Antimicrobial agents, such as antibiotics, are essential to treating many human and animal infections and diseases. Their overuse and misuse, however, has led to the development of antimicrobial resistance (AMR), meaning that a drug, such as an antibiotic, might no longer be effective in treating the infection. Without urgent action, the world is at risk of becoming a place where common infections are untreatable or even kill, and where complex surgical procedures become life-threatening.
Due to the overuse of antimicrobials, drug-resistant bacteria can be found in animals and food products intended for human consumption. As a result, food has become a potential vehicle for the transmission of resistant pathogens from animals to humans.
Foodborne diseases are a significant public health concern in the WHO European Region. Every year, about 23 million people fall ill by consuming contaminated food and 5000 people die. A substantial proportion of illnesses and deaths from consuming contaminated food are caused by bacteria, such as campylobacter and salmonella, which show increasing levels of resistance to commonly used antimicrobials.
Surveillance of AMR in the food chain is essential
One of the key ways to highlight the public health threat posed by AMR is through effective surveillance programmes. Information about the levels of AMR in common foodborne pathogens and levels of antimicrobial residues in food of animal origin is extremely important for guiding risk management and policy action.
Unfortunately, few countries in the European Region have sufficient surveillance capacity for AMR in the food chain. That is why it is a key priority for WHO to assist countries in the Region to establish and strengthen systems for surveillance of AMR and antimicrobial residues in the food supply, as well as to integrate AMR testing in existing systems for foodborne disease surveillance and response.
Despite the limited surveillance capacity for AMR 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 Ministry of Health in Uzbekistan, where she works to reduce AMR and uphold food safety standards. In 2016, she conducted a research project looking at antimicrobial resistant strains of campylobacter and salmonella in chickens bred specifically for food.
The research showed that most of the salmonella strains found in the chicken were multi-drug resistant, meaning that the infections they cause can be difficult to treat. The overuse and misuse of antimicrobials in poultry production was one of the drivers of this resistance.
“Ideally, monitoring resistance should be routine in the health and agricultural sectors,” said Dr Abdukhalilova. “Monitoring of resistance to antimicrobial drugs in common foodborne pathogens simply has to be done.”
As a result of the research, AMR surveillance has been included in Uzbekistan’s National Programme to Combat Microorganism Resistance to Antimicrobial Drugs for 2020–2024.
A One Health approach to fighting AMR
Given that AMR lies at the intersection of human, animal and environmental health, greater coordination across sectors and stakeholders is needed to combat AMR in the food chain. Fostering such coordination is known as the One Health approach.
Because most countries in the European Region lack adequate coordination and data sharing between human and animal sectors, WHO and its partners are committed to working with Members States in the Region to strengthen multisectoral coordination and bolster One Health efforts to combat AMR. This commitment was recently strengthened with the establishment of the Regional One Health Coordination Mechanism by the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE) and WHO.
As a result of her work, Dr Abdukhalilova echoes the need for a One Health approach to fighting AMR in the food chain: “It is important to…coordinate and exchange information between different sectors, such as poultry production and health care”.