One of the world’s fastest-growing human populations is in Sub-Saharan Africa (SSA), accounting for more than 950 million people, which is approximately 13% of the global population. Livestock farming is vital to SSA as a source of food supply, employment, and income. With this population increase, meeting this demand and the choice for a greater income and dietary options come at a cost and lead to the spread of zoonotic diseases to humans. To control these diseases, farmers have opted to rely heavily on antibiotics more often to prevent disease than for treatment. The constant use of antibiotics causes a selective pressure to build resistant bacteria resulting in the emergence and spread of multi-drug resistant (MDR) organisms in the environment. This necessitates the use of alternatives such as bacteriophages in curbing zoonotic pathogens. This review covers the underlying problems of antibiotic use and resistance associated with livestock farming in SSA, bacteriophages as a suitable alternative, what attributes contribute to making bacteriophages potentially valuable for SSA and recent research on bacteriophages in Africa. Furthermore, other topics discussed include the creation of phage biobanks and the challenges facing this kind of advancement, and the regulatory aspects of phage development in SSA with a focus on Kenya.

Multi-drug resistant (MDR) Salmonella enterica Enteritidis is one of the major causes of foodborne illnesses worldwide. This non-typhoidal Salmonella (NTS) serovar is mainly transmitted to humans through poultry products. Bacteriophages (phages) offer an alternative to antibiotics for reducing the incidence of MDR NTS in poultry farms. Phages that survive the harsh environment of the chicken gastrointestinal tract (cGIT), which have low pH, high temperatures, and several enzymes, may have a higher therapeutic or prophylactic potential. In this study, we analysed the stability of 10 different S. Enteritidis phages isolated from Kenyan poultry farms in different pH-adjusted media, incubation temperatures, as well as simulated gastric and intestinal fluids (SGF and SIF, respectively). Furthermore, their ability to persist in water sources available in Kenya, including river, borehole, rain and tap water, was assessed. All phages were relatively stable for 12 h at pHs ranging from 5 to 9 and at temperatures ranging from 25 °C to 42 °C. At pH 3, a loss in viral titre of up to three logs was observed after 3 h of incubation. In SGF, phages were stable for 20 min, after which they started losing infectivity. Phages were relatively stable in SIF for up to 2 h. The efficacy of phages to control Salmonella growth was highly reduced in pH 2- and pH 3-adjusted media and in SGF at pH 2.5, but less affected in SIF at pH 8. River water had the most significant detrimental effect on phages, while the other tested waters had a limited impact on the phages. Our data suggest that these phages may be administered to chickens through drinking water and may survive cGIT to prevent salmonellosis in poultry.

Antimicrobial resistance (AMR) poses a global threat to both human and animal health, associated with widespread use of antimicrobials across sectors. In low- and middle-income countries (LMICs) such as Malawi, weak regulatory frameworks and limited enforcement capacity contribute to inappropriate use of antibiotics. This study examined the governance and regulatory frameworks for antimicrobial use (AMU) in Malawi's agricultural sector, identified regulatory gaps, and offers recommendations to antimicrobial stewardship. A qualitative approach was used, combining a review of policy and legal documents with semi-structured stakeholder interviews. Relevant policies and laws were sourced from government databases, the Food and Agricultural Organisation of the United Nations' (FAO) FAOLEX and AMR-LEX databases, and other publicly available resources. The FAO's legal assessment methodology was used to evaluate the policy landscape across nine key thematic areas: (1) veterinary medicinal products, (2) animal health and production practices to prevent animal diseases in terrestrial and aquatic animals, (3) feed registration, (4) pesticides, (5) food safety, (6) environment, soil and waste, (7) water quality, (8) plant health, and (9) institutional coordination. Stakeholder interviews with representatives from relevant government ministries and regulatory bodies validated findings from the document review and provided additional insight into governance challenges. A One Health governance mapping exercise was conducted to identify key institutional actors, assess their role in AMR/AMU governance, and evaluate inter-institutional relationships using social network analysis. The analysis identified 522 policies relevant to AMU in agriculture, with most addressing aquatic animal health (11.3 %, n = 59), food safety (10.9 %, n = 57) and animal feed (10.9 %, n = 57). Several critical regulatory gaps were identified, including the absence of a legal definition for “antimicrobials,” a national essential veterinary medicines list, and standardized veterinary treatment guidelines. Additionally, there are no restrictions on the use of critically important antimicrobials for human health in veterinary settings, minimal oversight of antimicrobial-medicated feed, and no established protocols for on-farm antimicrobial disposal. Stakeholder mapping revealed limited knowledge sharing among institutions and a dependence on international donors for AMR/AMU-related activities, raising concerns about the sustainability of current initiatives. Malawi also lacks an integrated AMR and AMU monitoring system, a national prioritised AMR research agenda, and clear targets for reducing AMU in animals. To address these gaps, we recommend that Malawi: (1) establish a comprehensive AMR and AMU monitoring program, (2) update existing regulations to provide clear definitions and classification of veterinary antimicrobials, (3) develop and implement national veterinary treatment guidelines, (4) restrict non-therapeutic AMU, (5) enhance regulatory oversight of medicated feed, (6) strengthen One Health coordination mechanisms, (7) promote stakeholder collaboration, and (8) secure sustainable, nationally driven funding. Implemention of these measures will enhance antimicrobial stewardship, reduce AMU, mitigate the spread of AMR, and support the long-term sustainability of agricultural production in Malawi.

Introduction: Veterinary antibiotics are essential for maintaining animal health and welfare, however, small-scale farmers in Malawi face challenges in accessing them due to limited availability, affordability, and long distances to rural drug retailers.Methods: This study mapped the veterinary antibiotic distribution chain, examined the governance structure of the chain, and analyzed access and usage practices among stakeholders in Malawi. Data were collected through focus group discussions (n = 15), key informant interviews (n = 6) and individual interviews (n = 189).Results: The key stakeholders identified included regulators, local pharmaceutical manufacturers, wholesalers, veterinary clinics, veterinary retail shops, animal health practitioners, and farmers. The distribution of veterinary antibiotics was characterized by both formal and informal pathways for importing and distributing veterinary medicines. Additionally, there were issues with antibiotic mishandling such as improper storage on open shelves in direct sunlight and disposal in pit latrines. There was a marked lack of proper antibiotic dispensation training among veterinary medicine shop attendants, and in terms of regulation, there were gaps in coordination and overlapping mandates among regulatory authorities hindering effective regulation.Discussion: Regulatory agencies need to strengthen oversight of veterinary antibiotics, conduct trainings on antibiotic stewardship with various stakeholders, and enhance public-private partnerships to better manage the informal pathways for importing and distributing veterinary medicines. This multi-sectoral approach aims to ensure responsible use and improve the pharmacovigilance of veterinary antibiotics.

Women and men keeping chickens in Kenya aspire to have a source of income, feed their families healthy food, and grow their businesses. Managing animal diseases and minimizing input costs enable their success. This study uses qualitative methods to recommend design opportunities for a veterinary product under development in Kenya that contains bacteriophages (phages) that target pathogenic Salmonella strains responsible for fowl typhoid, salmonellosis, and pullorum in chickens and foodborne illness in people. Our findings revealed the interplay between gender and two production systems: free-range and semi-intensive. Chicken keepers in both systems could benefit from phages combined with the orally administered Newcastle disease vaccine, one of the most commonly used preventive veterinary interventions, or phages as a treatment for fowl typhoid. Oral administration is less labor intensive, with greater benefits for women who have less control over family labor and reported doing more care tasks themselves. Men in free-range systems usually pay for veterinary inputs. In semi-intensive production systems, a phage-based product used prophylactically could be an alternative to expensive, intramuscular fowl typhoid vaccines. Keeping layers was common for women in semi-intensive systems, as they are more economically impacted by reduced laying caused by bacterial diseases. Awareness of zoonoses was low, but men and women were concerned about the negative health effects of drug residues in meat and eggs. Therefore, highlighting the lack of a withdrawal period for a phage product may appeal to customers. Antibiotics are used to both treat and prevent diseases, and phage products will need to do both to compete in the Kenyan market. These findings guide the ongoing design of a phage-based product with the goal of introducing a new veterinary product that meets the diverse needs of chicken keepers in Africa and serves as an alternative or complement to antibiotics.