Antimicrobial Resistance

Food safety

What is the problem

Food plays an important role in the development and spread of antimicrobial resistance (AMR). The presence of AMR microorganisms in our agricultural production systems and food chains is a potential route of exposure for everyone. Good hygiene practices in agriculture, fundamental in achieving food safety, are also key to addressing antimicrobial resistance.

Ingestion of AMR organisms via food can, if they are pathogenic, result in human illnesses -- and those illnesses might not respond to available antibiotic or other treatments. Moreover, even if the microorganisms are not themselves pathogens, they can contribute to a reservoir of antimicrobial resistance within our food supply. And given the widespread movement of food products, they may contribute to the spread of AMR as well as transmit resistance to other pathogenic organisms.

A growing world population and the resulting increase in demand for food is putting added pressure on our food supply chains and systems. The innumerable niches these systems provide for microbial populations foster conditions that can favour the selection of antimicrobial resistant microorganisms, which can directly cause human illness or indirectly damage food production. That is especially the case if imprudent use of antimicrobials in food production – including livestock, aquaculture, and crop production – is prevalent. The use of sanitizers and biocides through the food chain may further contribute to AMR.

Antimicrobial resistant microorganisms in food are not only a major public health challenge, but also represent an economic risk. There are cost implications involved in adapting or changing practices in order to reduce their presence and proliferation. They also have the potential to affect market access, either through health regulations or consumer purchasing behaviour. These economic risks need to be assessed in a broad manner due to the capacity for AMR to spread across borders.

Challenges and solutions

The multisectoral dimension of AMR highlights the challenge of developing and applying a cross-cutting and integrated approach to address this serious food safety hazard.

One critical front for action is raising awareness of the issue of AMR in the food safety and food chain context, so that producers and government authorities alike are sensitized to its importance. While good food safety management practices can minimize the transmission of AMR via food, the problem for many countries lies within their weak and fragmented food control systems. Often, these lack the infrastructure, regulation and capacity necessary to implement and monitor food safety at the national level. It is imperative to build strong integrated national food control systems, including appropriate governance and operational mechanisms to address the global AMR challenge. Additionally, improvements in food control systems must also be accompanied by developments in other areas, such as animal and plant production and health, to address AMR. 

Management of AMR in the food chain is complex and requires the implementation of good practices starting at primary production and continuing through to consumption. At the practical level, the overall aim of controlling the transmission of AMR through foods is similar to requirements for the control of other foodborne hazards, with greater emphasis on measures to manage microbial populations that harbour the AMR gene pool as well as consideration of the food environment factors that may contribute to resistance development.

At the production level, FAO supports the implementation of the necessary good hygiene practices and contamination prevention measures as well as the responsible use of antimicrobial medicines to help reduce food safety risks. This continues beyond the farm gate, where adherence to good hygiene practices by all food operators, enforced through a risk-based inspection system, is equally important.

Effective monitoring and surveillance systems that track the use of antimicrobials and the spread of AMR through human food chains are also necessary. One part of such an effort are existing veterinary drug residue monitoring programs; these are currently in place in some countries but not in others, and often need to be strengthened. Through its AMR laboratory mapping tool, FAO is helping countries assess their national surveillance and laboratory capacities. FAO and the International Atomic Energy Agency (IAEA) are also providing governments with support and training on how to set up and effectively operate veterinary drug residue monitoring programmes.

Governance

The Codex Alimentarius has laid the foundations for food control authorities to tackle AMR through the introduction of a range of standards related to AMR, veterinary drugs and their residues, food hygiene, animal feed, etc. These standards serve two important purposes: 1) they aim to prevent the development of AMR and 2) they aim to minimize the transmission of AMR through the food chain. In 2016 Codex re-established a Task Force dedicated to AMR to continue to serve the food safety community with internationally-recognised standards to guide the management of AMR by national food control authorities. Countries can now take these standards and incorporate them into national legislation and adapt them into implemental guidance.

Scientific advice

FAO has been collaborating with WHO and OIE for over a decade to provide scientific advice on AMR.  In addition, JECFA (Joint FAO/WHO Expert Committee on Food Additives), and JEMRA (Joint Expert Meetings on Microbiological Risk Assessment) take into consideration the issue of antimicrobial resistance in their assessments as needed. Some of the issues to be considered in the future include whether current food safety practices and guidelines relating to aspects such as veterinary drug and pesticide residues, the use of sanitizers/biocides, as well as the management of water and manure in the food chain contribute to the problem of antimicrobial resistance.

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