New study explores the benefits of a One Health approach to investigating antimicrobial resistance in Vietnam

ILRI/Nguyen Ngoc Huyen).

The One Health concept promotes the enhancement of human, animal and ecosystem health through multi-sectoral governance support and policies to combat health security threats.

In Vietnam, antimicrobial resistance in animal and human health settings poses a significant threat, but one that could be minimised by adopting a One Health approach to antimicrobial resistance surveillance.

Vietnam is a potential hotspot for the emergence of antimicrobial resistance due to the high burden of infectious diseases that are directly transmissible and that are foodborne, coupled with limited enforcement of regulations to penalise non-compliance, and the relatively unregulated access to antimicrobials for humans and high antimicrobial usage for livestock.

To advance understanding of the willingness and abilities of the human and animal health sectors to investigate antimicrobial resistance through a One Health approach, a recent study published in BMC Public Health (February 2020) explored the perceptions and experiences of those tasked with investigating antimicrobial resistance in Vietnam, and the benefits a multi-sectoral approach offers.

The study used qualitative methods to provide key informants’ perspectives from the animal and human health sectors. Two scenarios of foodborne antimicrobial resistance bacteria found within the pork value chain were used as case studies to investigate challenges and opportunities for improving collaboration across different stakeholders and to understand benefits offered by a One Health approach surveillance system.

Fifteen semi-structured interviews with 11 participants from the animal and six from the human health sectors at the central level in Hanoi and the provincial level in Thai Nguyen were conducted.

Eight themes emerged from the transcripts of the interviews. From the participants’ perspectives on the benefits of a One Health approach: (1) communication and multi-sectoral collaboration, (2) building comprehensive knowledge and (3) improving likelihood of success. Five themes emerged from participants’ views of the challenges to investigate antimicrobial resistance: (4) diagnostic capacity, (5) availability and access to antibiotics, (6) tracing ability within the Vietnamese food chain, (7) personal benefits and (8) Managing the system.

The findings of the study suggest that there is potential to strengthen multi-sectoral collaboration between the animal and human health sectors in Vietnam by building on existing informal networks.

Based on these results, the authors of the study recommend an inclusive approach to multi-sectoral communication supported by government network activities to facilitate partnerships and create cross-disciplinary awareness and participation.

The themes relating to diagnostic capacity show that both the animal and human health sectors face challenges in carrying out investigations on antimicrobial resistance although based on the results, there is a greater need to strengthen the animal health sector.

Citation
Mitchell, M.E.V., Alders, R., Unger, F., Hung Nguyen-Viet, Trang Thi Huyen Le and Toribio, J.-A. 2020. The challenges of investigating antimicrobial resistance in Vietnam – what benefits does a One Health approach offer the animal and human health sectors? BMC Public Health 20: 213.