Alternative Medicines on the Farm: A Study of Dairy Farmers' Experiences in France

What do complementary and alternative medicines mean to UK dairy farmers and how do they use them?

Background

Complementary and alternative medicine (CAM) is used by some farmers to support herd health management practices. There is concern by a large majority of the veterinary community, who consider CAM to be counter to evidence-based practice. Little is known about what and how CAM is used on farms, and it is not clear which products or practices are encompassed by what farmers consider to be CAM. This paper reports on a study exploring the use of CAM on dairy farms in the UK.

Methods

Twenty farms with a range of management systems and herd sizes were recruited. Interviews were conducted with 24 farmers via face-to-face, telephone or videoconferencing modalities necessitated by the Covid-19 movement restrictions. 16 farms were visited to collect observational data using ethnographic fieldnotes and photographs. Interviews were conducted using topic guides and explored participants' experience of CAM and potential influence on antibiotic use. Interviews were audio recorded, transcribed, and thematically analysed using NViVo software.

Results

A range of views and conceptualisation of CAM was identified among the participating dairy farmers. CAM was not usually seen as one particular product or health management tool but encompassed a range of health management strategies and philosophies. Results indicated that some farmers explore and engage with a range of complementary and alternative medicines and approaches to animal health on dairy farms. Some farmers considered food products, shop bought products, environmental enrichment, in-depth animal observations and technology to form part of their CAM approach. Farmers associated CAM with holistic health management and animal welfare. CAM formed part of a wider ethos regarding holistic farming and land use and was sometimes used to support them in avoiding overuse of antibiotics.

Discussion

Farmers use CAM, and their conceptualisation of it is complex. Several resources and stakeholders were consulted by farmers to understand CAM and conventional medicine. Farmers interest in CAM warrants further consideration. This may support dairy farmers to reduce antimicrobial use responsibly, with veterinary support.

The Introduction of the Global Traditional, Complementary, and Integrative Healthcare (TCIH) Research Agenda on Antimicrobial Resistance and Its Added Value to the WHO and the WHO/FAO/UNEP/WOAH 2023 Research Agendas on Antimicrobial Resistance

Background/Objectives: Given the magnitude and urgency of the global antimicrobial resistance (AMR) problem and the insufficiency of strategies to reduce antimicrobial use, there is a need for novel strategies. Traditional, Complementary, and Integrative Healthcare (TCIH) provides strategies and solutions that contribute to reducing (inappropriate) antimicrobial use, preventing or treating infections in both human and veterinary medicine, and may contribute to promoting the health/resilience of humans and animals and reducing AMR. The aims of this study were to present the core results of a global TCIH research agenda for AMR and its added value to two existing global AMR research agendas published in 2023. Methods: A survey, interviews, and consensus meetings among network members, as an adapted version of the nominal group technique, were executed to develop the global TCIH research agenda. A comparison of the global TCIH research agenda with the two existing global AMR research agendas was performed. The TCIH additions to these two existing global AMR research agendas were determined. Results: The global TCIH research agenda adds to 19 of 40 research priorities of the World Health Organization (WHO) AMR research agenda 2023 and three of the five pillars of the WHO/Food and Agriculture Organization of the United Nations (FAO)/United Nations Environment Programme (UNEP)/World Organisation for Animal Health (WOAH) research agenda 2023. In addition, the TCIH research agenda adds two new research themes with four new research priorities and three new research priorities to already existing themes of the two global AMR research agendas. Conclusions: The global TCIH research agenda fits with and adds to two global AMR research agendas and can be used as an additional strategy to reduce AMR and (inappropriate) use of antibiotics.

Animal board invited review: Improving animal health and welfare in the transition of livestock farming systems: Towards social acceptability and sustainability

The need to integrate more clearly societal expectations on livestock farming has led the authors of this article to consider that livestock farming systems must be redesigned to position health and welfare at the heart of their objectives. This article proposes a vision of the advances in knowledge required at different scales to contribute to this transformation. After defining health and welfare of animals, the article emphasises the need to consider health in a broader perspective, to deepen the question of positive emotional experiences regarding welfare, and raises the question of how to assess these two elements on farms. The positive interactions between health and welfare are presented. Some possible tensions between them are also discussed, in particular when improving welfare by providing a more stimulating and richer environment such as access to outdoor increases the risk of infectious diseases. Jointly improving health and welfare of animals poses a number of questions at various scales, from the animal level to the production chain. At the animal level, the authors highlight the need to explore: the long-term links between better welfare and physiological balance, the role of microbiota, the psycho-neuro-endocrine mechanisms linking positive mental state and health, and the trade-off between the physiological functions of production, reproduction and immunity. At the farm level, in addition to studying the relationships at the group level between welfare, health and production, the paper supports the idea of co-constructing innovative systems with livestock farmers, as well as analysing the cost, acceptability and impact of improved systems on their working conditions and well-being. At the production chain or territory levels, various questions are raised. These include studying the best strategies to improve animal health and welfare while preserving economic viability, the labelling of products and the consumers' willingness to pay, the consequences of heterogeneity in animal traits on the processing of animal products, and the spatial distribution of livestock farming and the organisation of the production and value chain. At the level of the citizen and consumer, one of the challenges is to better inter-relate sanitary and health perspectives on the one hand, and welfare concerns on the other hand. There is also a need to improve citizens' knowledge on livestock farming, and to develop more intense and constructive exchanges between livestock farmers, the livestock industry and citizens. These difficult issues plead for interdisciplinary and transdisciplinary research involving various scientific disciplines and the different stakeholders, including public policy makers through participatory research.

Informational resources used by farmers with ruminants and monogastrics for animal health monitoring: importance of sensory indicators

Managers of health in livestock systems are asked to shift from a curative approach to a more preventive approach. This change requires sociological and technical reconfiguration and raises the issue of how changes are implemented by farmers and their technical support ecosystem (advisors, trainers, veterinarians). Here, we report work conducted in western France by an Agricultural European Innovation Partnership Operational Group bringing together animal scientists and sociologists to advance knowledge on animal health in a range of livestock sectors, i.e. dairy cattle, beef cattle, small ruminants (sheep, goats), poultry and pigs. In this study, our aim was to answer this question: what are the Informational Resources (I.R.) that farmers use to promote animal health of their herds? First, we used a survey to characterize 129 I.R. used by advisors, then, we used statistical analysis to classify these I.R. into six clusters. Second, we organized eight focus-group sessions that involved a total of 50 farmers from across all livestock sectors to find out how they mobilize the I.R. and what they see as important for animal health monitoring practice. Finally, we performed individual interviews with 42 farmers to expand the data captured in the collective focus groups. Results showed that farmers and advisors have a broad and diverse range of I.R. to help monitor animal health. We identified six clusters of I.R.: regulatory tools, periodic reports, tools for farmer-led monitoring, tools and indicators for national reference datasets, slaughterhouse and laboratory indicators, and training delivered to farmers. During focus group, livestock farmers identified some of their I.R. within these clusters but they also cited other daily routines that help them monitor animal health that were not cited by advisors. We found that farmers mainly use sensory indicators (typically smell, sight, touch) in their daily practice whereas advisors mainly use relatively sophisticated retrospective monitoring tools. Farmers also cited the importance of indicators that can rapidly objectify any change in animal condition, behavior, or health. This work finds a split in the distribution of animal health management roles, with farmers implementing daily checks whereas advisors run periodic health surveillance, thus revealing differentiated roles and needs between farmers and their advisors.

Demedication without demedicalization? Redefining the medical and economic boundaries of veterinary professional jurisdiction

Veterinarians' professional jurisdiction is nowadays facing major challenges. Regulatory changes in the prescribing and dispensing of medicines, which have historically been at the heart of veterinary jurisdiction, could fragilize the medical power of this professional group. This article analyses the practices and strategies deployed by veterinarians to preserve and readapt their jurisdiction, by discussing recent work in sociology of professions and reflecting on how the case of veterinarians could help rethink the contrasting case of human doctors. This article is based on two field studies in France (in diverse livestock sectors) made of more than 40 interviews and 70 h of ethnographic observation of veterinary activity. We first show how veterinarians' jurisdiction over medicines was built up and how their professional autonomy is put under pressure by recent injunctions to demedicate livestock and to develop preventive approaches to animal health. We then detail how the economic and medical boundaries of veterinary jurisdiction are being redefined through dynamics of protocolization and contractualization of care which allow veterinarians to impose themselves as health managers. Finally, we demonstrate that this situation favors the emergence of new forms of professional legitimacy based on an "evidence-based veterinary medicine" that their competitors cannot contest, and on the development of economic infrastructures that supports and makes it possible to monetize this new professional expertise. Finally, this article discusses contemporary processes of medical professionalization. It argues that, unlike human medicine, veterinary medicine has been able to maintain its professional power even if its historical jurisdiction has been reshaped. This has required a redefinition of professional activity both as a medical (i.e. approaches to animal health) and economic (i.e. business model of veterinary companies) practice.

The antimicrobial landscape as outlined by Danish dairy farmers

Limiting antimicrobial use (AMU) in dairy farming is an important step toward reducing antimicrobial resistance (AMR). Therefore, it is relevant to understand dairy farmers' choices and the potential for change in relation to AMU, even in countries with low usage. Furthermore, there is an increasing recognition of the need to focus on both the individual farmer's behavior as well as the context surrounding and influencing the farmer's decisions in relation to AMU if the goal is further reduction. To date, no studies have taken into account both the individual farmer and their context in both conventional and organic dairy farms under Danish conditions. For this study, 15 Danish dairy farmers were interviewed using qualitative semi-structured research interviews, and the notion of landscape was used to describe the context of their AMU. We found that AMR was considered a distant element of the farmers' antimicrobial landscape. Daily challenges such as acutely diseased animals and poor housing conditions seemed more urgent and overruled the threat of AMR. We also found that interviewed farmers had differing opinions on farm management, partly shaped by changes in legislation and ways of farming over time. At one end of the scale, some organic farmers had rethought the current way of farming; keeping robust animals in a natural setting was expected to prevent disease. They were positive about legislation, and the numerous restrictions on AMU over time were thought to contribute to ensuring quality for consumers. At the other end of the scale, some conventional farmers perceived disease as something that should be controlled through treatment, and the currently eased legislation and intensification of farming have legitimatized AMU for this purpose, leading to an expectation among these farmers of certain rights to handle medicines themselves. These contrasting views might lead to inspiration and competition in terms of reducing AMU, as the farmers appeared to value the opinions of other farmers, and they were found to continuously assess each other. Through such ongoing assessment, pioneers of AMU reduction-whether organic or conventional-might motivate their colleagues to change their AMU. Future research should address the potential of experience- and attitude-sharing among farmers as motivation to reduce AMU.