vaccine

Improving Policy Language to Reduce Threat of Antimicrobial Resistance  

A new study analyzes policy messaging around antimicrobial use in food-producing animals, providing recommendations on how to reframe this language in a way that motivates farmers to curb this use and help reduce the global threat of antimicrobial resistance.

Antimicrobial resistance (AMR) is a global threat, driven in part by indiscriminate use of antibiotics, antivirals, and other agents in food-producing animals. Tailored messaging about this threat can help curb excessive use of antimicrobials, particularly by farmers and other food producers, who often oppose regulations for these agents in food-producing animals.

A new study led by researchers at Boston University’s School of Public Health and College of Engineering examined how AMR and antibiotic use are framed in policy documents and reports by global health and agricultural organizations, and found that current messaging in these documents about the risks of AMR and how to curb antibiotic use fails to resonate with farmers and motivate them to reduce antibiotic use. 

Published in JAC—Antimicrobial Resistance, the study found that the most common AMR messaging in these documents focused on the consequences to human health, followed by animal health and welfare, and then food production and security. “Self-interest” messaging that emphasized how farmers themselves can benefit from reducing antibiotic use, however, was largely absent.

As countries across the globe apply a One Health approach to AMR—the idea that the health of humans, animals, and the greater environment are inherently linked and interdependent—it is important for policy messaging to include perspectives that incorporate all of the One Health domains.

“Broad messaging may be ineffective when trying to reach specific stakeholders, especially end-users like farmers,” says study lead author Carly Ching, research scientist at BU’s Zaman Lab. “Instead, it may be more effective to highlight specific motivating factors.” 

For the study, Ching, along with senior author Veronika Wirtz, professor of global health at SPH, and coauthor Muhammad Zaman, professor of global health at SPH and a Howard Hughes Medical Institute Professor of Biomedical Engineering at the College of Engineering, analyzed policy documents and reports from the Food and Agriculture Organization and the Word Organization for Animal Health. 

Each organization prioritized framing that aligned closely with their mission. Specifically, the FAO presented messaging on food production and security (such as how an increase in demand for animal food products could further increase antibiotic use), while WOAH messaging focused on animal health and welfare (such as how antimicrobials are frequently relied upon to maintain livestock health, welfare and productivity in animal production systems). Adopting a more balanced messaging that incorporates both of these animal-specific frames could resonate more deeply with farmers and farm workers, and encourage them to reevaluate antimicrobial use, the researchers say. 

So how can organizations adjust their framing to better communicate the risks of AMR and antibiotic use in food-producing animals and motivate farmers to curb this use? One solution is to create messaging that is more personally relevant to farmers and appeals to their self-interest. This could include framing that highlights the potential health benefits of eating antibiotic-free meat, or identifies how AMR could lead to an increase in infectious diseases that pose an economic threat to farmers directly—such as the H5N1 bird flu.

“Public health communicators can speak to ‘self-interests’ by emphasizing direct benefits to the target audience that align with scientific evidence,” says Wirtz. “For example, sharing personal stories from other farmers who have successfully reduced antimicrobial use can help build trust and relevance.” 

The researchers also encourage framing that avoids assumptions about farmers’ knowledge of AMR, and uses language that considers differences in cultural practices and norms among farmers in different countries. 

“In terms of sector or culturally tailored messaging, while human and animal health are connected in a One Health approach, the expectations may differ,” Ching says. “In agriculture and farming, there is a push to be voluntarily better than standard practices, while in human healthcare, clinical guidelines pertaining to antimicrobial use are standard. As such, calling normal farm practices ‘misuse’ could be confusing, since these are common in their context.”

Effective messaging around AMR and farmers’ antibiotic use should also appeal to global interests, such as the framing of health security as global stability, the researchers say. Understanding that infectious disease threats in other countries can cross borders and quickly become a local threat to their own populations can motivate them to adopt practices (i.e. reduced antibiotic use) that can prevent this scenario from occurring.

“Overall, we found that the most used motivational frame, on average, across all documents was still human health, which speaks to how One Health messaging still focuses largely on human health,” says Ching. “Thus, a conscious effort still needs to be made to uphold an integrated perspective of all One Health domains. Future research includes better understanding the motivation behind antimicrobial use among farmers, as well as effective strategies for disseminating messages.”