Russia and the quadripartite alliance will not leave superbugs any chance

On 29 November 2022, the round table “Let’s come together to counter antimicrobial resistance (AMR)” was held in Moscow at the initiative of the representative of the Quadripartite Partnership in the Russian Federation.

Oleg Kobiakov, Director of the FAO Liaison Office with the Russian Federation, particularly noted that an effective control of AMR through the best practices and experience is a shared responsibility of producers, consumers, investors and policymakers in agrifood systems.

“FAO, presenting the new FAO five-year plan to counter antimicrobial resistance, warns that a silent threat looms over the agrifood industry,” Oleg Kobiakov said in his speech. 

“The impact of antimicrobial resistance may lead to economic losses, livestock decline, hunger and malnutrition, especially in low- and middle-income countries,” FAO Director-General Qu Dongyu said in his opening remarks at the Antimicrobial Awareness Week.

“Pathogenic microflora – bacteria, bacilli, fungi and viruses – when repeatedly exposed to antibiotics and other antimicrobials, become resistant to treatments designed to kill or suppress them, making drugs ineffective and creating a specter of uncontrolled "superbugs", the head of the FAO Moscow Office continued. Approximately 700 000 deaths per year are associated with AMR, and this number could rise to 10 million by 2050 if medical, veterinary and environmental authorities do not take strong countermeasures.”  

“AMR poses particular risks to agriculture due to the misuse or overuse of antimicrobials, of which the livestock sector is a major consumer. Antimicrobials are also used for growing crops, especially rice and tomatoes, and in aquaculture.

For livestock and crop production, the availability of life-saving, effective medicines is essential. Controlling AMR effectively through the best practices and experience is a shared responsibility of producers, consumers, investors and policymakers in agrifood systems.

The new FAO Five-Year Action Plan on Antimicrobial Resistance 2021-2025 provides guidance on how FAO supports its members. Among its key principles there are the need for research-backed evidence to identify and manage AMR risks before they escalate into large-scale emergencies, the benefits of surveillance and education worldwide, and the importance of incentivizing and empowering stakeholders to raise awareness of AMR risks.

As resistant microbes cross borders, a global effort is the only way to ensure that humanity is protected. FAO is working on the establishment of the Multi-Stakeholder Partnership Platform on AMR, which will become operational in 2022 and will ensure that all aspects and all levels of the spectrum of AMR threats are taken into account,” Oleg Kobiakov said. 

Background: FAO has already helped over 40 low- and middle-income countries develop and implement national AMR action plans. FAO is facilitating access to resources and technical networks and has developed a toolkit to help countries scale up their AMR activities in various sectors of agriculture and food production.

“I am convinced that by applying modern science and technology, developing innovative approaches, the quadripartite partnership, formed by the World Health Organization (WHO), the World Organization for Animal Health (WOAH, formerly the OIE), the Food and Agriculture Organization of the United Nations (FAO) and the United Nations Environment Programme (UNEP), is able to effectively help member countries to keep the global problem of antibiotic resistance under control,” Oleg Kobiakov stressed in conclusion.

The representative of the World Organization for Animal Health (WOAH, formerly OIE) Arsenty Polyakov, on behalf of OIE Regional Representative for Europe, Dr Budimir Plavsic, highly appreciated the partnership with all three UN Agencies – WHO, FAO and UNEP, as well as with national agencies and organizations, which are actively involved in the implementation of the One Health concept.

Global use of antimicrobials in animals has decreased by 27% since 2016, according to the 6th Annual Report on Antimicrobial Agents Intended for Use in Animals, published this summer.

“Fighting antimicrobial resistance is truly a global challenge and must be addressed through the One Health approach. This is why cooperation across sectors dealing with human, animal, plant and environmental health plays a crucial role.

The Quadripartite Alliance has just announced the launch of the Multi-Stakeholder Platform for fighting AMR, which is aimed at creating a global movement. We hope that the governments and organizations of many countries will actively participate in it.” 

Dr Danilo Lo Fo Wong, Coordinator of the Antibiotic Resistance Control Programme at the WHO Regional Office for Europe, outlined the key tasks and challenges in achieving the desired effect in the fight against AMR within the European Region. He noted that in 2022 a record number of countries in the Region provided data to the publicly available global AMR monitoring database. Among the main challenges hindering country-level impact, Dr Lo Fo Wong identified the lack of perspective and voice of patients in resource mobilization to combat AMR.

Secondly, in many countries there is a “lack of unified high-level leadership and support, and a lack of unified coordination in the implementation of the One Health policy. This manifests itself in the following shortcomings: “There is no agreed systemic approach (this affects management and accountability). More than 75% of the national action plans in the Region do not calculate all necessary expenses, that are by the way not budgeted. To a limited extent, work on AMR is coordinated with universal health coverage, primary health care, and pandemic preparedness and response.”

In addition, in a number of countries, “access to early and high-quality laboratory diagnostics is limited, and representative and reliable data on AMR surveillance and antimicrobial consumption is not available,” said the WHO representative. In conclusion, Dr Lo Fo Wong emphasized that WHO provides technical support to countries in developing their national plans, promoting intersectoral collaboration, and AMR cost calculation and budgeting.

In mid-September, Russia celebrated the 100th anniversary of the establishement of the state sanitary and epidemiological service, said Elena Igonina, Adviser to the Epidemiological Surveillance Department of the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor). One of the main methods of preventing and counteracting infections, including the prevention and control of possible epidemics, is the implementation of activities within the framework of the Sanitary Shield programme.

The implementation of this programme, as Elena Igonina explained, allows “to make the diagnosis of infections fast and accessible anywhere in the country at any time; decode in a laboratory any unknown infection in 24 hours and develop a test system for any new infection in 4 days; protect the country from future biological threats and preserve the health and well-being of citizens.” 

For this purpose, territorial administrations, centres of hygiene and epidemiology, more than 20 research institutes, plague control stations, and disinfection organizations are already operating in Russia.

Rospotrebnadzor, together with FAO, with the support of the Russian Government, is implementing a project to assist the countries of Central Asia and Eastern Europe to counteract the development of microbial resistance to AMR. 

Moreover, a three-stage monitoring system, comprising territorial laboratories, eight support bases in the federal districts of Russia and a Reference Centre, has been created, Elena Igonina shared later. Regular trainings on AMR and molecular genetic testing methods are being held (more than 450 subject-matter specialists have been trained), equipment and reagent kits have been delivered to partner countries for the identification of bacteria in food products and food raw materials for the detection of GDRs (genetic determinants of resistance) using the PCR-RT method.

The Russian authorities are taking effective measures to stop the ever-increasing threat of AMR, Roman Kozlov, Rector of the Smolensk State Medical University and concurrently the Chief Freelance Specialist of the Russian Ministry of Health in Clinical Microbiology, said in his presentation “Antibiotics and Antibiotic Resistance during the COVID-19 Pandemic”.

In Russia in 2020-2021, 64 laboratories in 36 cities in 32 regions collaborated in the study of antibiotic resistance of nosocomial pathogens. The laboratories of medical organizations that diagnose infectious diseases are being modernized. This programme involves 133 laboratories in 84 regions of the Russian Federation, where 5 733 pieces of modern equipment have been delivered. For these purposes, 5 769 940 thousand roubles have been allocated from the federal budget.

How is the global monitoring of the progress of nations in countering AMR being conducted? Doctor of Medical Sciences Lyalya Gabbasova, Deputy Director of the Medical Research and Education Centre of Lomonosov Moscow State University, Coordinator of data provision from Russia to TrACSS, spoke about that. She noted, in particular, the effectiveness of the partnership in this area of the Quadripartite Organizations, namely of ​​the World Health Organization (WHO), the World Organization for Animal Health (WOAH, formerly the OIE), the Food and Agriculture Organization of the United Nations (FAO) and the United Nations Environment Programme (UNEP).

The new quadripartite One Health Joint Plan of Action has been presented, and as Lyalya Gabbasova emphasized, “it is aimed at supporting and expanding capacity in six areas: opportunities provided for health systems under One Health; new and re-emerging zoonotic epidemics; endemic zoonoses, neglected vector-borne tropical diseases; food safety risks; antimicrobial resistance; environment.”

The One Health initiative, as noted by Dr Gabbasova, “is aimed at creating a sustainable balance and optimizing the health of humans, animals, ecosystems and the environment as a whole.”