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The lifting of COVID-19 (coronavirus disease 2019) lockdown requires, in the short and medium terms, a holistic and evidence-based approach to population health management based on combining risk factors and bio-economic outcomes, including actors' behaviors. This dynamic and global approach to health control is necessary to deal with the new paradigm of living with an infectious disease, which disrupts our individual freedom and behaviors. The challenge for policymakers consists of defining methods of lockdown-lifting and follow-up (middle-term rules) that best meet the needs for resumption of economic activity, societal wellbeing, and containment of the outbreak. There is no simple and ready-to-use way to do this since it means considering several competing objectives at the same time and continuously adapting the strategy and rules, ideally at local scale. We propose a framework for creating a precision evidence-based health policy that simultaneously considers public health, economic, and societal dimensions while accounting for constraints and uncertainty. It is based on the four following principles: integrating multiple and heterogeneous information, accepting navigation with uncertainty, adjusting the strategy dynamically with feedback mechanisms, and managing clusters through a multi-scalar conception. The evidence-based policy intervention for COVID-19 obtained includes scientific background via epidemiological modeling and bio-economic modeling. A set of quantitative and qualitative indicators are used as feedback to precisely monitor the societal-economic-epidemiological dynamics, allowing tightening or loosening of measures before epidemic damage (re-)occurs. Altogether, this allows an evidence-based policy that steers the strategy with precision and avoids any political shock.

International audience ; The lifting of COVID-19 (coronavirus disease 2019) lockdown requires, in the short and medium terms, a holistic and evidence-based approach to population health management based on combining risk factors and bio-economic outcomes, including actors' behaviors. This dynamic and global approach to health control is necessary to deal with the new paradigm of living with an infectious disease, which disrupts our individual freedom and behaviors. The challenge for policymakers consists of defining methods of lockdown-lifting and follow-up (middle-term rules) that best meet the needs for resumption of economic activity, societal wellbeing, and containment of the outbreak. There is no simple and ready-to-use way to do this since it means considering several competing objectives at the same time and continuously adapting the strategy and rules, ideally at local scale. We propose a framework for creating a precision evidence-based health policy that simultaneously considers public health, economic, and societal dimensions while accounting for constraints and uncertainty. It is based on the four following principles: integrating multiple and heterogeneous information, accepting navigation with uncertainty, adjusting the strategy dynamically with feedback mechanisms, and managing clusters through a multi-scalar conception. The evidence-based policy intervention for COVID-19 obtained includes scientific background via epidemiological modeling and bio-economic modeling. A set of quantitative and qualitative indicators are used as feedback to precisely monitor the societal-economic-epidemiological dynamics, allowing tightening or loosening of measures before epidemic damage (re-)occurs. Altogether, this allows an evidence-based policy that steers the strategy with precision and avoids any political shock.

International audience ; Antimicrobial use (AMU) in animal agriculture unavoidably leads to the selection of resistant bacteria,potentially transmitted to humans. To address this public health threat, international and national publicpolicies are implemented, but very few have been assessed neither ex ante nor ex post. In thisperspective, we first discuss economic approaches regarding AMU. We then discuss the potentialeconomic and social effects of regulatory policy instruments as well as voluntary approachesimplemented to achieve a reduction of AMU. ; L'usage des antibiotiques (UAB) en santé animale comme en santé humaine entraine la sélection debactéries résistantes. Leur transmission à l'homme par contact direct ou via la chaine alimentaireconstitue un risque de santé public, qui a conduit à la mise en place de politiques publiques visant àréduire l'UAB. Toutefois, les évaluations socio-économiques de ces politiques sont quasi absentes.Dans cet article, nous proposons de discuter en premier lieu comment l'UAB peut être envisagé sous unangle économique, puis nous abordons comment les politiques publiques, réglementaires ouvolontaires, peuvent contribuer à la réduction de l'UAB en productions animales, en passant en revueleurs performances sociales et économiques.

International audience ; Antimicrobial use (AMU) in animal agriculture unavoidably leads to the selection of resistant bacteria,potentially transmitted to humans. To address this public health threat, international and national publicpolicies are implemented, but very few have been assessed neither ex ante nor ex post. In thisperspective, we first discuss economic approaches regarding AMU. We then discuss the potentialeconomic and social effects of regulatory policy instruments as well as voluntary approachesimplemented to achieve a reduction of AMU. ; L'usage des antibiotiques (UAB) en santé animale comme en santé humaine entraine la sélection debactéries résistantes. Leur transmission à l'homme par contact direct ou via la chaine alimentaireconstitue un risque de santé public, qui a conduit à la mise en place de politiques publiques visant àréduire l'UAB. Toutefois, les évaluations socio-économiques de ces politiques sont quasi absentes.Dans cet article, nous proposons de discuter en premier lieu comment l'UAB peut être envisagé sous unangle économique, puis nous abordons comment les politiques publiques, réglementaires ouvolontaires, peuvent contribuer à la réduction de l'UAB en productions animales, en passant en revueleurs performances sociales et économiques.

The growing concern of the selection of bacteria resistant to antimicrobials and their possible transmissions to humans lead French Authorities to implement several legislative measures to decrease antimicrobial use in livestock production. This context leads to question whether the demand of antimicrobials could be regarded as a simple demand of agricultural input, or rather as a demand of an input with distinctive effects, submitted to regulatory prescription. In this paper, the accuracy of the regulatory measures implemented by the Authorities are assessed, regarding the whole factors gathered in a conceptual framework enlightening the decision-making process of antimicrobial use. Lastly, other alternative policies are described. ; La sélection de bactéries résistantes aux antibiotiques transmissibles à l'homme, induite par l'usage des antibiotiques en productions animales, pousse les pouvoirs publics à réduire leur utilisation, dans le cadre du Plan Ecoantibio 2012-2017 et de la Loi d'Avenir pour l'Agriculture. Cet article questionne la pertinence des mesures en cours d'implémentation par les administrations françaises au regard d'un cadre d'analyse, regroupant dans un modèle conceptuel l'ensemble des facteurs sanitaires, économiques et institutionnels déterminant la demande d'antibiotiques. La compréhension des clés d'usage des antibiotiques, produit banal et substituable, ou au contraire ressource particulière, soumise à prescription, permet également d'envisager d'autres politiques de réduction.

International audience ; Antimicrobial use in animal agriculture is often perceived to play a role in the emerging threat of antimicrobial resistance. Increased consumer awareness of this issue places pressure on animal husbandry to adopt policies to reduce or eliminate antimicrobial use. We use a scoping review methodology to assess research on consumer perceptions of antimicrobial drugs in meat products in the United States, Canada, or the European Union. Evaluating peerreviewed and grey literature, we included studies for assessment if they met these topical and geographic requirements, involved primary data collection, and were originally published in English. Our screening process identified 124 relevant studies. Three reviewers jointly developed a data charting form and independently charted the contents of the studies. Of the 105 studies that measured consumer concern, 77.1% found that consumers were concerned about antimicrobial use in meat production. A minority of studies (29.8% of all studies) queried why consumers hold these views. These studies found human health and animal welfare were the main reasons for concern. Antimicrobial resistance rarely registered as an explicit reason for concern. A smaller group of studies (23.3%) measured the personal characteristics of consumers that expressed concern about antimicrobials. Among these studies, the most common and consistent features of these consumers were gender, age, income, and education. Regarding the methodology used, studies tended to be dominated by either willingness-to-pay studies or Likert scale questionnaires (73.64% of all studies). We recommend consideration of qualitative research into consumer views on this topic, which may provide new perspectives that explain consumer decision-making and mentality that are lacking in the literature. In addition, more research into the difference.

International audience ; Antimicrobial use in animal agriculture is often perceived to play a role in the emerging threat of antimicrobial resistance. Increased consumer awareness of this issue places pressure on animal husbandry to adopt policies to reduce or eliminate antimicrobial use. We use a scoping review methodology to assess research on consumer perceptions of antimicrobial drugs in meat products in the United States, Canada, or the European Union. Evaluating peerreviewed and grey literature, we included studies for assessment if they met these topical and geographic requirements, involved primary data collection, and were originally published in English. Our screening process identified 124 relevant studies. Three reviewers jointly developed a data charting form and independently charted the contents of the studies. Of the 105 studies that measured consumer concern, 77.1% found that consumers were concerned about antimicrobial use in meat production. A minority of studies (29.8% of all studies) queried why consumers hold these views. These studies found human health and animal welfare were the main reasons for concern. Antimicrobial resistance rarely registered as an explicit reason for concern. A smaller group of studies (23.3%) measured the personal characteristics of consumers that expressed concern about antimicrobials. Among these studies, the most common and consistent features of these consumers were gender, age, income, and education. Regarding the methodology used, studies tended to be dominated by either willingness-to-pay studies or Likert scale questionnaires (73.64% of all studies). We recommend consideration of qualitative research into consumer views on this topic, which may provide new perspectives that explain consumer decision-making and mentality that are lacking in the literature. In addition, more research into the difference.

International audience ; The rising public health threat of antimicrobial resistance, the influence of food service companies, as well as the overall lack of positive image of using medical products in intensive farming are major drivers curbing antimicrobial use. In the future, government policies may affect practices of antimicrobial use in beef production in feedlots, a prominent current user of antimicrobials in animal agriculture, but also the agricultural industry generating the highest cash receipt in the U.S. Our objective was to estimate the cost effect from the following policies in feedlots: 1) using antimicrobials for disease prevention, control, and treatment; 2) using antimicrobials only for treatment of disease; and 3) not using antimicrobials for any reason. We modelled a typical U.S. feedlot, where high risk cattle may be afflicted by diseases requiring antimicrobial therapy, namely respiratory diseases, liver abscesses and lameness. We calculated the net revenue loss under each policy of antimicrobial use restriction. With moderate disease incidence, the median net revenue loss was $66 and $96 per animal entering the feedlot, for not using antimicrobials for disease prevention and control, or not using any antimicrobials, respectively, compared to using antimicrobials for disease prevention, control, and treatment. Losses arose mainly from an increase of fatality and morbidity rates, almost doubling for respiratory diseases in the case of antimicrobial use restrictions. In the case of antimicrobial use prohibition, decreasing the feeder cattle price by 9%, or alternatively, increasing the slaughter cattle price by 6.3%, would offset the net revenue losses for the feedlot operator. If no alternatives to antimicrobial therapy for prevention, control and treatment of current infectious diseases are implemented, policies that economically incentivize adoption of non-antimicrobial prevention and control strategies for infectious diseases would be necessary to maintain animal welfare and the ...