Use of stakeholder mapping and analysis to explore the food animal drugs supply chain in Lao PDR

Objective
Reducing the inappropriate and uncontrolled use of antimicrobials in food animals is a key measure promoted by international organisations to tackle antimicrobial resistance (AMR). This requires a clear understanding of the drugs supply chain, including information about drivers and barriers for access. As such data was not available for Lao PDR, we have implemented a study to identify stakeholders of the food animal’s antimicrobial map flow (public and private) and to analyse their roles, behaviour and interactions regarding drugs supply.

Method
We first compiled all the information about regulation of drugs importation, access, sources and stewardship available in Lao PDR. Then semi-structured interviews with key informants were organised to identify actors of the supply chain, their interactions and position regarding the risk of AMR and possible changes in national legislation. Finally, we organized three multi-stakeholder’s meetings with representatives of all sectors, to discuss the results of previous stakeholder mapping.

Results
We managed to identify 21 main stakeholders involved in the drugs supply chains, with their respective role and influence. Informal pathways of antimicrobial supply were mapped, identifying illegal sources of drugs from Vietnam, Thailand or China. Drugs restricted to human usage were found to be easily purchased by farmers to treat livestock.

Discussion
In the framework of the on-process AMR surveillance plan in food animals, these results help to identify constraints and barriers regarding the implementation of new regulations on antimicrobial usage in Lao PDR.

Acknowledgment: Thanks to the Regional Office for Asia and the Pacific of the Food and Agriculture Organization of the United Nations, the Fleming Fund and GREASE platform for their financial support. Thanks to the Faculty of Agriculture of the National University of Laos for their collaboration.