One of the most pressing problems facing public health globally is a rapidly increasing prevalence of antimicrobial resistance (AMR).(Ventola, 2015) In 2011, the World Health Organization focused their World Health Day theme on "Combat Drug Resistance - No action today, no cure tomorrow".(Chan, 2011) Today, antimicrobials have become a victim of their own success(Rimbara, 2012) – a problem fuelled by the growing use of antibiotics in farmed animals, often to treat illnesses that do not require antimicrobial therapy.
Routine administration of human prescribed antibiotics to promote growth and prevent diseases in animals reared for food remains common practice among farmers in countries of Asia and the Pacific.(Phillips et al., 2004) According to Van Boeckel (2015), “this widespread use of antimicrobials in livestock contributes––by means of natural selection––to the emergence of antimicrobial-resistant bacteria (ARBs) and has significant public health implications: ARBs of animal origin can be transmitted to humans through the environment and food products and to agricultural workers by direct contact”.(Van Boeckel et al., 2015) These practices are contributing to the spread of drug-resistant pathogens in both livestock and humans, and pose a significant public health threat.(Marshall & Levy, 2011) A recent study from seven European countries showed a strong correlation between consumption levels of eight classes of antimicrobials and the prevalence of AMR commensal Escherichia coli in pigs, poultry and cattle.(Van Boeckel et al., 2015, Fortané et al., 2015)
Fiji is the second largest Pacific island country, comprising a total land area of 18,274 km² located between Vanuatu to the west and Samoa to the east. The country’s 0.9 million population(Fiji Bureau of Statistics, 2017) inhabit more than 300 islands. Like most Pacific Island countries, Fiji is vulnerable to environmental degradation as a result of natural disasters; highly destructive cyclones in particular have had a direct impact on the livelihoods of local people.(Lal et al., 2009) The country’s Western Division (Nadi, Lautoka, Ba, Tavua and Rakiraki) has historically been on the forefront of destruction caused by natural disasters, which have wreaked havoc on what was once the backbone of the Fiji economy, the agricultural industry.
Despite these environmental challenges, agriculture remains a mainstay of the economy contributing approximately $451 million (9%) of gross domestic product annually(Investment Fiji, 2016); and includes sugarcane, coconut and both commercial and subsistence livestock production. In the wake of natural disasters, flooding causes many emergence of bacterial diseases that have hindered the livestock industry,(Okaka & Odhiambo, 2018) prompting closer monitoring of the occurrence of animal diseases, and their management. Since 2017, such monitoring has extended to the importation of animal antimicrobial medicines which is managed closely by the Biosecurity Authority of Fiji at national borders.
To-date, no research has been undertaken in Fiji to determine the nature and impact of antimicrobial use in livestock production. This study aimed to: 1) characterise veterinary antimicrobial imports into Fiji over a 12 month period; and 2) evaluate the knowledge, perception and practice of antibiotic use and AMR among livestock farmers in the Central Division of Fiji. By better understanding the perceptions and practices of farmers regarding antibiotics, this research aimed to inform effective behaviour change strategies and policies to rationalise antibiotic use.