SUSTAINABILITY

Antimicrobial resistance. International agencies continue to strongly embrace the “One Health” approach to combating antimicrobial resistance (AMR) in food. This approach promotes a unified action plan at the national level to prioritize, budget and implement existing national health programs. Indeed, WHO published on October 13 a guide for the development of costing and budgeting tools for National AMR Action Plans. On the same day, the FAO Codex Alimentarius Task Force issued two documents to incorporate the “One Health” approach into international best practices. The review of AMR strategies has already begun to have an impact in Latin American countries: on October 7, Chile presented the National AMR Action Plan 2021-2025 prepared with support from the European Union and PAHO. Similar publications are expected in the coming months in the remaining countries of the region.

The WHO publication comes after working on a pilot plan in Jamaica and Paraguay. This guide seeks to guide countries in the development of a NAP on Antimicrobial Resistance. The NAP is a “plan of plans” comprising all national programs that have not been budgeted and linked together. For example, some activities of different national programs may be included in other existing programs without any connection between them. In the plan of plans, four major categories are identified that contemplate different scenarios for the implementation of the public policy on antimicrobial resistance: In the animal scenario, veterinary medicine, animal feed safety, herd health, biosecurity and hygiene are contemplated. At the plant level, food safety, crop production and health are considered. At the environmental level, the administration of pesticides is considered. In a residual category, water management and waste management are covered.

In addition, the Codex Ad Hoc Intergovernmental Task Force on Antimicrobial Resistance finalized on October 13 the revision of the “Code of Practice to Minimize and Contain Antimicrobial Resistance” and developed the document “Guidance on Integrated Monitoring and Surveillance of Antimicrobial Resistance (GLIS) to Address Foodborne AMR Management along the Food Chain.” Both texts, to be published in the coming days, address the management of foodborne AMR along the food chain and incorporate the “One Health” approach, taking into account the work of international organizations such as FAO, WHO and OIE. By virtue of their final approval, the documents are expected to be sent to the Codex Alimentarius Commission to be held in November 2021.

The focus of these documents has guided Chile to release its Antimicrobial Resistance Action Plan 2021-2025 on October 7. In publishing the plan, PAHO highlighted the work of the Chilean Ministry of Health, as it contemplates an intersectoral approach to tackling antimicrobial resistance. The five strategic axes of the national plan include integrated antimicrobial surveillance, control and monitoring of antimicrobials in humans, animals and agriculture.

Next steps

The unification of national health programs into a large national action plan is in line with the “One Health” policy endorsed at PAHO’s 59th Directing Council on September 21, 2021. Through this public policy, a harmonization and unification of national programs into a single national antimicrobial resistance policy is envisaged. Following the case of Chile, it is expected that Latin American governments, at ministerial level, will address the creation of unified antimicrobial resistance action plans with the support of international organizations in the coming months.