Understanding the veterinary antibiotics supply chain to address antimicrobial resistance in Lao PDR: Roles and interactions of involved stakeholders.

In response to the global call to mitigate risks associated with antimicrobial resistance (AMR), new regulations on the access and use of veterinary antibiotics are currently being developed by the Lao government. This study aims to explore how the implementation of these new regulations might effectively reduce and adapt the sale, distribution and use of veterinary antibiotics in Lao PDR. To this end, we used the theory of change, framing the AMR issue within the context of the stakeholders involved in the veterinary antibiotics supply chain. Qualitative and quantitative methods were used to collect data, based on questionnaires (n=36 antibiotic suppliers, n=96 chicken farmers, n=96 pig farmers), and participatory tools such as a workshop (n=10 participants), semi-structured interviews (n=20), and focus group discussions (n=7 participants). The stakeholders' understanding of the AMR issue and potential challenges related to the implementation of new regulations regarding access and use of antibiotics, were also investigated. We mapped the veterinary antibiotic supply chain in Lao PDR, and analysed the roles and interactions of its stakeholders. Twenty-three stakeholders representing the private and the public sectors were identified. Many informal and formal links connected these stakeholder within this supply chain. The lack of veterinarian-farmer interaction and the evolving nature of the veterinary antibiotics supply chain accentuated the challenges of achieving behaviour change through regulations. Most of the antibiotics found on farms were categorized by the World Health Organisation's as critically important antibiotics used in human medicine. We argue that AMR risk mitigation strategy requires dialogue and engagement between private and public sectors stakeholders, involved in the importation, distribution, sale and use of veterinary antibiotics. This study further highlighted that AMR is a complex adaptive challenge requiring multi-sectoral approach. We believed that a sustainable approach to reduce and adapt veterinary antibiotics use should be prepared in collaboration with stakeholders from private and public sectors identified in this study, in addition to the new regulations. This collaboration should start with the co-construction of a common understanding of AMR issue and of the objectives of new regulations.

The endoparasitism challenge in developing countries as goat raising develops from smallholder to commercial production systems: A study from Laos.

Progressing economic development in Southeast Asia has increased regional demand for goat meat, leading to expanding production by smallholders and recently, development of commercial farms. In Laos, an emerging export market for goats into Vietnam has led to increased goat numbers, with potential increases in risk of disease, particularly endoparasitism. A cross-sectional survey investigated the prevalence of gastrointestinal parasites in indigenous Kambing-Katjang goats on smallholder farms (n = 389) in 8 villages where no anthelmintic treatments were in use, providing comparisons with a case study of imported Boer crossbred goats (n = 45) on a commercial farm where intensive anthelmintic treatments were required to manage mortalities attributable to Haemonchosis. Clinical examinations, collection of faecal samples, and pathological examination on the commercial farm, accompanied collection of information on animal gender, age and body weight, with data analyses performed in Genstat. Faecal samples contained eggs of multiple endoparasitic species, with Strongyles spp. and coccidian oocysts of Eimeria spp. most prevalent. Significant associations between the presence of endoparasites and the farm type (smallholder versus commercial; p < 0.008 and 0.001) were observed, with the odds ratios of the commercial farm having Stronglyes spp. and Eimeria spp. of 1.3 (CI = 0.6-2.9) and 4.8 (CI = 2.5-9.1). Mortalities from endoparasitism were only recorded at the commercial farm, with the loss of 24 goats in the final 3 months of the dry season (Feb-April). This study identified a moderate prevalence of multiple endoparasitic species in smallholder goat farms that appeared well-tolerated, whereas in the developing commercial system, endoparasites posed significant risks to enterprise viability, even with use of anthelmintics. Further studies on endoparasite control are required if commercial tropical goat meat production is to prove sustainable and assist in addressing regional food security, plus provide a pathway to improve the livelihoods of Lao goat smallholders seeking to expand and intensify their enterprises.