The Moral Economy of Antimicrobials in Animal Agriculture: Advancing Policy and Practice in an Era of Antimicrobial Resistance

We will initially focus on a single food animal production industry; with consideration of the use of antimicrobials in beef cattle feedlots. We will work with feedlot personnel, feedlot owners/management, veterinarians, pharmaceutical companies (sales/marketing and management), regulatory agencies (FDA and patent office), and legislators who have served on congressional or senate hearings on related matters. We will carry forward the practical information gleaned from this applied research and share this information in novel classroom and extension/outreach settings with present and future stakeholders identified from the analyses. We will build on a recognition of the inherent benefits to both animal agriculture and human health accruing from the prudent and strategic use of antimicrobial products in the prevention and treatment of infectious diseases of animals. The overall objective of the proposed program is to identify optimum approaches for managing and regulating the use of antimicrobial products in the present, and to develop strategies to extend their usefulness into the future. Working from acquired knowledge on the ethical, social, cultural, and economic bases for the contemporary dispensation of antimicrobials in animal agriculture, we will advance future scenarios for optimized antimicrobial usage under different management and regulatory frameworks. There are separate objectives for each of the three areas of applied research, education, and extension: Research Objectives: 1. Determine the past and present social norms and obligations governing the marketing, prescription and use of antimicrobials in cattle feedlots. 2. Facilitate a systematic review by a panel of experts, in order to generate a range of future scenarios under which existing and to-be-developed antimicrobials might be regulated and managed to optimize their therapeutic use, extend their life, and protect public health. 3. Examine the way that the current social norms, obligations and regulatory frameworks determine the barriers and opportunities that exist under each of the futuristic scenarios. Education Objective: 1. Develop, implement and evaluate new curricula aimed at providing awareness and education on antimicrobial resistance issues and any forthcoming changes in the use of antimicrobials in animal agriculture to both veterinary and animal science students. Extension Objective: 1. Prepare, deliver and evaluate novel extension materials for providing practicing veterinarians and cattle producers with cutting edge information pertaining to changes needed to extend the useful life of antimicrobials while protecting human health.
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Research Objective 1: Through an analysis of relevant policy and regulatory documents and guidelines, interviews with, and a survey of: feedlot personnel and owners/operators; veterinarians; pharmaceutical sales, marketing, regulatory compliance staff, and management; regulators in the Food and Drug Administration and Patent Office; and other policy makers, we will characterize the moral economy of antimicrobial use in animal agriculture. Mapping the moral economy of antimicrobials involves first identifying the actual practices associated with the movement of antimicrobials from development to testing, approval and regulation through to manufacture, distribution and dispensation. In part, this mapping calls for an identification of the participants in this antimicrobial distribution system and a description of how each party understands their interactions as legitimated by a set of social norms and obligations. Research Objective 2: By combining the multiple study findings from Research Objective 1 (above) with existing information on AMR transmission gleaned from the literature, we will better be able to point to a realistic future paradigm for regulating and managing antimicrobials in animal agriculture in a manner consistent with scientific evidence, economic constraints, and social, cultural, and ethical values. To facilitate such an effort, we will assemble a team of 10 recognized outside experts (complemented by the additional expertise represented within the proposal team), from a range of relevant disciplines and backgrounds, to forge an array of future scenarios under which antimicrobials might better be managed and regulated to prevent and mitigate against AMR. Research Objective 3: We will conduct scenario-based research by examining the barriers and opportunities that exist in order to invoke wholesale and/or subtle changes in the way antimicrobials are used in animal agriculture. There may be novel ways to manage these products on an "industry-wide" basis, but contemporary regulatory (including patent law), marketing (pharmaceutical), economic, and social/ethical barriers exist against implementation of any such changes. We will assess the range of options from status quo through the most radical WHO recommendations, with an array of novel approaches in between. Education Objective: We will determine past, present, and planned education of post-secondary students, relating to the use of antimicrobials and their management vis AMR. We will explore the development of novel educational materials at all stages of animal science and veterinary education; including pre-veterinary, pre-clinical and clinical training; both during classroom and practical hands-on experiences. Extension Objective: The Texas Cooperative Extension will provide support for information delivery systems that create an awareness of the AMR research results among various audiences. County Extension faculty will serve as the primary points of contact for distribution of educational information. Distance-learning products will make possible the distribution of information to specialized audiences throughout the state and, potentially, throughout the United States.
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There are inherent benefits to both animal agriculture and human health resulting from the prudent and strategic use of antimicrobial products in the prevention and treatment of infectious diseases of animals. Strategic use implies that a framework exists for the coordinated dispensation of antimicrobial products in agriculture - this is not presently the case. It is widely recognized that economic, regulatory and policy factors drive decisions pertaining to the manufacture, distribution, sale and use of antimicrobials in animal agriculture. We suggest that there exist additional ethical, social, and cultural bases for the dispensation of antimicrobials in animal agriculture. Taken together, the aforementioned factors can be said to constitute the moral economy of antimicrobials. The research objective of this integrated program is to identify optimum approaches (and barriers) to managing and regulating the use of antimicrobial products (in order to mitigate against the development and spread of antimicrobial-resistant bacterial species) in the present, and to develop strategies to extend their usefulness into the future. Our education program is centered around the development of university-level curriculum changes that provide awareness and education on antimicrobial resistance issues. Our extension objective is to prepare, deliver and evaluate novel extension materials to provide practicing veterinarians and cattle producers with information needed to extend the useful life of antimicrobials.