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Access to veterinary medicines in sub-Saharan Africa (lay summary)

This is a lay summary of the article published under the DOI:

Published onApr 30, 2023
Access to veterinary medicines in sub-Saharan Africa (lay summary)
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More animal drug regulation needed in sub-Saharan Africa

Researchers have called for international regulations to better control how animal drugs are made, sold and used in sub-Saharan Africa. This region has an unstable veterinary drug market, which can lead to misusing or overusing animal medicines. This in turn impacts how effective such veterinary drugs are against animal diseases in the long term.

Veterinarians (animal doctors) give animals infected with microbes (like bacteria) medicines called antimicrobial drugs. When these drugs are misused or overused, disease-causing microbes may develop resistance to the drug, meaning that the drug is less effective at killing them. 

Antimicrobial resistance is a global problem because animal diseases become harder to manage. One way to help prevent antimicrobial resistance is to better control the use, supply and demand for veterinary drugs.

In this study, researchers looked specifically at the access to veterinary drugs in sub-Saharan Africa. They wanted to understand how drug policies in other countries might help create more access to animal medicines in the region. They therefore reviewed  information on the topic of veterinary medicine in Africa. They looked at information from experts in the field, articles that discussed using antimicrobials for farms, and guidelines from different organisations that speak about animal farming and using veterinary medicine. 

Researchers noted that the market for veterinary drugs in Africa makes up only 3% of the global drug market. Most of the drugs were imported from countries outside of Africa. 

They said that because of poverty, farmers in Africa largely can’t afford animal drugs.

In most African countries the private sector provides animal drugs and services, but they hardly provide to the rural areas because there are too few animals, and not enough drugs will be bought. The rural areas get basic veterinary services by people who are not licensed to give services. But, the supply of drugs is not very good or regular. 

Because Africa uses a lot of meat, people sell veterinary drugs without knowing how much must be used on animals or how to use it. Also, some people sell the drugs without vet permissions, which is why the drug market and quality in Africa is unstable. 

Africa is not included in the development of new drugs specific to African animals and diseases and so, there is a limit to the drugs that African farmers can use. This leads to “off-label” use, which is when the drug is not used for its intended purpose. There are also illegal drugs sold for animal farming in Africa, and this causes farmers to use cheaper drugs that may be of bad quality.

The researchers found that donations created more access to veterinary drugs in developing countries in the form of returned or unwanted drugs. They said that it helps the countries get drugs that they actually need, but there are no specific safety instructions for using the drugs. 

However, public-private partnerships, which merge the public and private sectors to help in veterinary services, have improved the quality and access of veterinary drugs recently.  

Other studies previously looked at the demand of veterinary drugs in different countries, but this study specifically focused on the supply and use of drugs in animal farming. 

The authors conclude that although Africa has low access to legitimate veterinary drugs, antimicrobial resistance in African countries is still high due to illegal drug use that leads to overuse or misuse. Thus, understanding the drug market, the supply and the use of these drugs for animal farming could help control antimicrobial resistance. 

The authors of this paper were from France and Mozambique.

Abstract 

The significant increase in antibiotics resistance (AMR) has become a major issue over the last decade. Current international focus falls largely on reducing the excessive use and misuse of antibiotics in animal farming. The drivers of this consumption are generally studied through farmers' behavior and veterinary-farmers interactions. However, drug use also results from structural factors that determine the functioning of the drugs market chain and farmers' access to drugs. This article presents an overview of the limits to access to veterinary drugs in sub-Saharan Africa (SSA), as well as the international policy tools and setups that claim to improve it. We analyze the scientific and grey literature, the publicly available data of the veterinary pharmaceutical industry and international organizations in order to gather information on the veterinary drugs markets in SSA, and on the norms, recommendations, guidelines and initiatives at international level that impact the functioning of the markets chains in SSA. We highlight numerous roadblocks to access to veterinary medicines in SSA. The African market is highly dependent on imports. It suffers from a high level of fragmentation, weak distribution infrastructures and services and is driven by the multiplication of private non- professional actors playing a growing role in the veterinary drug chains. The distribution system is increasingly dualized, with on the one hand the public sector (supported by development organizations) supplying small scale farmers in rural areas, but with limited and irregular means; and on the other side a private sector largely unregulated which supplies commercial and industrial farming systems. Different innovations have been developed at the international level to lower these barriers, such as homogenization of national legislations, donations and vaccine banks. Along decades-old inter-state cooperation, many new forms of Public-Private partnerships and hybrid forums are emerging, signaling a growing power of the private sector in the global governance. In sub-Saharan Africa (SSA), access to veterinary drugs is far from a given and remains an issue for many farmers. Drugs access is highly heterogeneous, little regulated and the market chains are increasingly segmented. The duality of the structure of the market chains has significant implications for the strategies aiming at controlling AMR at global level. Many of them emphasize the need to reduce the use of antibiotics at farm levels, without embracing this duality within countries. These strategies need to take to take into account the diversity of the conditions of access and use of drugs. Policies aimed at regulating the risks associated with the use of some drugs, especially antimicrobials, should not only focus on end users, farmers and veterinarians, but also encompass the actors that influence the flow of these compounds.

Disclaimer

This summary is a free resource intended to make African research and research that affects Africa, more accessible to non-expert global audiences. It was compiled by ScienceLink's team of professional African science communicators as part of the Masakhane MT: Decolonise Science project. ScienceLink has taken every precaution possible during the writing, editing, and fact-checking process to ensure that this summary is easy to read and understand, while accurately reporting on the facts presented in the original research paper. Note, however, that this summary has not been fact-checked or approved by the authors of the original research paper, so this summary should be used as a secondary resource. Therefore, before using, citing or republishing this summary, please verify the information presented with the original authors of the research paper, or email [email protected] for more information.

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Access to Veterinary Medicines in sub-Saharan Africa
Description

The significant increase in antibiotics resistance (AMR) has become a major issue over the last decade. Current international focus falls largely on reducing the excessive use and misuse of antibiotics in animal farming. The drivers of this consumption are generally studied through farmers' behavior and veterinary-farmers interactions. However, drug use also results from structural factors that determine the functioning of the drugs market chain and farmers' access to drugs. This article presents an overview of the limits to access to veterinary drugs in sub-Saharan Africa (SSA), as well as the international policy tools and setups that claim to improve it. We analyze the scientific and grey literature, the publicly available data of the veterinary pharmaceutical industry and international organizations in order to gather information on the veterinary drugs markets in SSA, and on the norms, recommendations, guidelines and initiatives at international level that impact the functioning of the markets chains in SSA. We highlight numerous roadblocks to access to veterinary medicines in SSA. The African market is highly dependent on imports. It suffers from a high level of fragmentation, weak distribution infrastructures and services and is driven by the multiplication of private non- professional actors playing a growing role in the veterinary drug chains. The distribution system is increasingly dualized, with on the one hand the public sector (supported by development organizations) supplying small scale farmers in rural areas, but with limited and irregular means; and on the other side a private sector largely unregulated which supplies commercial and industrial farming systems. Different innovations have been developed at the international level to lower these barriers, such as homogenization of national legislations, donations and vaccine banks. Along decades-old inter-state cooperation, many new forms of Public-Private partnerships and hybrid forums are emerging, signaling a growing power of the private sector in the global governance. In sub-Saharan Africa (SSA), access to veterinary drugs is far from a given and remains an issue for many farmers. Drugs access is highly heterogeneous, little regulated and the market chains are increasingly segmented. The duality of the structure of the market chains has significant implications for the strategies aiming at controlling AMR at global level. Many of them emphasize the need to reduce the use of antibiotics at farm levels, without embracing this duality within countries. These strategies need to take to take into account the diversity of the conditions of access and use of drugs. Policies aimed at regulating the risks associated with the use of some drugs, especially antimicrobials, should not only focus on end users, farmers and veterinarians, but also encompass the actors that influence the flow of these compounds.

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