Development of the Zambian Standard Treatment Guidelines in the Animal Health Sector: A Key Step in Advancing Antimicrobial Stewardship

Abstract

Background: Zambia, like many low- and middle-income countries, faces a growing burden of antimicrobial resistance (AMR), driven by the misuse of antimicrobials in both human and animal health, a limited diagnostic capacity, and weak regulatory enforcement. To address this challenge, Standard Treatment Guidelines (STGs) were developed for the veterinary sector, which represents a major milestone in the country’s AMR containment strategy. STGs are evidence-based protocols that guide veterinary professionals in consistently and appropriately diagnosing and treating animal diseases. They promote the rational use of veterinary medicines, and can mitigate AMR and improve animal health outcomes. By translating the best evidence into best practices, STGs also provide a practical foundation for antimicrobial stewardship (AMS) programs. Until 2023, Zambia lacked nationally adopted STGs for the veterinary sector. The introduction and standardization of these guidelines are expected to promote prudent antimicrobial use and raise the standard of care delivered to animal patients across the country. Objective: The aim of this paper is to provide a practical reference for future revisions of STGs and outline the successful methodology used to create STGs in the Zambian animal sector. Methods: A situational analysis was conducted to identify priority animal health conditions and existing treatment gaps within the veterinary sector. A multidisciplinary expert committee was then formed, comprising veterinarians, veterinary paraprofessionals, academics, regulatory authorities, and private sector stakeholders, to lead the development of the STGs. The process was guided by the WHO methodology for developing treatment guidelines, including a comprehensive review of the clinical evidence, local disease patterns, antimicrobial resistance data, and existing treatment practices. Draft STGs were developed with clearly defined, species-specific treatment protocols tailored to the Zambian context. For the validation process, the AGREE II instrument was used to assess the quality, clarity, and applicability of the guidelines. Structured stakeholder consultations with practitioners, policy-makers, and technical experts were held to ensure that the guidelines were practical, evidence-based, and aligned with national priorities. The validated drafts were then disseminated and piloted in selected districts. Conclusions: The development of the species-specific STGs represents an essential turning point in the country’s efforts to promote responsible veterinary care and contain AMR. STGs have become a prominent key support in the delivery of quality animal care. Further, the guidelines will assist in the optimization of antimicrobial use in animal health in Zambia.