This use of antimicrobials in animal farming is a major contributor to the problem of antimicrobial resistance (AMR). These anti-infective pharmaceuticals have been massively and increasingly used in livestock since the late 1940s.Footnote 1 Today, approximately 70% of antimicrobials used worldwide are administered to farm animals, totaling around 100,000 tons in 2020.Footnote 2 This figure is projected to increase by an additional 8% by 2030.Footnote 3 European countries have halved their consumption over the last fifteen years, both in volumes and exposure (with variations depending on the commodity chain), while North America has maintained a fairly stable consumption level (with a fairly significant reduction in poultry production, but an increase in other commodity sectors, notably pork).Footnote 4 In the Global South, there are also significant disparities. For instance, antimicrobial use (AMU) is high in Southeast Asian countries, particularly within commodity chains targeting international markets, whereas it remains low in most African countries, albeit rising swiftly in sectors of livestock commercialization. This contrast highlights critical questions regarding the strategies that have been implemented and, more importantly, their broader impacts—effects that cannot be assessed solely through the measurements of antibiotic consumption at the national or sectoral level. Reduced antimicrobial use does not automatically imply fewer health harms, infections, or less complex sociotechnical and socioeconomic exploitation. Indeed, even if the issue is highly debated in the epidemiological and microbiological fields, evidence supporting the benefits of reducing AMU in livestock on AMR in humans is still scarce or at least weaker than expected,Footnote 5 partly due to the lack of robust data, as AMU and AMR surveillance systems remain fragile in many parts of the world. In this context, the questions of why, how, and for what objectives efforts to halve AMU in livestock in Europe have been pursued remain particularly pressing.
We recently compiled an edited volume that seeks to answer these questions based on research conducted in France.Footnote 6 This short article summarizes the findings of research on antimicrobial use in the livestock industry and suggests three pathways to address the limitations of current reduction and transition strategies.
1. AMR policies caught between reduction and transition
Although European policies designed to reduce the use of antimicrobials in livestock production have proven successful—as evidenced by a nearly 50% reduction in France since 2012—there has been no fundamental change in the agri-food system. This situation raises a crucial question that public policies and stakeholders tend to overlook: What are we truly aiming to achieve through AMR policies, and what are we actually trying to change? In other words, we need to disentangle the concepts of reduction and transition from each other and examine the assumptions made about their potential connection. Policy narratives often automatically link antimicrobial reduction with agricultural transition, reflecting the assumption that the former will inevitably lead to the latter. However, AMR policies often frame transition primarily as a technical, rather than systemic, change—one that ultimately calls into question the very nature of agrifood infrastructure.Footnote 7 The livestock industry involves a complex system of practices, representations, technical tools, economic structures, professional models, and institutional frameworks. The industry’s reliance on antimicrobials actually stems more from the overall architecture of this system than from the direct input of antimicrobials themselves. Yet while there have been extensive discussions regarding reduction (covering questions such as which molecules, indications, usages, etc., should be prioritized?), the concept of transition remains rather vague allowing for minimalist interpretations of what we want or need to change.
AMU in livestock farming is examined solely from the angle of allegedly massive and excessive consumption. However, there is little discussion about the fact that antimicrobials are structurally used as quick fixes, that is, short-term tools designed to respond to emergency situations.Footnote 8 Our dependence on antimicrobials is therefore only addressed quantitatively, not qualitatively. As a result, AMR policies are caught between two contradictory logics. On the one hand, there is a health rationale, which aims to reduce AMU to limit the proliferation of resistant bacteria and, in turn, preserve the effectiveness of these essential medicines. This rationale is based on a narrative of “reduction” that imposes a discourse in which “good” and “bad” uses must be delineated, and certain practices eliminated. On the other hand, there is an agricultural rationale that defends the idea that, while it is certainly necessary to reduce AMU, such an approach must not jeopardize the development of agriculture, which plays a vital role in providing food and jobs. This rationale uses the narrative of “transition” to subtly convey the promise that lower AMU will lead to sustainable and responsible agriculture while simultaneously reaffirming the idea that industrial agriculture will produce more at less cost. In the end, this dual narrative of reduction on the one hand, and transition on the other, creates a number of tensions and even contradictions at the very heart of AMR policies, which must simultaneously praise an “antibiotic-free” world and continue to justify certain uses of these medicines.
Our work on antibiotic regulation in the French livestock sector shows that, despite the decreasing use of antimicrobials, they still serve as quick fixes, and continue to form part of a biosecurity ideal that supports the technical and economic infrastructure of agro-veterinary capitalism.Footnote 9 Through the dual narrative of reduction and transition, health and agricultural logics comfortably accommodate the model of industrial livestock farming, which claims it can “secure” the use of antimicrobials through the ever-increasing rationalization and intensification of production. Securing AMU consists here in both making it safer and perpetuating it in renewed, yet reduced, forms. We observed this dynamic at various levels and sites of the farming system: the development of prescription guidelines for “prudent use,” the rise of “antibiotic-free” labels that keep authorizing certain molecules, the multiplication of diagnostic tests, the implementation of new antimicrobial classifications such as the “Critically Important Antimicrobials” list, the re-evaluation of Maximum Residue Limits for international trade of foodstuffs, the reaffirmation of veterinarians as “guardians” of antibiotics, and so forth.Footnote 10
For example, as developed in this edited volume, so-called antibiotic-free labels do not necessarily guarantee the complete absence of antibiotics in livestock production. Rather, they often prohibit only certain kinds of uses, such as preventative or systematic use. More importantly, these labels tend to constrain farmers’ choices—regarding feed supply, husbandry practices, vaccination strategies, and so forth—thereby reinforcing both the intensification of the production model and the vertical integration of the food chain. Veterinary medicine, in turn, adapts to this ongoing industrialization through new forms of animal health management that increasingly rely on financialization and contractualization of veterinary business models. In this context, antibiotics—though reduced—are re-legitimized through rapid and point-of-care tests and through the implementation of prescription guidelines, as explored in other sections on this work and in related research.Footnote 11 AMR policies thus tend to render what remains of AMU either invisible or “reasonable,” ultimately perpetuating the industrialization of livestock, with far-reaching social, environmental, and health implications beyond AMR itself.
In this sense, what we are facing is not only a dependence on antibiotics but also a form of antibiotic resilience. Even if the massive use of antibiotics is no longer essential to the development of industrial livestock system, the systems adapt and persist without transforming their underlying infrastructure. This dynamic is emblematic of the Anthropocene, an era in which efforts to manage the harm caused by human exploitation of nature rely on ever more sophisticated forms of that same exploitation.Footnote 12 The notion of the Antibiocene extends this perspective to the problem of AMR, inviting us to reflect on “what life amongst the detritus of the antimicrobial era looks like.”Footnote 13
2. Three pathways for thinking about “Just Transitions”
Despite the remarkable resilience of our system of “antibiodependency” (to quote the title of our book), there are nonetheless several ways to overcome some contradictions and bypass certain dead-ends. Here we outline three possible escape routes that can help sketch out pathways toward more “just transitions,” inspired by dynamics observed in the livestock sector but extended to the broader landscape of AMR policies.
By the term “just transition,” which we borrowed from the title of this special issue, we would like to go beyond the reduction/transition trap in which AMR policies are currently ensnared, especially because the transition is limited to a narrow conception of reduction that merely allows the system to maintain and even strengthen itself. As Fressoz points out in his book on the history of energy, transition is a historically situated concept that “turns evil into remedy” and could be defined as “the ideology of the 21st century’s capital.”Footnote 14 There might be avenues, however, to think differently of transition pathways that could bring a certain sense of multi-species justice.
2.1. Overcome the injustice and inequality imbedded in the concept of One Global Health
First of all, the One Health and Global Health paradigms that underpin AMR policies tend to reproduce patterns of injustice and inequality between humans and animals, as well as between countries of the North and South. In the third part of the edited volume, we show how the “One Global Health perspective” that currently prevails in international AMR policies frames “animal health” primarily in terms of human health interests—and, more specifically, those of Northern societies. Within this scientific and political configuration, the food and development challenges faced by food-producing countries of the Global South are either overlooked or only marginally addressed.Footnote 15 This situation is directly linked to a conception of AMR that, on the one hand, views all antimicrobial consumption as excessive (or at least potentially eliminable) and, on the other hand, positions the South as a global threat because LMICs host the most worrying disease “hotspots” and “reservoirs.”Footnote 16 In reality, not all situations should be framed the same way; the problem of excess is at odds with that of access.Footnote 17
Indeed, in some instances, the best way to avoid the spread of resistant bacteria, while at the same time effectively managing the infections they generate, lies precisely in improving the availability of antimicrobials, both for human and animal health. Although this is obvious to health anthropologists, it is regrettably not always the case for the institutions in charge of national and regional AMR action plans, which are designed and implemented using fairly standardized models based on major instruments such as surveillance and stewardship.Footnote 18 In the case of livestock production, our collective investigations show that the farms and food chains that benefit most from AMR policies are those oriented toward export markets, as they are more closely aligned with industrial models that facilitate the reduction of AMU. In contrast, small-scale farms producing for local markets face specific animal health challenges that, in fact, require better access to antimicrobials (including antibiotics and anthelmintics). This calls for a rethinking of how the problem and its potential solutions are framed, moving beyond the postcolonial One Global Health approach, which tends to favor particular types of agrifood infrastructures and production models through its biosecurity ideal.Footnote 19
2.2. Bring the public back in
This difficulty in extracting AMR from the pre-formatted framework of infectious disease control stems from the fact that the main audience for the problem are also the owners of the problem, that is, healthcare professionals and international health experts. The public—whether human patients or animal owners—remains largely invisible and unheard. In a sense, AMR appears as a problem in search for its audience. In human medicine, the education and awareness campaigns that were conducted in recent years by the French public health agency (Santé Publique France), patients are portrayed as being “bad” or even “false.” They are presented as people who misuse antimicrobials, mainly because they cannot distinguish between a viral and a bacterial infection, and therefore represent a danger not only to themselves but also to the community as a whole. In livestock farming, awareness campaigns often construct an image of farmers as actors who must comply with and defer to veterinarians for medical decision-making. Knowledge about antibiotics and bacteria is thus portrayed as something that should not belong to them. In both contexts, it is clear that many people may find it difficult to identify with this highly negative representation, which fails to reflect the lived experiences of individuals confronting resistant infections—whether in themselves or in their animals. This helps explain why efforts to construct and mobilize a public around AMR have so far fallen short, thereby severely limiting the impact of policies that continue to be defined by and for experts.
In truth, none of this should come as a surprise: most of the knowledge informing health policies concerning patients and farmers is rooted in cognitive-behavioral approaches that seek to identify and correct people’s misbehaviors and false beliefs.Footnote 20 This “knowledge deficit” model assumes that patients, farmers, and even human and animal health professionals are mistaken—in this case, in their choice of medication—because they are poorly trained or insufficiently educated, and that awareness campaigns are the only possible remedy.Footnote 21 We argue, in contrast, that antibiodependency stems not from inappropriate or irrational individual behaviors, but from economic structures, professional organizations, and public policies. As we argue in the book, this is evident in the fields of livestock farming and animal health; similar patterns, as other research has shown, are also found in human health.Footnote 22 Ultimately, giving voice to those who are directly exposed and affected—rather than speculating about their misconceptions—could help embed these lived realities within the broader narrative, and thus the very framing, of AMR.
2.3. Turn the dystopia into a utopia
Finally, we must consider the imaginaries in which AMR narratives are embedded. From the outset, AMR policies have been shaped by a catastrophist narrative that casts the problem in the language of war, tragedy, and nightmare.Footnote 23 It often seems impossible to imagine a world without antibiotics except through a dystopian lens. Yet while dystopia imaginaries can, in some cases, serve as powerful mobilizing forces—as with carcinogenic pesticides, toxic chemicals like PFAS—they are far less effective in the case of AMR. The reason is that dystopias inspire action only when they carry the promise of utopia: for instance, a world free from dangerous pollutants is both conceivable and desirable. The situation of AMR, however, is different. Antimicrobials are as perilous as they are precious: a world without them is precisely the nightmare we seek to avoid, yet a world with them offers no real path for transformation, as it reproduces the very conditions leading us toward catastrophe. In short, the narrative of AMR is a dystopia devoid of utopian seeds. We argue that this blocked imaginary constitutes a major obstacle to transformative AMR policies—although, as discussed elsewhere in this work, the imaginaries emerging from the livestock farming sector provide some promising avenues for reflection.
Indeed, one cannot deny that the strong mobilization of agricultural and veterinary stakeholders has made AMU reduction possible, despite its pernicious effects. However, if we look at the imaginaries that these policies have conveyed, and compare them with the same policies in the human health sector, it is noteworthy that they articulate a horizon for change that may not be utopian, but is nonetheless desirable. Whereas campaigns for human medicine show (fake) patients suffering and not getting better, those for the agricultural sector show healthy cows in lush green meadows. Although such images do not correspond to reality (where industrial livestock farming is reinforced), they have helped produce a powerful imaginary. In their own way, these images have been able to present a way of reconciling the need to eliminate and to preserve antimicrobials. A world which we can dream of —not of the disappearance of antimicrobials, but of a future in which we no longer depend on them, or at least far less so; a world where this aspiration, though insufficient on its own, is part of a broader effort to curb the global persistence of resistant bacteria.
Our future does not necessarily have to be “without antibiotics,” but rather “antibiotic-free”—not in the sense of the labels mentioned earlier, which romanticize the absence of antibiotics while in fact perpetuating certain forms of use, but in the sense of disentangling our healthcare and agrifood infrastructures from antibiotics, or more fundamentally, from antibiodependency. We need to glimpse and sketch out a liberation, not a deprivation. But to achieve this goal, AMR must not be reduced to a medical and biosecurity issue. Instead, we should embrace a “post-colony” approach of microbes and accept to work with them without exploiting them, which is the only way to domesticate their resistance to our antibiocenic footprint.Footnote 24 AMR should be apprehended as a matter of social and ecological multi-species justice, involving issues such as access to healthcare, hygiene, food safety and quality, along with environmental protection and the preservation of biodiversity (plant, animal, and microbial). An “antibiotic-free” world is not the apocalyptic outcome of a war already lost to bacteria, but a world liberated from structural reliance on medicines that are too frequently used as the “quick fixes” for unsustainable health and food systems. We need to imagine and build it as soon as possible. Policies must move beyond the reductionist, transition-oriented logic of Anthropocenic resilience to embrace “just transitions”—ones grounded in inclusive narratives that recognize the plurality of human and non-human publics implicated in AMR.
Author contribution
Conceptualization: H.B.; N.F.
Acknowledgments
The research mentioned in this article has benefited from a grant from the French National Research Agency (ANR-18-CE03-0001).
Conflicts of interests
The authors declare none.
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