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Abstract

A poster informing on the development, implementation, and current results of the FAO ATLASS tool, for assessment of laboratories and antimicrobial resistance surveillance systems at national and regional levels.
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FAO Assessment Tool for Laboratories and AMR Surveillance Systems
(ATLASS) for the food and agriculture sectors
Francesca Latronico1*, Nicolas Keck1, 2, Michael Treilles1, 3, Emmanuel Kabali4, Carolyn Benigno5, Mary Joy Gordoncillo5, Beatrice Mouille1
Introduction
1 Food and Agriculture Organization of the United Nations, 00153 Rome, Italy, 2 Laboratoire Départemental Vétérinaire, 34080 Montpellier, France, 3 QUALYSE Laboratory, 79220 Champdeniers, France 4 Food and Agriculture Organization of the United
Nations, Southern Africa Subregional Office, Harare, Zimbabwe, 5 Food and Agriculture Organization of the United Nations, Regional Office for Asia and the Pacific, Bangkok, Thailand
Materials and Methods
FAO-ATLASS has two main modules, ATLASS Surveillance and ATLASS Laboratory. Each module includes two questionnaires (Figure 1). In-country assessment missions, conducted by
trained assessors, include meetings with key stakeholders and visits to selected laboratories involved in AMR surveillance to assess the performance of AMR-linked activities based on
the five main pillars. Based on the questionnairesanswers, an ATLASS PIP stage is proposed (Figure 2).
ATLASS PIP stages assist in making recommendations to governments to prioritize actions for
improvement.
Figure 1. FAO-ATLASS structure Figure 2. FAO-ATLASS Progressive Improvement pathway (PIP)
Results
FAO-ATLASS allows national authorities to identify a stepwise approach to improve AMR surveillance systems via PIP, and can provide an evidence base for action and advocacy.
Implementation of FAO-ATLASS can contribute to harmonized and better coordinated surveillance strategies at the regional and global levels aiming to an integrated AMR
surveillance system in support of the One Health approach to tackle the threat posed by AMR.
Figure 4. Example of FAO-ATLASS PIP with recommendations in blue
cells for each pillar and subcategories (left box), and FAO-ATLASS PIP
scoring system (right box)
Area
Question
number
Sub category
Current SET AMR
score
Improvement
s for next
level
Next le vel
Improvemen
ts for next
level
Next le vel
+1
ST1
Exis tence of a n operationa l steering s tructure
representati ve of the par tners involved i n AMR surveil lance
under a one heal th approa ch (steering commi ttee)
2≥3 ≥4
ST2
Development of a nati onal a ction pl an on antimi crobia l
resi stan ce
2≥3 ≥4
ST3
Relevance of AMR su rveill ance objecti ves and in dicators
rela ted to the country food a nd anima l producti on in the
country
3≥3 ≥4
ST4
Soli d external communi cation po licy wi th decisi on makers
and other pa rtners
2≥2 ≥3
ST5 Regula tions on AMR sur veill ance organi zation 3≥3 ≥4
PIP Stage Governance: 2 3 4
ST6
Exis tence of a n operationa l management structure (centra l
unit)
2≥2 ≥3
ST7
Frequency of coor dinati on meetings between central
epidemiol ogy unit with l ocal un its
1≥2 ≥3
ST8
Exhaus tiveness or r epresentativeness o f the AMR
survei lla nce active s ampling s cheme in food and
agri culture sector s incl uding envi ronment
3≥2 ≥3
ST9 Standa rdizati on of data co llected 2≥2 ≥3
ST10
Exhaus tiveness or r epresentativeness o f the sa mpling of
AMR pass ive survei lla nce in food an d agricu lture sectors
inc luding envi ronment
2≥2 ≥3
ST11
Adequate skil l level in epidemiol ogy of members of the
central unit
4≥2 ≥3
ST12
Adequacy of the data management system for the needs of
the system (rela tional databas e, etc.)
2≥2 ≥3
ST13
Data i nput interval in ac cordance wi th the objecti ves and
use of s ystem results
2≥2 ≥2
ST14
Data veri fica tion and va lida tion procedures formali zed an d
operati onal
2≥2 ≥2
ST15 Anal ysis of data fits the needs of the s ystem 2≥2 ≥3
PIP Stage Epidemiology Unit: 1 2 3
ST16
Effective integrati on of competent labora tories i n the
survei lla nce system
2≥2 ≥3
ST17
Level of the standa rdizati on of work between different
la boratories impli ed in the surveil lanc e system
1≥2 ≥3
ST18 Relevanc e of diagnos tic techniques 3≥2 ≥3
ST19
Technica l level o f data management of the labor atory
network
1≥2 ≥3
PIP Stage lab Networks: 1 2 3
ST20
Exis tence of a wareness bui lding pr ograms for fi eld
stakehol ders in a pass ive (event-based) su rveill ance sys tem
if exi sting
2≥2 ≥3
ST21
Adequacy of ri sk as sessment ac tivities with the needs o f the
survei lla nce system
1≥2 ≥2
ST22 Regula r release of r eports on surv ei llan ce results 2≥2 ≥2
ST23
Systematic distri bution of reports on results to field ac tors
(outsi de of a bull etin ).
2≥2 ≥2
ST24
Presence of a communicati ons sys tem orga nized
hori zontally a nd vertica lly between field a ctors (mai l, web,
telephone…)
1≥2 ≥3
PIP Stage Communication: 1 2 3
ST25
Adequacy of the steerin g committee materia l and fi nanci al
resourc es
2≥2 ≥3
ST26
Adequacy of huma n, materi al, an d financi al r esources for
la boratory needs
1≥2 ≥3
ST27
Adequacy of huma n, materi al, an d financi al r esources for
epidemiol ogy needs
3≥1 ≥2
ST28 Regula r advanc ed tra ining 1≥2 ≥3
ST29 Adequacy of ma teri al a nd financ ial r esources for traini ng 1≥2 ≥3
ST30
System of performanc e indica tors developed and vali dated
by the directors of the surveil lanc e system
2≥1 ≥2
ST31
Performanc e indica tors regula rly measu red, interpreted,
and di ssemina ted
1≥1 ≥2
ST32 External evaluati ons ca rried out 1≥1 ≥2
ST33 Impl ementation of corrective meas ures 1≥1 ≥2
PIP Stage Sustainability: 1 2 3
No
capacities
Limited
capacity
Develope
d capacity
Demonstr
ated
capacity
Sustainabl
e capacity
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥1 ≥2 ≥3 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
1 2 3 4 5
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥3 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥2 ≥3 ≥4
≥1 ≥2 ≥2 ≥3 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
1 2 3 4 5
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
1 2 3 4 5
≥1 ≥2 ≥3 ≥3 ≥4
≥1 ≥2 ≥2 ≥3 ≥4
≥1 ≥2 ≥2 ≥3 ≥4
≥1 ≥2 ≥2 ≥3 ≥4
≥1 ≥2 ≥3 ≥4 ≥4
1 2 3 4 5
≥1 ≥2 ≥3 ≥3 ≥4
≥1 ≥2 ≥3 ≥3 ≥4
≥1 ≥1 ≥2 ≥3 ≥4
≥1 ≥2 ≥3 ≥3 ≥4
≥1 ≥2 ≥3 ≥3 ≥4
≥1 ≥1 ≥2 ≥3 ≥4
≥1 ≥1 ≥2 ≥3 ≥4
≥1 ≥1 ≥2 ≥3 ≥4
≥1 ≥1 ≥2 ≥3 ≥4
1 2 3 4 5
Governance
Scoring system:
PIP Stage scoring:
PIP Stage scoring:
PIP Stage scoring:
PIP Stage scoring:
Communication
Epidemiology Unit
Laboratories
Sustainability
PIP Stage scoring:
*email: Francesca.Latronico@fao.org
Ethiopia
Kenya
Tanzania
Zambia
Zimbabwe
Ghana
Senegal Sudan Lao PDR
Myanmar
Indonesia
Philippines
Vietnam
Singapore Cambodia
Thailand
Armenia
Figure 3. Countries that already hosted FAO-ATLASS assessment missions, 2016-2018
FAO-ATLASS has been translated in English, French, Russian, and Spanish. As of 29 October 2018, AMR
surveillance systems have been assessed through FAO-ATLASS in 17 countries (Figure 3). Missions provided
baseline data to monitor the progress towards reliable and sustainable AMR surveillance systems, and
recommendations to prioritize actions for improvement by the ATLASS PIP (Figure 4). Nationals of member
countries have been trained as ATLASS assessors for Africa, Central and South East Asia to ensure
standardized ATLASS assessments within the regions. The community of ATLASS assessors is expected to
monitor and sustain the momentum in progressing AMR surveillance in the agricultural sector in their
respective countries and regions.
Conclusions
FAO-ATLASS can be used to:
Generate baseline in AMR detection capacities and surveillance for
the food and agriculture sectors by external and self-assessment
Assess the five main pillars of an AMR surveillance system:
1. Governance, 2. Epidemiology unit, 3. Laboratories,
4. Communication, and 5. Sustainability
Measure the stage for AMR capacity detection, data collection,
analysis and information dissemination
Identify steps for improvement
Monitor progress in improvements through Progressive Improvement
Pathway (PIP)
In 2016 the Food and Agriculture Organization of the United Nations
(FAO) published the FAO Action Plan on antimicrobial resistance (AMR)
that identifies the need to develop capacity for AMR surveillance and
monitoring in food and agriculture sectors as one of four focus areas.
In order to support countries in assessing and improving their AMR
surveillance system in the food and agriculture sectors (animal health
aquatic and terrestrial, food safety, water and environment), FAO
has developed the Assessment Tool for Laboratories and AMR
Surveillance Systems (FAO-ATLASS).
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