Surveillance and One Health in food production are key to curbing antimicrobial resistance
Antimicrobial agents, such as antibiotics, are essential for the treatment of many human and animal infections and diseases. However, their overuse and misuse has led to the development of antimicrobial resistance (AMR), which means that a drug, such as an antibiotic, may no longer be effective in treating the infection. Without urgent action, the world risks becoming a place where common infections are incurable, even fatal, and where complex surgeries are life-threatening.
Due to the overuse of antimicrobials, drug-resistant bacteria can be found in animals and food products intended for human consumption. Therefore, food has become a potential vector for the transmission of resistant pathogens from animals to humans.
Foodborne diseases are an important public health problem in the WHO European Region. Each year, approximately 23 million people become ill from consuming contaminated food and 5,000 people die. A significant proportion of illnesses and deaths linked to the consumption of contaminated food are caused by bacteria, such as Campylobacter and Salmonella, which show increasing levels of resistance to commonly used antimicrobials.
Monitoring AMR in the food chain is essential
One of the main ways to highlight the threat to public health posed by antimicrobial resistance is through the establishment of effective surveillance programs. Information on antimicrobial resistance levels in common foodborne pathogens and antimicrobial residue levels in foods of animal origin is extremely important to guide risk management and policy action.
Unfortunately, few countries in the European Region have sufficient capacity to monitor antimicrobial resistance in the food chain. That is why WHO has made it a key priority to support countries in the Region to establish and strengthen surveillance systems for antimicrobial resistance and antimicrobial residues in the food supply, as well as integrate antimicrobial resistance testing into existing foodborne disease surveillance and response systems.
Despite the limited capacity for surveillance of antimicrobial resistance in the food chain in the Region, some countries have made good progress.
Strengthening surveillance in Uzbekistan
Dr. Gulnora Abdukhalilova is a scientist at the Uzbekistan Ministry of Health, where she works to reduce antimicrobial resistance and enforce food safety standards. In 2016, she conducted a research project on antimicrobial resistant strains of campylobacter and salmonella in chickens raised specifically for food.
Research has shown that most strains of salmonella found in chicken are multidrug resistant, which means the infections they cause can be difficult to treat. The overuse and misuse of antimicrobials in poultry production has been one of the drivers of this resistance.
“Ideally, resistance monitoring should be routine across the health and agriculture sectors,” Dr Abdukhalilova said. “Surveillance for antimicrobial drug resistance in common foodborne pathogens simply needs to be done.”
As a result of the research, AMR surveillance was included in the national program of Uzbekistan to combat resistance of microorganisms to antimicrobial drugs for 2020-2024.
A One Health Approach to Combat AMR
As antimicrobial resistance lies at the intersection of human, animal and environmental health, greater coordination across sectors and stakeholders is needed to address antimicrobial resistance in the food chain. Promoting such coordination is known as the One Health approach.
Given that most countries in the European Region lack adequate coordination and data sharing between the human and animal sectors, WHO and partners are committed to working with Member States in the Region to strengthen multisectoral coordination. and supporting One Health efforts to combat antimicrobial resistance. This commitment was recently reinforced with the establishment of the One Health regional coordination mechanism by the Food and Agriculture Organization of the United Nations (FAO), the World Organization for Animal Health (OIE) and the WHO.
Following her work, Dr. Abdukhalilova echoes the need for a One Health approach to tackling antimicrobial resistance in the food chain: “It is important to…coordinate and exchange information between different sectors, such as poultry production and healthcare”.