FARMS-SAFE: Future-proofing Antibacterial resistance Risk Management Surveillance and Stewardship in the Argentinian Farming Environment

点击翻译按钮获取中文摘要

Antibacterial drug resistance (ABR) is a global threat to health and development and a problem that is getting steadilyworse. Within Latin America, Argentina has been tracking levels of ABR in human infections since 1986. Argentina wasalso the first country in the region to develop a national strategy for the control of ABR. This national Strategy takes astarting assumption that the use of antibacterial drugs (ABs) in livestock agriculture is in part responsible for the threatof ABR in humans. The use of ABs on farms can potentially result in ABR human infections via 3 main pathways: (1)ABR bacteria selected in the farm environment infect humans, or at least the mobile ABR genes carried within themare transmitted to bacteria that infect humans; (2) Agricultural AB residues in food are ingested by humans, selectingfor ABR in human bacteria; (3) Agricultural ABs contaminate the non-farm environment, selecting ABR in bacteriathere, which then infect humans. In Argentina, data are extremely limited for the amount of ABR bacteria on farmsand in the near-farm environment. Furthermore, whilst AB residues are monitored in foodstuffs entering the formalmarket, there is a significant informal market, and AB levels in the environment are not routinely measured. Onepotential response to the rising threat of ABR is regulation, and both international organizations - led by the WHO -and individual countries have sought to formulate, for example, new regulatory frameworks to address the and use ofABs in farming, as well as the management of farm waste. As the O'Neill report recognises, however, developingcountries "...will need extra support and additional time to train veterinarians, develop regulations, build surveillancecapacity and improve farming practices". The premise of this project - FARMS-SAFE - is that as well as providing bettersurveillance information for ABR and AB usage, extra support for Argentina and other Latin American countries shouldencompass a risk-based approach to the design of regulation as well as to the strengthening of enforcement capacities;their weakness is another source of risk.FARMS-SAFE will address this issue by reference to four key risk areas via an UK/Argentinian research consortium:1. Animal disease as a driver of ABR risk - We will identify why farmers use ABs in the context of animal disease.2. Animal husbandry practice as a driver of ABR risk - We will identify what farm management practices are beingemployed that influence the usage of ABs and will perform surveillance of the usage of ABs on farms in Argentina.3. Farm waste management as a driver of ABR risk. We will perform surveillance of ABR bacteria with clearpotential to affect human health on farms in the near farm environment and will measure the levels of ABs and other chemicals in the near-farm environment. We will correlate ABR with AB usage and will identify management riskfactors for ABR and AB contamination in the environment.4. Regulatory capacity as a driver of ABR risk. We will identify the key individuals and organisations involved inregulation of ABR and work with them to develop tools that can be used to regulate in a way that is informed by therisks that drive ABR.This work will lead to significant new understanding of the prevalence and causes of ABR in Argentinian farmingsystems, how this influences the near-farm environment (and so potentially influences human health) and will informpolicy making within Argentina, Latin America and the wider world. We will also create a surveillance structure andtrained researchers who can continue to monitor ABR, AB usage and environmental contamination with ABs and ABRinto the future, and who can measure success and failure of strategies employed to reduce this risk.