Towards Developing an International Environmental AMR Surveilance Strategy

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There is an urgent and increasing need to fully understand the development and transmission of AMR both into and within the wider environment. However, at present research into environmental aspects of AMR has been largely confined to individual institutions or academic laboratories. National governments and international bodies (EU, UN, WHO) have recognised that we must establish effective environmental surveillance systems to identify and monitor AMR in our waters, soils air and wildlife in order to increase understanding of the natural environment's role in emergence and spread of AMR and how the introduction of antimicrobials / resistant microorganisms from human / animal sources into the environment contribute to AMR. A One Health approach promotes harmonised surveillance across human, veterinary and food sectors and the use of common outcome indicators to monitor AMR and antimicrobial use: several joint national reports publish AMR trends for key indicator bacteria and key antibiotics (for example UK One Health report, DANMAP and Scottish One Health Antimicrobial Usage and Antimicrobial Resistance Report (SONAAR). However, there is no clear consensus so far regarding which indicators to measure for the environmental sector. This network aims to identify robust, measurable surveillance indicators and methodologies for environmental AMR by: building on and transferring existing knowledge from clinical and animal AMR indicators and methodologies in the context of a multi-sectoral, One Health approach. We will bring together key researchers with policy makers and regulators across the environmental, human health and veterinary sectors and from countries with a wide range of economic settings. We aim to arrive at a standardised set of targets and reproducible, accessible methodologies allowing comparative data to be generated in a coordinated manner. We will then set out our findings in advice and briefings to governments and international bodies.