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Tackling anti-microbial resistance on multiple fronts

Date

A line of cows eating from a trough, a blue tractor in the background

Anti-microbial resistance, or AMR, is a major global health threat, directly responsible for over a million deaths each year and indirectly a cause of five million more. AMR occurs when bacteria, viruses, fungi and parasites develop an ability to withstand the effects of treatments designed to kill them.

The WHO Global Action Plan on AMR requires countries to develop national action plans to match their particular circumstances. After finding that the World Health Organisation's (WHO) Global Action Plan on AMR excluded Spanish and Portuguese language publications from its assessment, Dr Avello took on an analysis of all the published national action plan documents of Latin America.

She then partnered with Dr Mariano Fernandez Miyakawa (National Agricultural Technology Institute of Argentina); they brought together a range of stakeholders from academia, agriculture and policy to develop scientific evidence on AMR in agri-systems, find alternatives to antimicrobials for poultry production, and influence policy change.

I noticed that there were gaps, where national action plans in Latin America were not fully aligned with the Global Action Plan. So, the idea came about to develop recommendations that could improve the subsequent national action plan documents, raise awareness of actions that were needed in agriculture and, if possible, to influence policy, initially within Argentina.

– Dr Paula Avello

Impact

  • International collaboration: brought together stakeholders from government, agriculture, and academic sectors
  • AMR solutions: created alternatives to antimicrobials for poultry production from technical, economic, and regulatory perspectives
  • Policy impact: influenced policy change in Argentina, including the prohibition of antibiotics as growth promoters in all livestock destined for human consumption.

Key information

  • Major funders: Biotechnology and Biological Sciences Research Council Impact Acceleration Account (BBSRC IAA)
  • Partners and collaborators: MICROB-R
  • Disciplines: biology, mathematics
  • Investigators: Dr Paula Avello, Dr Mariano Fernandez Miyakawa.

The challenge of antimicrobial resistance

As AMR becomes more widespread, antibiotics and other antimicrobial medicines are increasingly becoming ineffective against diseases such as malaria, HIV/AIDS and tuberculosis.

Misuse and overuse of antimicrobials fuel AMR. It is not only a challenge for healthcare systems. The use of antimicrobials is also widespread in agriculture, and antimicrobials are increasingly found in the wider environment. The World Health Organisation (WHO) advocates a ‘One Health’ approach to tackle AMR, recognising that the health of humans, domestic and wild animals and the wider environment are inter-dependent. The 2015 WHO Global Action Plan on Antimicrobial Resistance recommends coordinated action across the human health, food production, animal and environmental sectors to tackle the issue.

In 2020, when the Covid-19 pandemic forced the world into lockdown, Dr Paula Avello was working on a UK Research and Innovation (UKRI) funded project, called TangoChicken, looking at AMR in commercial poultry production in Argentina. With a background in mathematics, Dr Avello was developing models to help understand the role of the litter used in poultry farms in the transmission of AMR into the wider environment.

With the research on hold due to the pandemic, Dr Avello turned her attention to the policy environment for AMR in agriculture. The WHO Global Action Plan on AMR requires countries to develop national action plans to match their particular circumstances. Dr Avello noticed that systematic assessments of these action plans had focused exclusively on those published in English, excluding those from Latin America, which are published in Spanish or Portuguese. She decided to remedy this with an analysis of all the published national action plan documents of Latin America.

“I noticed that there were gaps, where national action plans in Latin America were not fully aligned with the Global Action Plan,” says Dr Avello. “So, the idea came about to develop recommendations that could improve the subsequent national action plan documents, raise awareness of actions that were needed in agriculture and, if possible, to influence policy, initially within Argentina.”

Collaboration across sectors

Through TangoChicken, Dr Avello had been introduced to Dr Mariano Fernandez Miyakawa, who was the ideal partner for this policy work. Dr Fernandez Miyakawais an expert in the AMR field, particularly on the development of alternatives to antibiotics in livestock and in understanding and combating the spread and emergence of AMR in animal production systems. His work includes the development of policy frameworks for safer practices to reduce AMR and monitoring the national Argentine strategies against AMR in collaboration with stakeholders across human, animal and environment sectors.

Dr Fernandez Miyakawa coordinates the AMR programme at an Argentinian government research agency called the National Agricultural Technology Institute (INTA) and is a member of the Argentine National Commission for the Control of AMR (CONACRA). 

Together, Dr Avello and Dr Fernandez Miyakawa successfully applied for Biotechnology and Biological Sciences Research Council Impact Acceleration Account (BBSRC IAA) funding to run an event in Buenos Aires, drawing on Dr Fernandez Miyakawa’s networks and connections to bring together a range of stakeholders from the research, farming and policy areas.

As part of the event, called ‘Fighting antimicrobial resistance: alternatives to antimicrobials for poultry production from technical, economic, and regulatory perspectives’, Dr Avello and Dr Fernandez Miyakawa delivered two workshops. One focused on AMR policy in Latin America, and the second looked at ways to develop scientific evidence on AMR in agri-systems. 

“The event provided a great opportunity for different people to share their ideas, understand each other’s perspectives and come up with solutions together,” says Dr Fernandez Miyawaka. “For the researchers, it helped them understand the challenges faced by farmers and producers. For those farmers, it allowed them to see the wider role played by agriculture in AMR.”

The event helped to influence a change in policy by the Argentinian government. This saw the prohibition, in 2024, of the use of antibiotics as growth promoters in all livestock destined for human consumption. This change brings Argentina into line with the WHO Global Action Plan and with policies in the EU and UK, which have banned the use of antibiotics as growth promoters for some time. It also makes Argentina one of the leading countries for the control of AMR in Latin America.

Following on from the IAA project, Dr Avello and her colleagues successfully applied for NERC funding to extend the work to Chile. They are now working with Chilean partner MICROB-R – a multidisciplinary research group established to study AMR – to develop a framework of key predictors for AMR emergence and transmission within Chilean wastewater.

This project was sponsored by the UKRI Impact Acceleration Account.