Written by Dr Joanna McKenzie, COMBAT-AMR One Health lead

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One Health is defined as “a collaborative, multisectoral, and trans-disciplinary approach - working at local, regional, national and global levels - to achieve optimal health and well-being outcomes recognising the interconnections between people, animals, plants and their shared environment."
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Why is a One Health approach to tackling antimicrobial resistance (AMR) important?
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An extremely complex mix of factors involving humans, animals, plants and their environments drive the emergence and spread of AMR.

Incorrect and/or prolonged use of antimicrobials for clinical treatment  in humans, animals, aquatic species and plants plus uncontrolled public access to antimicrobials drives the emergence of resistance within bacteria carried by individuals within these populations.

Once resistant, the bacteria and/or their genes can spread due to poor hygiene in hospitals, communities, homes and farms. They can spread through waterways in the environment which are contaminated through inadequate sewage and water treatment, and through food that is contaminated with resistant bacteria from food handlers, food processing and retail environments or from food-producing animals. They can also spread through international travel and through international trade of food and animals.

This means that a collective effort from people working with humans, animals, agriculture and the environment is needed to effectively reduce the impact of AMR.
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What are the major levels at which a One Health approach is implemented?
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A One Health approach involves collaboration between the human health, animal health and environmental management sectors at the following three levels:

• Governance: Multi-sectoral leadership of the national programme and policies to address AMR in humans, animals and the environment, including relevant ministries, policy makers and AMR Committees or focal points.
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• Technical leadership: Multi-sectoral technical leadership to synthesise knowledge of AMR from multiple sectors and advise on policies and programmes, most commonly through a national multi-sectoral technical committee involving clinicians, veterinarians, microbiologists, epidemiologists, health professionals, pharmacists, and other experts.
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• Operations: Collaboration between sectors to implement AMR programmes, which may include areas such as: sharing laboratory resources, procurement, sharing expertise, aligning antimicrobial susceptibility testing methods.
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How does COMBAT-AMR support a One Health approach?
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The COMBAT-AMR project is facilitated by a multi-sectoral, multi-disciplinary and multi-country team who meet regularly to share information and approaches across both the human and animal health sectors.

To identify areas in which the COMBAT-AMR project can strengthen collaboration between the sectors to enhance the management of AMR in humans and animals, a situation and needs assessment is being conducted. This assessment will provide an understanding of current AMR-related resources, skills, knowledge and activities in both human and animal health sectors, as well as current levels of collaboration between the sectors.

By strengthening existing networks, COMBAT-AMR will build multi-country and multi-sectoral communities of practice with increased opportunities for knowledge, expertise and resource sharing, to address the rising threat of AMR in Pacific Island Countries.

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Dr Joanna McKenzie

Specialist in One Health Epidemiology and International Development, School of Veterinary Science, Massey University

Dr Joanna McKenzie’s major interest is in bringing the multi-disciplinary One Health concept to reality through education, research and in particular the development and implementation of integrated policies and operational programs to manage zoonotic disease and antimicrobial resistance in people, domestic animals and wildlife.  For the past four years, Dr McKenzie has been the global one health advisor for Mott MacDonald, management agency for the UK government’s Fleming Fund programme to strengthen antimicrobial resistance surveillance in 24 lower- and middle-income countries in Southeast Asia, South Asia, West and East Africa. Prior to this she spent many years teaching and leading a multi-disciplinary Master’s degree program and collaborative research projects to investigate and manage emerging and endemic zoonotic diseases in South Asia, including Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan and Sri Lanka.

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Learn more about current COMBAT-AMR project activities.