Weaning U.S. food-animals off antimicrobials: What can we learn from state- and city-level policies?

Antimicrobials are widely used worldwide in food animal production for controlling and preventing disease and for improving feed conversion efficiency and growth promotion. Inappropriate use of antimicrobials in animal agriculture has the potential to promote antimicrobial resistance, which represents a threat to human, animal, and environmental health. State and municipal policies in the United States have recently been implemented to improve antimicrobial use and reporting in this sector. This study analyzed the implementation of two state-level policies (California (CA) and Maryland (MD)) and a city-level policy in San Francisco (SF), California that aimed to reduce the use of antimicrobials in food-animals and increase transparency of antimicrobial use. A qualitative analysis was based on in-depth interviews with key informants (KIs) (n = 19) who had direct experience implementing or working in the context of these sub-national policies. Interviews were recorded and transcriptions were analyzed independently by two researchers using a three-stage, grounded theory coding procedure. This study identified four major findings, including 1) vague language on antimicrobial use within policies reduces policy effectiveness; 2) the lack of reporting by producers challenges the ability to evaluate the impact of the policies on actual use; 3) diverse stakeholders need to be involved in order to develop a more effective policy; and 4) funding should be linked to the policy to provide for reporting and data analysis. This analysis provides insights on the successes and failures of existing policies and serves to inform future sub-national policies aiming to improve the judicious use of antimicrobials in food-animals.