The research is motivated by the inadequacy of current global AMR management plans in addressing the complexities of antibiotic use in low-resource settings. A vignette illustrating the disconnect between advice from French industrial farmers and the realities of West African livestock breeders sets the stage. The study focuses on West Africa, where antibiotics serve as 'quick fixes' for managing various challenges, including infections, hygiene, uncertainty, and poverty. The central research question revolves around how to decrease antibiotic dependence without harming livelihoods, food security, and animal welfare in low-resource contexts. The paper utilizes the concept of 'noncoherence' from Science and Technology Studies (STS) to analyze how diverse and seemingly contradictory elements interact in livestock breeding practices.

The global AMR policy framework, exemplified by the WHO's Global Action Plan (GAP), aims for a standardized, coherent response to reduce antibiotic use across sectors. However, critiques highlight the limitations of the 'knowledge deficit' model underlying the GAP, emphasizing the need for a more nuanced understanding of the socioeconomic and material factors influencing antibiotic use. Critical social scientists argue that successful antibiotic reduction requires analyzing the socio-material structures and practices in which antibiotics are embedded, particularly in low-income countries where antibiotics play a crucial role in poverty reduction. Existing studies emphasize the need for context-specific interventions and investments in supportive infrastructures to replace antibiotics without compromising productivity or poverty reduction indicators.

The study, part of the AMRIWA project, employed qualitative and ethnographic methods in Benin and Burkina Faso. Data collection included nine focus groups with veterinarians and livestock breeders, interviews with various stakeholders (breeders, NGO representatives, veterinary professionals, government officials), and observations of livestock agribusinesses. Data analysis involved inductive identification of emergent themes and practices, mapping the relationships between different organizational logics and practices, and applying the framework of noncoherence to understand the interaction of these elements. The researchers acknowledge variations in participant backgrounds and farming systems across the two countries.

The study identified three overlapping noncoherent problems: implementation, risk, and production. Implementation noncoherences arose from conflicts between AMR action plans and other development programs or social challenges (e.g., poverty reduction, food security). Weak extension services and limited resources hindered the effective dissemination of information and implementation of the GAP's objectives. Risk noncoherences stemmed from conflicting strategies for managing outcomes, particularly when AMR recommendations clashed with financial risk management in vulnerable settings. The lack of laboratory capacity, high cost and time delay of antibiograms, and reluctance to seek veterinary assistance were key factors. Production noncoherences occurred when animal management practices designed for high-income settings were applied in low-resource contexts. The lack of financial and technological capabilities for establishing biosecure farms led to increased dependence on antibiotics. The study also analyzed how these noncoherences interact, highlighting the interconnectedness of issues. For example, the limited diagnostic capacity increased the risk of unnecessary antibiotic use. Poor biosecurity measures due to financial constraints increased the risk of disease outbreaks which, in turn, drove antibiotic use. The lack of financial safety nets and the interconnected nature of agricultural businesses meant that adhering to withdrawal periods could lead to economic collapse. These factors led to a metaphylactic approach to antibiotic usage, where whole flocks were treated to minimize mortality and financial losses.

The findings demonstrate that simply educating producers about AMR risks is insufficient to address the issue of antibiotic overuse in low-resource settings. The complex interplay of socioeconomic, institutional, and material factors necessitates a more nuanced approach to AMR management. The study underscores the need to go beyond a standardized, coherent model and embrace the heterogeneity of practices and contexts. The identified noncoherent problems highlight the shortcomings of a top-down approach and the importance of considering local specificities in policy design.

The study concludes by emphasizing the need for a more flexible and context-specific approach to global AMR policy. It suggests shifting from a model of standardization and harmonization to one that embraces heterogeneity and utilizes locally available resources. The authors propose leveraging digital technologies for veterinary consultations and promoting research into locally appropriate solutions for biosecurity and disease control, including exploring traditional remedies and vernacular practices. Future research should focus on developing and implementing these context-specific interventions and evaluating their effectiveness in reducing antibiotic use while supporting livelihoods and food security.

The study's scope was limited to peri-urban areas in Benin and Burkina Faso. The findings may not be generalizable to all low-resource settings. The reliance on qualitative methods limits the generalizability of results and quantitative evaluation of the impact of proposed interventions. The study also highlights the fact that the research was partially halted by the COVID-19 pandemic, which may have affected the extent and nature of data collection.