Control of. Antimicrobial. Agri Food Sector. Jeffrey LeJeune, DVM, PhD
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1 Control of Foodborne Antimicrobial Resistance in the Agri Food Sector Jeffrey LeJeune, DVM, PhD
2 THE BURDEN OF AMR Deaths Distribution Dollars
3 3
4
5 Rendering EPIDEMIOLOGY OF ANTIMICROBIAL RESISTANCE Dead stock Drinking water Farm Effluents and Manure Spreading Offal AQUACULTURE Rivers and Streams SOIL WILDLIFE Sea / Lakes Sewage Vegetation, Seed Crops, Fruit Drinking Water Swimming Industrial & Household Antibacterial Chemicals Animal Feeds SHEEP VEAL CALVES SWINE FOOD ANIMALS OTHER FARMED LIVESTOCK CATTLE POULTRY Commercial Abattoirs / Processing Plants Meat Handling Preparation Consumption HOSPITALIZED HUMAN EXTENDED CARE FACILITIES COMMUNITY - URBAN -RURAL COMPANION ANIMALS Direct Contact after Linton AH (1977), modified by Irwin RJ
6 (Berkner et al., 2014)
7 7
8 The AMR Global Action Plan World Health Assembly -May 2014 World Health Assembly May 2015, endorsed World Organization for Animal Health (OIE) Resolution May 2015 Food and Agriculture Organization of the United Nations (FAO) Resolution - June 2015 FAO Action Plan on AMR UN General Assembly Declaration September 2016
9 FAO Action Plan on AMR
10 AMR and One Health Livestock Production Animal Health Feed Safety Communication Legal Framework Fisheries and aquaculture FAO Action Plan Regional / Sub regional level National level Codex Alimentarius Food Safety Water Plant health
11 1. Increased Awareness
12 2. Practices o Pre-harvest Reducing use Not for growth promotion Only when needed d (OWN) Improving animal health biosecurity disease prevention e.g. vaccine use hygienic and management practices o Post harvest Food hygiene and sanitation istockphoto
13 (A) Largest five consumers of antimicrobials in livestock in Increase % increase Thomas P. Van Boeckel et al. PNAS 2015;112: by National Academy of Sciences
14 3. Improved Regulations and Guidelines National Legal Framework o Eliminating use as growth promoters o Requiring veterinary prescriptions o Justification of use of critically important antibiotics in animals o Environmental Discharge Gettyimages
15 Codex Alimentarius International group to establish standards guidelines and practices for food (1961) 186 countries observers FAO/WHO Joint Expert Committee on Food Additives (JECFA) Establish Maximum Residual Limits (MRLs) FAO/WHO Joint Expert Meeting on Microbiological Risk Assessment (JEMRA) FAO/WHO Joint Meeting on Pesticide Residues (JMPR) Codex Task Force on Antimicrobial Resistance (TFAMR5)
16 TASK FORCE Electronic Working Groups (EWG) (i) revision of the Code of practice to contain and minimise antimicrobial resistance; and (USA; CL, CN and UK) (ii) develop guidelines on surveillance of foodborne antimicrobial resistance. (NL; CN, KY NZ)
17 4. Surveillance o Antimicrobial Use o Antimicrobial Resistance o Integrated Approaches Humans Animals Foods Environment
18 Achieving Integrated Surveillance o Build on existing framework National WHO, OIE o Tailored to Country Situational Analysis Laboratory Assessment
19 Assessment Tool for Laboratories and AMR Surveillance Systems s ATLASS Activities, Capacity Compliance, Progress Mapping Monitoring Action, Advocacy National, GLASS Evidence Linkages
20 Progressive Management Pathway to Combat AMR o Roadmap (Guide) for progress and goals Awareness Governance Practices (Infection Control) Leadership Research and Development Evidence Surveillance Laboratory Capacity Reporting, Coordination, Integration Comp prehenivne ess Stage 1 Stage 2 Time Stage 3 Stage 4 Stage 5
21 Progressive Management Pathway Labora atory Co omplexity Limited by Capacity (ATLASS) WGS Campylobacter Broth dilution PCR.. Enterococcus AST-KB CRE ESBL E.coli Chicken Poultry Meat Inter-agency communications Water Vegetables Integrated Analysis Programme Complexity and Integration Dictated by Needs (Situational Analysis)
22 AMR: Key Messages for Countries 1. Improve overall coordination 2. Improve regulatory framework 3. Reduce the need for and promote prudent use of antibiotics 4. Improve surveillance 5. Advocate and communicate 6. Build capacity and provide training 7. Address knowledge gaps and research needs
23
24 ATLASS Structure ATLASS-Surveillance module ATLASS-Lab- Activity ATLASS-Lab module ATLASS-Lab- LMT filled once for each country, answers from several respondents filled for each laboratory assessed Lab 1 Lab 1 Lab 2 Lab 2 Etc. Etc.
25 Assessment Tool for Laboratories and AMR Surveillance Systems Assessment Tool for Laboratories and AMR Surveillance Systems Assessment Tool for Laboratories and AMR Surveillance Systems ATLASS o Contact us at: o EMPRES-Lab-Unit@fao.org
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