FAO Assessment Tool for Laboratories and Antimicrobial resistance Surveillance Systems (FAO ATLASS)

Assessors training

Background and justification

Antimicrobial resistance (AMR) is broadly defined as the ability of bacteria, fungi, viruses, and parasites to become resistant to antimicrobials. However, the main AMR concerns are more specifically linked to antibiotic resistance which is the ability of bacteria to develop mechanisms to resist to antibiotics. It has been estimated that if no prompt action is taken forward to reduce the development and the spread of AMR, 10 million lives per year globally with an associated enormous cumulative economic cost will be at risk due to AMR by 2050 (O’Neill J. et al., 2016).

As for all infectious diseases, surveillance is considered one of the cornerstones for AMR management, and can provide information for action in support to national and international strategies to tackle AMR. The Food and Agriculture Organization of the United Nations (FAO), following the adoption of FAO resolution in 2015 and the publication of the FAO Action Plan in 2016, has developed the “FAO Assessment Tool for Laboratories and Antimicrobial resistance Surveillance Systems” (FAO-ATLASS) in order to support countries in assessing and improving their national AMR surveillance system in the food and agriculture sectors. FAO-ATLASS aims to collect descriptive data and score the performance of national AMR surveillance-linked activities by i) mapping laboratory analytical capabilities and networks, and ii) assessing activities on data collection and analysis, governance, communication, and sustainability. Based on FAO-ATLASS assessment, a Progressive Improvement Pathway stage is assigned for each laboratory, each pillar (laboratory network, epidemiology unit, governance, communication, and sustainability), and the national AMR surveillance system as a whole. These results help assessors to provide recommendations to prioritize actions for improvement.

To date, FAO-ATLASS has been used to assess a total of 14 national AMR surveillance systems in Africa (Ghana, Kenya, Senegal, Tanzania, Zambia, and Zimbabwe) and Asia (Cambodia, Indonesia, Lao PDR, Myanmar, Philippines, Singapore, Thailand, and Vietnam). During the next years, it is foreseen an increase in the use of FAO-ATLASS worldwide as it allows better harmonization and improved coordination of AMR surveillance system in the food and agriculture sectors at national and international level in the vision of One Health approach.

The assessment missions with the application of FAO-ATLASS are carried out by trained assessors that know how to correctly use the tool and are up-to-date of last modifications. The recommended approach at country level is to always carry out the first assessment mission by external assessors to have baseline information, while follow-up assessments may be carried by national assessors, or, as for laboratory self-assessment, by ATLASS focal points.

FAO is currently building a worldwide community of assessors that will continuously serve as technical resource to monitor and sustain the momentum toward the enhancement of AMR surveillance in the food and agriculture sectors. To start building the pool of FAO-ATLASS assessors in Eastern Europe and Central Asia, FAO Regional Office for Europe and Central Asia (FAO REU) is proposing a training for experts who will help REU countries in the future. These ATLASS assessors in the region will help countries in applying FAO-ATLASS to strengthen their AMR surveillance programs as well as to build the capacity of national laboratories on collection of AMR data. This training will be organized under the regional project CGP/RER/057/RUS and will support global effort reducing the advance of AMR in food and agriculture. Hence, the 1st FAO-ATLASS assessors training for FAO REU is proposed to be held in Moscow, 27-31 August 2018, in collaboration with the Federal Service on Customers' Rights Protection and Human Well-being Surveillance of Russia, and the Central Research Institute of Epidemiology in Moscow (Russia). The training will include the visit to an actual laboratory, namely microbiological laboratory Federal Centre of Hygiene and Epidemiology, involved in AMR surveillance activities in the food and agriculture sector as practical experience for the future assessors.