Exploring the challenges to investigating antibiotic resistance along the pork value chain in Viet Nam and the benefits of the One Health approach

Background Antibacterial resistance (ABR) is a global health crisis, which threatens the ability to treat diseases and complicate medical procedures. The Vietnamese government have recognised the multifaceted risk ABR poses to human health and the country’s sustainable development and are in the process of developing a surveillance system for ABR. However, the implementation of policies that require inter-sectoral collaboration can be challenging. This project aimed to explore the experiences of actors in the animal health and human health sector to elucidate their perspectives and experiences of investigations in addressing ABR along the pork-value-chain in Viet Nam. Methodology Using qualitative methodology, 11 semi-structured interviews were conducted with a total of 12 key informants working across the animal health (8; 2 men and 6 women) and human health (4; 3 men and 1 women) sector in Hanoi, Vietnam. Interviewees were purposively selected using the snowball effect. Two case studies were developed to guide the questionnaire with the interviewees. The questionnaire included 20 (human health) and 23 (animal health) open ended questions, split into 4 different sections: 1) background; 2) investigation process; 3) resources available; and, 4) inter-sectoral collaboration. The transcribed interview data was separated into sections and codebook was generated. Thematic analysis of each section was employed to generate themes to determine the challenges and constraints in investigations processes (section 1 – 3) and participant perspectives on the One Health (OH) approach to ABR surveillance (section 4). Results Two identified themes 1) public health systems and food systems; context and regulatory factors, 2) data availability; information and knowledge development factors, were identified to have emerged from the data from sections 1 – 3. Under these two major themes, three sub-themes 1) technical capacity, 2) financial capacity, 3) human resources were factored across both themes. Two major themes emerged from the analysis of section four; 1) communication and data availability factors influencing cross-sectoral collaboration, 2) harmonization of data and government policy and regulation development. Under both themes, two-subthemes were identified 1) relationship development and understandings increases the knowledge and understanding of ABR, 2) resources; fosters the environment of sharing resources, responsibility and understanding of ABR’. Key findings The key findings presented from this study suggest that, participants perceive that the use of antibiotics within animal food production is a key driver of antibiotic resistance in human health in Viet Nam; there is divergence of opinions on laboratory capacity by sector and profession; and there is insufficient data available and data sharing between sectors. The One Health approach to surveillance is seen to offer potential to strengthen data for policy decisions