2 Misconceptions about a One Health approach to AMR

‘One Health involves all sectors other than human health. For example, the “One Health sectors” are animal health, environmental health, plant health, etc.’

This misconception implies that One Health is the responsibility of sectors other than human health. In reality, One Health is the collaboration of all sectors contributing to and affected by AMR – including human health. There is no such thing as a ‘One Health sector’; One Health includes all sectors, especially human health.

‘The One Health approach is necessary because the overuse of antimicrobials in animals has led to the AMR problem in humans.’

There is a perception that the use of high volumes of antimicrobials in animals is a major cause of AMR in humans, and that the AMR problem can be mitigated by reducing levels of antimicrobial use (AMU) in animals.

Scientific evidence does not support the perception that AMU in animals is the major contributor to AMR in humans. While the use of some antimicrobials in animals does contribute to AMR in humans, the current evidence indicates that poor use of antimicrobials in human health care is the major factor driving AMR in humans.

‘One Health means treating all sectors with the same level of priority.’

One Health recognises that maintaining the effectiveness of antimicrobials for human health is the highest priority. This may lead to different levels of funding within grants or government budgets in order to address the most important factors associated with AMR in humans.

Whilst recognising AMR in humans as a priority, a One Health approach also recognises that AMR impacts the health of animals, aquatic species and plants, and is also important for animal health and welfare, and food security. Hence it is important that the One Health approach respects and understands the AMR problem in all sectors and provides adequate resources to investigate and manage AMR in all affected sectors.

‘A One Health approach to AMR and AMU surveillance involves implementing the same surveillance methods in all sectors.’

Approaches to AMR and AMU surveillance may differ between the sectors, depending on the objectives of surveillance in each sector and on the sources of samples from humans, animals, aquatic species and plants. For example, One Health AMR surveillance currently supported by the Fleming Fund is based on the following different surveillance approaches to identify AMR risks for humans in both human and animal populations:

• passive AMR surveillance in humans using data generated from laboratories from routine testing of samples submitted from patients with suspected infection
• active AMR surveillance in animals using data generated by testing samples collected from healthy animals at markets, abattoirs or farms.

‘One Health involves conducting antimicrobial susceptibility testing (AST) on samples from humans, animals, food and the environment in a single laboratory.’

One Health involves optimising the use of laboratory resources to conduct AST in samples from humans, animals, food and/or the environment. The particular mix of laboratories will depend on each country’s situation. For example, in small countries with a small animal production sector, the optimal use of limited resources may be to test animal samples in the human health laboratory. In countries that do not have laboratories that provide microbiology services for the food and environment sectors, it may be more cost-effective to test food and/or environment samples in animal health or human health laboratories.