatment and prevention have become stretched to the point of rupture, a rupture thrown into sharp focus by the issue of AMR. Better, smarter, more rapid and more accessible diagnoses, driven by a shift in the behaviours and conditions associated with diagnostic decision making (whether performed in the laboratory or at the point-of-care by veterinarians or farmers) represents a critical step to delivering a more effective and sensible use of antibiotic medicines in animal health. Improvements in diagnostic development and practice, however, and in their relationship to prescription and treatment, require social, governance and technical innovations, understanding the parameters and conditions of which demands urgent research. In this proposed research, we ask: "What needs to be in place to develop better conditions for a diagnostic-led approach to animal care and treatment?"This interdisciplinary research team will work with and draw from original, empirically driven information, understanding and analysis from diagnostic tool developers and regulators, veterinary practices and professional bodies, farmers and treatment, decision makers, veterinary laboratories, the food industry and government regulatory authorities to develop durable and innovative strategies for facilitating and advancing smarter approaches to the use of antibiotics in agriculture.We aim to collaboratively generate, evaluate and analyse behaviours and strategies in the practice and governance of animal disease diagnosis, and to show how innovation in the development of diagnostic tools and methods in diagnostic practice along with diagnostic regulation and governance can lead to more sensible use and prescription of antibiotics in animal farming. To do this, we will assess current diagnostic and treatment decision practices in the UK. We will generate understanding of the current development of, market for, and regulation of new and innovative diagnostic tools and technologies. Working with veterinarians, diagnostic developers, farmer and regulators, we will identify pathways and possibilities for improved diagnostic practice and, with partner veterinary practices, will trial new diagnostic tools on a series of farms. We will conduct pilot and capacity-building research in Tanzania, where the relative absence of robust national-level institutions and governance structures for the management of animal disease creates a different context for the coherent stewardship of antibiotic practice and diagnostic use.We will assess the adaptability and responsiveness of the different production sectors (poultry, pigs and cattle), along with a variety of veterinary structures, to the trialled innovations in diagnosis and diagnostics, and will determine the likely benefits of these innovations for prescription practice, for animal health and for livestock production. We will evaluate the implications these innovations will have for the organisation, cost-effectiveness and efficiency of veterinary practice, as well as for veterinary training. We will identify the changes in behaviour, practice and knowledge necessary to accompany the more widespread adoption of novel and innovative practices that are deemed effective. We will assess the regulatory and governance support necessary to see the adoption and use of innovative diagnostic practices. With our project partners, we will develop detailed strategies for the improved use of diagnostic tools and practices to enable more effective and sensible use of antibiotics in livestock agriculture.