Tackling Antimicrobial and Pesticide Resistance Through Joint Crop-Livestock Clinics: Lessons and Experiences from Hoima and Kayunga Districts, Uganda

Antimicrobial and pesticide resistance is rising in Uganda, driven by the misuse and overuse of drugs and chemicals across the human, animal, crop and environmental sectors. While tackling antimicrobial resistance (AMR) is a national priority, implementation of AMR measures at sub-national levels remains limited, even though last-mile implementors and beneficiaries are regarded as critical to addressing AMR. Since 2021, crop-livestock clinics, or “joint clinics”, have been introduced in six districts to provide timely, quality advice to farmers on crop and livestock health and production. Although not originally designed as an AMR intervention per se, interviews with farmers and multisectoral district officers in Hoima and Kayunga districts show that these clinics play an informal, yet significant, role in resistance management and stewardship. In this case, we identify joint clinic contributions, strengths and limitations regarding awareness creation, infection prevention and control, access, surveillance, and research and innovation. We also found that the clinics are weakly connected to other sectors, reflecting broader fragmentation in resistance management, where efforts are largely siloed by resistance type – antibiotics, acaricides or insecticides. This undermines synergies, efficient resource use, and strategies to address cross-resistance among health domains. A more holistic view on resistance management is needed, alongside incentives to align district interventions across sectors. This case highlights the under-recognized contributions of joint crop-livestock clinics to resistance management and stewardship and proposes opportunities to strengthen their integration into district One Health actions.