A qualitative approach for a situation analysis of AMR risks in the food animal production sector.

In response to the need to manage Antimicrobial Resistance (AMR), countries have produced National Action Plans (NAPs), which require detailed information of the AMR situation in all sectors. Considering the limited information that is publicly available for an analysis of the AMR situation in animal production, the FAO Regional Office for Latin America and the Caribbean (FAO RLC) developed the "FAO tool for a situation analysis of AMR risks in the food and agriculture sectors." The objective of this paper is to present the methodology developed for a qualitative evaluation of the risk factors of AMR toward animal and human health, based on terrestrial and aquatic production systems and their associated national public and private mitigation measures. The tool was developed reflecting the AMR epidemiological model and the guidelines to conduct a risk analysis of AMR from the Codex Alimentarius and WOAH. Applied in four stages of progressive development, the objective of the tool is to provide a qualitative and systematic assessment of the risks of AMR from animal production systems, to animal and human health, and to identify gaps in cross cutting factors in AMR management. The tool consists of three instruments: (i) a survey to collect data for a situation analysis of AMR risks; (ii) a methodological procedure for the analysis of the information obtained; (iii) instructions for the preparation of a national roadmap for the containment of AMR at a national level. Based on the results from the information analysis, a roadmap is prepared by guiding and prioritizing the needs and sectoral actions for the containment of AMR under an intersectoral, multidisciplinary and collaborative approach, and according to country priorities and resources. The tool helps to determine, visualize and prioritize the risk factors and challenges that contribute to AMR from the animal production sector and that need to be addressed to manage AMR.

Driving multisectoral antimicrobial resistance action in South America: Lessons learned from implementing an enhanced tripartite AMR country self-assessment tool.

As part of an innovative Tripartite-EU collaboration Project that supports seven South American countries, a Landscape Analysis Tool (LAT) was developed and implemented to collect data to complement the Tripartite AMR Country Self-Assessment Survey (TrACSS) process. The LAT enables collection of broader and deeper information to guide development of priority One Health activities, and strengthen national action plans to combat antimicrobial resistance. The Project developed the tool, trained a consultant pool in its use, and implemented it in conjunction with multi-sectoral country teams. The main results were seven priority-informed country workplans that proposed specific activities in line with the Strategic Objectives of each country's national action plan. LAT implementation clearly showed that the tool is a strong complement to the TrACSS process and that there can be considerable benefit to the process of collecting additional data layers, especially to strengthen country ownership of AMR-related information and solidifying multisectoral engagement. Countries elsewhere might consider implementing this complementary tool - either once to establish a baseline - or periodically to gain a better ongoing understanding of the situation on the ground.

The COVID-19 Pandemic and Global Food Security.

We present scientific perspectives on the impact of the COVID-19 pandemic and global food security. International organizations and current evidence based on other respiratory viruses suggests COVID-19 is not a food safety issue, i.e., there is no evidence associating food or food packaging with the transmission of the virus causing COVID-19 (SARS-CoV-2), yet an abundance of precaution for this exposure route seems appropriate. The pandemic, however, has had a dramatic impact on the food system, with direct and indirect consequences on lives and livelihoods of people, plants, and animals. Given the complexity of the system at risk, it is likely that some of these consequences are still to emerge over time. To date, the direct and indirect consequences of the pandemic have been substantial including restrictions on agricultural workers, planting, current and future harvests; shifts in agricultural livelihoods and food availability; food safety; plant and animal health and animal welfare; human nutrition and health; along with changes in public policies. All aspects are crucial to food security that would require "One Health" approaches as the concept may be able to manage risks in a cost-effective way with cross-sectoral, coordinated investments in human, environmental, and animal health. Like climate change, the effects of the COVID-19 pandemic will be most acutely felt by the poorest and most vulnerable countries and communities. Ultimately, to prepare for future outbreaks or threats to food systems, we must take into account the Sustainable Development Goals of the United Nations and a "Planetary Health" perspective.

Antimicrobial resistance in water in Latin America and the Caribbean: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify and map existing evidence of antimicrobial resistance (AMR) in water in Latin America and the Caribbean (LAC), while also identifying the gaps in AMR information in the region in eight themes of interest. INTRODUCTION: Antimicrobial resistance is a public health concern that has gained increasing global awareness. Concerns have been raised toward the importance of the environment's role in the dissemination of clinically relevant AMR. Although studies on AMR have been conducted, the reality of the role of the environment in the LAC region has not been studied. INCLUSION CRITERIA: Articles that examine AMR in water in the LAC region will be considered for inclusion. Antimicrobial resistance will be defined as a natural process that arises when the microorganisms that cause infection (e.g. bacteria) survive exposure to a drug that would normally kill them or stop their growth. The search will focus on eight themes of interest, as defined in the protocol, relating to the presence of resistant microorganisms in water sources and reported negative health effects. Qualitative and quantitative studies will be considered for inclusion. Reviews and gray literature will be excluded. METHODS: The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews. A search for published literature will be performed in PubMed, Web of Science and Scopus. Independent screening of articles will be performed by examining the abstracts and then the full texts, utilizing pre-defined inclusion and exclusion criteria. Data for specific variables will be extracted, and descriptive examination will be performed.

World Health Organization Estimates of the Global and Regional Disease Burden of 22 Foodborne Bacterial, Protozoal, and Viral Diseases, 2010: A Data Synthesis.

BACKGROUND: Foodborne diseases are important worldwide, resulting in considerable morbidity and mortality. To our knowledge, we present the first global and regional estimates of the disease burden of the most important foodborne bacterial, protozoal, and viral diseases. METHODS AND FINDINGS: We synthesized data on the number of foodborne illnesses, sequelae, deaths, and Disability Adjusted Life Years (DALYs), for all diseases with sufficient data to support global and regional estimates, by age and region. The data sources included varied by pathogen and included systematic reviews, cohort studies, surveillance studies and other burden of disease assessments. We sought relevant data circa 2010, and included sources from 1990-2012. The number of studies per pathogen ranged from as few as 5 studies for bacterial intoxications through to 494 studies for diarrheal pathogens. To estimate mortality for Mycobacterium bovis infections and morbidity and mortality for invasive non-typhoidal Salmonella enterica infections, we excluded cases attributed to HIV infection. We excluded stillbirths in our estimates. We estimate that the 22 diseases included in our study resulted in two billion (95% uncertainty interval [UI] 1.5-2.9 billion) cases, over one million (95% UI 0.89-1.4 million) deaths, and 78.7 million (95% UI 65.0-97.7 million) DALYs in 2010. To estimate the burden due to contaminated food, we then applied proportions of infections that were estimated to be foodborne from a global expert elicitation. Waterborne transmission of disease was not included. We estimate that 29% (95% UI 23-36%) of cases caused by diseases in our study, or 582 million (95% UI 401-922 million), were transmitted by contaminated food, resulting in 25.2 million (95% UI 17.5-37.0 million) DALYs. Norovirus was the leading cause of foodborne illness causing 125 million (95% UI 70-251 million) cases, while Campylobacter spp. caused 96 million (95% UI 52-177 million) foodborne illnesses. Of all foodborne diseases, diarrheal and invasive infections due to non-typhoidal S. enterica infections resulted in the highest burden, causing 4.07 million (95% UI 2.49-6.27 million) DALYs. Regionally, DALYs per 100,000 population were highest in the African region followed by the South East Asian region. Considerable burden of foodborne disease is borne by children less than five years of age. Major limitations of our study include data gaps, particularly in middle- and high-mortality countries, and uncertainty around the proportion of diseases that were foodborne. CONCLUSIONS: Foodborne diseases result in a large disease burden, particularly in children. Although it is known that diarrheal diseases are a major burden in children, we have demonstrated for the first time the importance of contaminated food as a cause. There is a need to focus food safety interventions on preventing foodborne diseases, particularly in low- and middle-income settings.