On this interview, News-Medical talks to Dr Javier Yugueros-Marcos, Head of the Antimicrobial Resistance and Veterinary Products Department on the World Organisation for Animal Health, about how the world can work together to advertise the sustainable and responsible use of antimicrobials.

Please could you introduce yourself and tell us about your role throughout the World Organisation for Animal Health (WOAH)? 

My name is Javier Yugueros-Marcos, and I joined the World Organisation for Animal Health (WOAH, founded as OIE) one yr ago in November 2021. I’m leading the department in control of the standard of veterinary products, which encompasses diagnostics, vaccines and therapeutics, including antimicrobials. Due to the importance of antimicrobials and antimicrobial resistance, about 80% of our activity revolves around them. 

We monitor antimicrobial use everywhere in the world, develop standards on the responsible and prudent use of antimicrobials, and assess the standard of actions in the sector in order that we are able to increase capacity-building and alter practices. 

WOAH’s mission is to assist create a future by which humans and animals profit and support one another for a healthier, more sustainable world. Why is that this mission so vital given the present state of worldwide health, and the way is the health of humans and animals interlinked? 

Our work began in 1924 after an animal disease had a big effect on food security: Rinderpest. Since then, we’ve been working on improving animal health worldwide, bringing about transparency when it comes to the status of animal health, and ensuring secure international trade of animals and animal products. All of this leads to raised health for humans. 

Today, the situation shouldn’t be much different because animal diseases still exist, and we still care about transparency and reporting animal disease outbreaks for secure international trade. Nevertheless, human and animal health are interlinked when it comes to greater than just international trade. Let me offer you two examples. 

One is zoonoses. It’s estimated that 60% of infectious diseases in humans originate from animals. This percentage is increasing to 3 out of 4, when talking about emerging pathogens. Notable examples include Ebola virus, Middle East respiratory syndrome-related coronavirus (MERS-CoV) and the primary generation of severe acute respiratory syndrome coronavirus (SARS-CoV). We suspect the identical for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus behind COVID-19, although we’ve not identified the intermediate species yet, if ever. 

It shouldn’t be only food-producing animals that humans risk contracting disease from, but in addition wildlife. And vice versa, as diseases may also be transmitted from humans to animals. Human population expansion is displacing animals from their environment, and the brand new contact that humans have with these displaced wild animals increases the chance of zoonotic disease occurrence and transmission. 

The second example is antimicrobial resistance (AMR), which is the predominant topic of this interview. Pathogens haven’t any borders, and the overuse and misuse of antimicrobials in any sector will immediately impact the others. When tackling this problem, it doesn’t make sense to watch the responsible use of antimicrobials in humans if we don’t collect the identical information in animals, and vice versa. All the pieces is connected. So long as we don’t work together on this interconnected world, we won’t give you the chance to unravel its problems. It took us some time, but I believe that many stakeholders are finally acknowledging that. 

World Organisation for Animal Health (WOAH, founded as OIE) – It’s Everyone’s Health.Play

Improving global health and well-being can only be achieved by also considering animals and the environment. How will the advance of animal health consequently improve the health of humans and the environment? 

Consider the examples I actually have just given of infectious human diseases coming from animals. Improving animal health will prevent lots of these events from happening and can eventually be sure that we’ve a healthier human sector. This includes not only food-producing animals and wildlife but in addition companion animals that are increasingly present in our lives. 

The opposite aspect of all that is to contemplate how dependent we’re on animals for our livelihoods. Today, one out of 5 people depend upon production animals for his or her income and livelihoods. This shouldn’t be so evident in high-income countries, but it surely is extremely present in low and middle-income countries which represent an enormous proportion of the worldwide population. 

Each time we speak about animals, we are likely to take into consideration terrestrial animals, but we also should take into consideration aquatic animals. Over 20 million people depend upon the aquaculture sector. That is the fastest growing sector  of those supplying protein for the world. 

Every yr you and your partners on the WHO, the FAO and UNEP rejoice World Antimicrobial Awareness Week. The theme for 2022 is “Stopping Antimicrobial Resistance Together”. What does this theme mean to you? 

There isn’t any more practical approach to avoid antimicrobial misuse than employing them only when other approaches don’t work, only once they are needed. Prevention is the very first thing that we’ve to remember. We’ve to maximise the technologies existing today to enhance biosecurity and ensure best-in-class animal husbandry practices. A technique that is well underway is thru using vaccination across the sectors. 

Before this, I used to be working within the human health sector, so I’m accustomedto promoting the term ‘hygiene’. Hygiene is the perfect approach to prevent infection. And we’ve seen this with the recent COVID-19 pandemic, where we employed social distancing, hand sanitizer use, and other measures. Thus, hygiene was enhanced. The identical applies for animals. And it shouldn’t be only our hands that pose a risk – for instance, farm employees must take into consideration changing their boots once they go into the farm, and checking visitors once they come onto the property. 

All these aspects, in addition to how animals are raised and live, affect their capability to fight infections. Maximising their immunity prevents them from getting sick, stopping all of us from using more antimicrobials. 

That is something that has been in some way forgotten, and we would love to stress this message. Easy and straightforward measures can save a number of trouble down the road. 

Image Credit: World Health Organization

With antimicrobial resistance being described by WHO as one in all the highest 10 threats to global health, what impact is it actually having on animals worldwide? 

We would love to be as advanced as our colleagues from the human health sector on this regard. Unfortunately, there’s currently no data available on the burden of antimicrobial resistance in animals at global level, but we’re working on it. 

There are several regional initiatives (i.e. Europe, Asia, Americas…) collecting data on the prevalence of antimicrobial resistance within the animal health sector. But as I said, we don’t have any comprehensive global data yet. Our colleagues from FAO are working on this. This yr they’ve began a pilot to gather data on antimicrobial resistance in animals. They’re starting in Asia, and their goal is to gather data globally by the tip of next yr. 

The opposite initiative that I desired to mention is one which we’re leading in collaboration with the University of Liverpool, which is named the Global Burden of Animal Diseases (or GBADs). It follows the identical methodology as something that was done for humans a number of years ago. We’ve recently developed a component on the economic impact of AMR in animals, particularly the socioeconomic impact on livelihoods where antimicrobial resistance is present. 

One key objective of World Antimicrobial Awareness Week is improving awareness of AMR. Despite continued awareness, many individuals still don’t fully understand the broader implications it has not just for human health, but for animal health and environmental health. What more can people and policymakers do to proceed educating about this global health threat? 

There are a few staple items that we must keep doing. One is repeating. Education is  the easy exercise of repeating things. Something that we’re beginning to work on is making the messages evolve and targeting populations where the message can trigger actions. 

We were discussing this with our Quadripartite colleagues (the Quadripartite alliance for One Health: FAO, UNEP, WHO and WOAH) a number of weeks ago. Certainly one of the populations that were identified as powerful drivers of  communication is the youth and kids specifically. They learn every part; they take heed to every part; they repeat every part that we are able to teach them. They represent the longer term. If we reach educating them and making them understand that antimicrobials don’t have to be overused or misused, then we might be achieving a level of understanding that has not been gained until now. 

On this regard, we’ve already engaged with young people and students. For instance, we are going to take part in the upcoming Global AMR Youth Summit, organised by the World Health Students Alliance and going down throughout the World Antimicrobial Awareness Week. 

By way of targeting populations and adapting the messages, we’re currently working on renewing our web content and making it more comprehensible for non-technical populations, for instance, concerned residents. 

By way of the policymakers, the 2 actions needed are 1) bringing them the info to showcase that there’s a problem, and a pair of) providing alternatives. It’s then our responsibility as an organisation to set standards on how antimicrobials might be used responsibly and prudently. These recommendations are then used to guide the event of national regulations or laws. 

We’re working on expanding the breadth of actions from food-producing animals to all animals, companion animals and wildlife included. We’re making the role and the responsibilities of each actor throughout the chain much clearer, from the veterinary authorities to the farmer and pet owners. We’re providing these overarching principles that in the long run might be translated into laws or regulation, and due to this fact have an motion in the sector. Additionally it is inside our responsibility to focus on the priority research areas for research agencies and countries to fund in order that in the long run we are able to provide alternatives to antimicrobials. 

©World Organisation for Animal Health

It has been described that to work collaboratively between sectors to tackle AMR, we’d like to make use of a One Health approach. What is supposed by the term One Health and what are its benefits for global health? 

One Health, in quite simple words, is about working together. We’re all interconnected. What is going on within the animal health sector is eventually going to affect the human sector. And the behaviour of humans has an impact on the animal health sector, in addition to in food systems and ecosystems. 

Translated into the world of governments, One Health shouldn’t be rather more than making all of the sectors work together. We are attempting to advertise dialogue across sectors. At global level, the Quadripartite organisations have learned to dialogue, work together, and undertake actions in collaboration. 

How will this level of international collaboration, especially between animal and human health professionals, help to tackle other problems comparable to rabies? 

AMR is a health challenge and it will probably be taken as a model on how collaboration could improve our response. The identical model might be applied to zoonotic diseases, people who may transmit from animals to humans, or humans to animals. When working on a human disease, if there’s an animal component, we’d like to select up the phone, write emails, and work with the department in control of animal health. 

The Quadripartite organisations have been working together on AMR since 2014/15. Today, AMR is one motion track of the One Health joint motion plan, which has been recently launched to advance One Health at global, regional and national levels. Our experience might be an asset to other people working in similar areas. AMR is a model, after which the model might be applied to other shared health challenges. 

Alongside your current work surrounding antimicrobial resistance, what are another priorities you’re currently addressing inside WOAH? 

Our AMR strategy has 4 pillars: awareness, surveillance and research, capacity-building, and standards implementation. 

By way of awareness, this conversation is a very good example. The World Antimicrobial Awareness Week, a worldwide campaign to lift awareness and understanding of AMR and promote best practices amongst One Health stakeholders.  

By way of surveillance, we’ve quite a lot of fascinating things ongoing. One is our database of worldwide antimicrobial use in animals, launched in 2015. For seven years, we’ve been using paper-based and Excel forms to gather the data from countries. This yr marks a turning point, as last September we launched a completely digitalised system to permit countries to report and use their data for their very own actions. The platform will turn into accessible for the general public within the upcoming yr. 

At the identical time, we’re initiating an analogous system for the detection of falsified and sub-standard products. The keys to antimicrobial stewardship are having the correct antimicrobial for the correct individual, at the correct time, with the correct dose, and for the correct period. But additionally it is vital to have the correct product, because if products are falsified or sub-standard, inoculations are usually not going to have any efficacy, leading eventually to resistance. We’re starting a pilot experience for a worldwide system for alerting sub-standard and falsified products. 

The opposite initiative that we’ve is the estimation of the economic burden of AMR. By way of research, we’re working with our Quadripartite partners, developing a One Health research priority agenda in collaboration with many various stakeholders. The goal is to supply a roadmap of priorities that needs to be tackled when it comes to research from the One Health perspective. 

Then, when it comes to capacity-building, we support the Multi-Partner Trust Fund initiative in collaboration with our Quadripartite partners and the donors, which is today funding 10 low- and middle-income countries to implement their national motion plans on AMR using a One Health approach. We’ve learned to confer with one another at global level, and we’re scaling up these efforts at local level in order that the Minister of Agriculture, the Minister of Health, the Minister of Environment, and the Minister of Aquaculture in a given country can do the identical  to successfully implement national motion plans on AMR across the sectors. Kenya, Zimbabwe, Tajikistan and Morocco are examples of nations supported through this fund. 

Last but not least, a robust legal framework is needed if countries are to take effective motion within the face of health threats comparable to AMR Along with providing Standards on the responsible use of antimicrobials, we even have a programme on Veterinary Laws Support (VLSP) that helps Members recognise and address their needs for clear, comprehensive veterinary laws.  

Image Credit: Pressmaster/Shutterstock.com

Are you hopeful that with this continued awareness, education and funding surrounding AMR, we are going to sooner or later see a world without AMR? 

I wish I could imagine such a world, but all organisms on Earth share the identical planet and we’re all connected. All of us adapt to the environment. Antimicrobial resistance is a natural phenomenon that microorganisms implement to evolve in a hostile, toxic environment. As soon as they see an antimicrobial agent stopping them from thriving, they will develop resistance. Alexander Fleming warned us all when he received his Nobel prize. With every recent antimicrobial that we’ve developed, sooner somewhat than later, resistance has appeared. 

A world without antimicrobial resistance is difficult to assume. Nevertheless, we are able to learn live in a world where we are able to use antimicrobials sustainably and reduce the burden of human, animal and plant diseases. That is what we’re working on. We’re working on making every actor within the animal health sector aware that we must use antimicrobials responsibly to make sure they continue to be available for future generations. 

Sustainability might be achieved by developing recent antimicrobials, but in addition, more importantly, by utilizing those that we’ve today responsibly.  

That is where motion for prevention is de facto vital. If we encourage hygiene, improve security at farms, and keep animals in good conditions in order that they’ve a robust immune system, then we are able to fight this battle and maintain low levels of antimicrobial resistance. Antimicrobials have to be used responsibly and sustainably. 

With the COVID-19 pandemic reminding us that each one sectors must work together to realize scientific progress, we’ve seen significant advancements in recent times, especially inside disease diagnostics. Are there any particular fields inside animal health that you simply are excited to observe evolve over the approaching years? 

I believe COVID-19 has also taught us in regards to the power of vaccination. I hope that after the pandemic everyone will understand its importance when it comes to prevention. Hopefully, it would help encourage trust and confidence on this practice. 

Regarding diagnostics, I’m slightly biased, because I worked for 18 years in the sector of diagnostics, and, as a former colleague used to say, “without diagnosis, medicine is blind”. That is true for the human health sector, but much more so for the animal health sector, which is severely impacted by the shortage of diagnostic tools, particularly revolutionary ones. I hope that this area might be reinforced, because of development in human health being imparted into the animal health sector.  

What’s next for you and your work at WOAH? Are you involved in any exciting upcoming projects? 

I actually have mentioned several already, but I’ll pick the three most enjoyable ones. 

First, the launch of the worldwide database on antimicrobial use in animals, called ANIMUSE. 

The worldwide burden of animal diseases can be an exciting project because it would give us an idea of the socioeconomic impact of animal diseases. I believe it would help mobilise resources and ratify the importance of AMR within the animal health sector. 

Finally, the revision of standards we’re undertaking. We’re expanding the content to other animals, not only food-producing animals, and clarifying the responsibilities of each actor to make use of antimicrobials responsibly. I’m very confident that this can assist in the sector if people know who does what and do it properly. 

About Javier Y. Marcos 

Javier Y. Marcos has a solid history of working in antimicrobial resistance (AMR), with eighteen years of experience in the event and commercialisation of diagnostics tests for infectious diseases, each for human and animal health. Having graduated as a Doctor in Veterinary Medicine in 1997, he also holds a PhD in Microbiology & Molecular Biology from the Leon University, Spain.

At the tip of 2021, he was appointed as Head of the AMR & Veterinary Products Department on the World Organisation for Animal Health (WOAH, founded as OIE), being accountable for the improved quality of veterinary medicinal products, and the coordination of actions supporting a responsible and prudent use of antimicrobials in animal health worldwide.