Introduction

The current and expected growth of the world’s population warrants increased production of high-quality animal protein. Dairy farming is regarded as one of the important ways of satisfying this need, especially in developing countries (1). Therefore, dairy development programs have been started aiming at increasing animal productivity by crossbreeding with high yielding breeds or their introduction, especially of the Holstein-Friesian (HF) cattle. Through continued crossbreeding, they gradually replace local cattle breeds that produce less milk but which are better adapted to local environment. Moreover, local breeds combine a variety of purposes, including production of milk, meat, traction, and manure to fertilize the fields. This common strategy of replacing local cattle breeds with HF cattle is also known as the “Holsteinization” of dairy farming (2).

The focus on crossbreeding and increasing the productivity of dairy cattle also results in an increased use of agro-chemicals, mainly antibiotics and anti-parasitic drugs. The residues of these agro-chemicals come into the environment, affecting natural processes and soil life (3). Public health is also affected due to residues in milk and meat, especially in countries with insufficient food quality controls (4). There is also evidence of a global rise in multi-resistant microbes due to the extensive and inappropriate use of antibiotics, and the use of antibiotics in animal production, including dairy farming, is a contributing factor (5–8). The use of antibiotics in animal production is a global issue and is not confined to developing countries.

Since their introduction in the 1940s, antibiotics have been very important in modern healthcare. Now, however, once-treatable infections are becoming difficult to cure, which increases costs, morbidity, and mortality in both humans and animals. Antibiotic resistance is a direct result of antibiotic use: the greater the volume of antibiotics used, the greater the risk of antibiotic-resistant populations emerging. Some classes of antibiotics, such as carbapenems and cephalosporins, are used as last resort for infections. Cephalosporins are one of most widely used drug classes worldwide, and the latest developed drugs are numbered third- and fourth-generation cephalosporins. These drugs are used as last resort for serious infections in humans due to food-borne pathogens Salmonella and Shigella (5). It is of the utmost importance to preserve the usefulness of antimicrobials in treatment of human disease. One of the means of doing this is to exclude them from veterinary use (8). According to the Dutch guidelines for veterinarians, the use of last resort antibiotics (carbapenems, glycopeptides, oxazolidones, daptomycine, mupirocine, and tigecycline) for animals is forbidden (9).

Antibiotic resistance can be developed by bacteria using different genetic strategies, such as producing destructive enzymes to neutralize antibiotics; mutation, so that drugs cannot recognize their targets; pumping antibiotics out of the cell (efflux); creating a “biofilm” so antibiotics cannot reach them; and creating bypasses so bacteria can function without the enzymes targeted by antibiotics (10).

The growing challenge of antimicrobial resistance is mainly due to the high use of antibiotics in human health care and their availability, also in developed countries (5–8). Other contributing factors include the high use of antibiotics in animal production and multi-resistant strains of microbes in animal farming across the globe. A recent scientific review in the UK indicates that, if no solutions are found, multi-resistant microbes will result in a global crisis with more human deaths in 2050 than cancer today – the majority in the poorer regions of Africa and Asia (11).

The intensification of animal production has also had a considerable impact on the environment. The current loss of biodiversity is devastating. One of the major causes of this phenomenon is habitat loss and modification as a result of intensified agricultural practices (12).

In 2014 the Dutch Association of Phytotherapy (NVF) and Dutch Farm Experience (DFE), a company that links international organizations to sustainable Dutch dairy farming, initiated the E-Motive exchange project between the Netherlands and India to reduce the use of antibiotic in dairy farming. Funded by Oxfam-Novib and the province of Overijssel, a group of farmers, veterinarians, and researchers from both countries visited each other over a period of 2 weeks. This resulted in increased awareness of the problem as well as a joint search for strategies in animal management, herbal medicines, and breeding that would reduce the use of antibiotics. In this process, Indian expertise on medicinal plants and ethno veterinary medicine is being combined with Dutch expertise on farm management and milk quality control. Due to the promising outcome of this Dutch–Indian exchange, the project was extended to 2015, and included two African countries, Ethiopia and Uganda, with special emphasis on cattle breeding.

This article discusses the differences and similarities in dairy farming in the Netherlands, India, Ethiopia, and Uganda and its effect on public and environmental health. It emphasizes the strategies that have been developed during the E-Motive exchange project to reduce the use of antibiotics and other chemicals in dairy farming. The impact of antibiotic use on human health through antibiotic use, the growing problem of antibiotic resistance, and the lack of adequate control systems are discussed as well as the effects of dairy farming on the environment. These include agro-chemical pollution and subsequent loss of biodiversity, changes in pasture management, and the loss of genetic diversity and local breeds. A five-layered strategy based on the experiences in the four countries is proposed to stimulate a more sustainable and healthier approach to dairy farming and to help reduce the use of antibiotics and improve milk quality.