Understanding the veterinary antibiotic flow in Malawi: complexities, gaps and needs.

Area of Science:

• Veterinary Medicine
• Animal Health
• Pharmacovigilance

Background:

• Veterinary antibiotics are vital for animal health and welfare.
• Small-scale farmers in Malawi experience significant barriers to accessing these essential medicines, including limited availability, high costs, and geographical distance to retailers.

Purpose of the Study:

• To map the veterinary antibiotic distribution chain in Malawi.
• To examine the governance structures within this chain.
• To analyze access and usage practices among various stakeholders.

Main Methods:

• Employed a mixed-methods approach.
• Conducted focus group discussions (n=15), key informant interviews (n=6), and individual interviews (n=189).

Main Results:

• Identified key stakeholders: regulators, manufacturers, wholesalers, clinics, retailers, practitioners, and farmers.
• Observed both formal and informal distribution pathways, alongside improper storage and disposal of antibiotics.
• Highlighted a lack of training for veterinary medicine shop attendants and regulatory gaps, including coordination issues and overlapping mandates.

Conclusions:

• Regulatory agencies must enhance oversight and training on antibiotic stewardship.
• Public-private partnerships are needed to manage informal distribution channels effectively.
• A multi-sectoral approach is essential for responsible veterinary antibiotic use and improved pharmacovigilance.