AMR & ONE HEALTH APPROACH

One Health Approach

A collaborative, multisectoral, and transdisciplinary strategy aimed at achieving optimal health outcomes by recognizing the interconnection between humans, animals, plants, and their shared environment. It integrates human, animal, and environmental health sectors.

WHO (World Health Organization)
FAO (Food and Agriculture Organization)
WOAH (World Organization for Animal Health)
UNEP (United Nations Environment Programme)

Which four international organizations make up the Quadripartite for One Health?

Communication – Clear exchange between sectors
Coordination – Avoiding siloed work
Collaboration – Inclusive of communities and civil society
Capacity Building – Training community health workers

What are the "4Cs" of the One Health Approach?

Strengthen health systems
Control zoonotic diseases
Manage endemic/neglected tropical/vector-borne diseases
Assess and manage food safety risks
Curb antimicrobial resistance
Integrate environment into One Health

What are the 6 main action tracks of the One Health Joint Plan?

Antimicrobial Resistance (AM)

The ability of microorganisms (bacteria, viruses, fungi, parasites) to resist the effects of medications, making standard treatments ineffective and infections harder to treat.

Inhibit cell wall synthesis

What are the mechanisms by which antibiotics act on bacteria? beta-lactams and vancomycin

disrupt cell membrane

What are the mechanisms by which antibiotics act on bacteria? polymyxins

Inhibit protein synthesis

What are the mechanisms by which antibiotics act on bacteria? macrolides, tetracyclines

Inhibit nucleic acid synthesis

What are the mechanisms by which antibiotics act on bacteria? quinolones, rifampicin

Mutation (vertical evolution)
Horizontal Gene Transfer via: conjugation, transduction, transformation

How do bacteria develop resistance?

Inactivation/modification of the antibiotic
Alteration of antibiotic target site
Modification of metabolic pathways
Reduced drug accumulation via efflux or permeability changes

What are the four general mechanisms of AMR?

Critical Priority: ESBL-producing Enterobacteriaceae
High Priority: Campylobacter, Salmonella, H. pylori
Medium Priority: S. pneumoniae, H. influenzae

What are the three categories in the WHO Priority Pathogen List?

Treatment failures
Increased mortality
Longer hospital stays
Threatens medical procedures
Global spread due to trade, travel, and shared ecosystems

Why is AMR considered a global health threat?

Poor prescribing practices
Inappropriate use
Lack of stewardship programs
Noncompliance with treatment guidelines
Substandard or wrong antibiotics

What are the primary contributors to AMR from the healthcare sector?

Not completing prescriptions
Using leftover antibiotics
Self-medication without proper diagnosis
Stopping treatment early due to mild side effects

Why are patients considered the top contributors to AMR?

Overuse of Azithromycin
Increased healthcare-associated infections
Disruption of TB, HIV, and vaccination programs
Widespread use of biocidal disinfectants

How did COVID-19 exacerbate AMR?

Discharged resistant organisms reach soil/water
Spread to livestock, wildlife, and crops
Inadequate antimicrobial disposal
Bacteria exchange genes in contaminated ecosystems

How does AMR impact the environment?

Practice hygiene and sanitation
Access to clean water
Hospital infection control
Vaccination
Antimicrobial stewardship programs

How can we prevent infections and reduce antibiotic use?

Promotes One Health coordination
Encourages cross-sectoral collaboration (health, environment, agriculture, etc.)
Includes research, civic, and private sectors
Reinforces antimicrobial stewardship

What is the role of the National Action Plan (NAP) 2024-2028 in AMR?

Environmental sector
Civic society
Private sector
Education/research sector

What sectors need stronger involvement in AMR control, according to the lecture?

Promotes coordinated efforts across human, animal, and environmental health
Enables global, national, and community-level collaboration
Addresses the interconnected nature of resistance emergence and spread

How does the One Health approach help combat AMR?