Towards global surveillance of Antimicrobial Resistance
Article published on the FAO website.
Antimicrobial resistance (AMR) is a global threat to lives and livelihoods. Resistant infections kill one person every minute and resistant pathogens are spreading between people and animals, and through food, water, waste, and soils, threatening food production and endangering human health and the health of wild, domesticated and farmed animals.
Without action, by 2050 the global economy may lose more than USD 6 trillion dollars annually because of AMR – nearly 4% of Gross Domestic Product (GDP; Adeyi et al. 2017).
FAO is supporting countries in developing their national response toward global monitoring, prevention and control of AMR.
What is FAO-ATLASS?
FAO-ATLASS is a tool for assessing and defining targets to improve national AMR surveillance systems in the food and agriculture sectors. It is composed of two modules: the surveillance module, and the laboratory module. Each module includes two standardized questionnaires, which are completed by the assessors.
The tool is now available in four languages.
The tool was first piloted in 2016, up to date, 28 countries hosted FAO-ATLASS assessment missions. FAO is also building a worldwide community of assessors to serve as a technical resource toward harmonized regional and global surveillance efforts.
FAO is working with the World Organisation for Animal Health (OIE) and World Health Organization (WHO) to coordinate country-level assessments across sectors under a One Health approach.
OUTPUTS
- Assessments generate a baseline, and classify a “stage” for AMR laboratory capacity detection, AMR surveillance, and information dissemination
- Assessment of the five main areas for effective surveillance
- Identification of specific steps for improvement, and help countries with prioritizing actions for building reliable national AMR surveillance systems
- Progress monitoring through the ATLASS Progressive Improvement Pathway
ASSESSMENT MISSIONS
FAO-ATLASS missions are carried out by assessors trained in the effective use of the tool, and how to perform harmonized assessments. The assessment team usually includes two main assessors (one with expertise in laboratory techniques for antimicrobial susceptibility testing, and one with expertise in AMR surveillance), in addition to FAO staff who accompany the team for additional support. The two main assessors can be national assessors or external assessors who have been trained.
FAO-ATLASS missions are up to a week long. The recommended approach is to carry out the first assessment mission with external assessors to generate baseline information. For follow-up assessments to track progress, these can be carried out by national assessors and are recommended on a yearly basis.
FAO-ATLASS missions consist of:
Step 1. Stakeholder meeting with focal points for national AMR surveillance in food and agriculture sectors, and representatives from other sectors such as human health and environment. The information collected is recorded using the FAO-ATLASS Surveillance module.
Step 2. Visit and assessment of laboratories using the FAO-ATLASS laboratory module.
Step 3. Restitution stakeholder meeting to share and discuss information gathered through the mission and specific recommendations. These discussions benefit from continuity in stakeholder focal points.
Step 4. Report written by the main assessors in a collaborative approach with the country. Once cleared the report is officially submitted to the national authorities to be used for national and regional discussions on the mission findings and recommendations. Post-ATLASS missions and workshops may be organized at the country or regional level to gather national authorities and experts to review FAO-ATLASS mission findings and to develop plans for progressive improvement of AMR surveillance in their country and region.
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