Reducing Antimicrobial Discharges from Food Systems, Manufacturing Facilities and Human Health Systems into the Environment
減少從食品系統(tǒng)、生產(chǎn)設(shè)施和人類衛(wèi)生系統(tǒng)排放到環(huán)境中的抗微生物藥物
Call to Action by the Global Leaders Group on Antimicrobial Resistance
抗微生物藥物耐藥性全球領(lǐng)導(dǎo)人小組的行動呼吁
Disposal of untreated or inappropriately managed waste and runoff from various sources including food systems, manufacturing facilities and human health systems can contain biologically active antimicrobials, antimicrobial resistant organisms, unmetabolized antimicrobials and antimicrobial resistance determinants (e.g. resistance-conferring genes) that are released into the environment. These discharges can contaminate the environment and contribute to the spread of antimicrobial resistance (AMR). The most important approach to controlling AMR spread from food systems and human health systems is responsible and sustainable use of antimicrobials in humans, terrestrial and aquatic animals and plants/crops. In addition, adequate measures to treat and safely dispose of waste are required, including human, animal and manufacturing waste.
處置來自食品系統(tǒng)、生產(chǎn)設(shè)施和人類衛(wèi)生系統(tǒng)等各種來源的未經(jīng)處理或管理不當?shù)膹U物和徑流時可能將具有生物活性的抗微生物藥物、抗微生物藥物耐藥微生物、未代謝的抗微生物藥物以及抗微生物藥物耐藥性決定因素（如賦予耐藥性的基因）釋放到環(huán)境中。這些排放物會污染環(huán)境，并導(dǎo)致抗微生物藥物耐藥性的傳播?？刂瓶刮⑸锼幬锬退幮詮氖称废到y(tǒng)和人類衛(wèi)生系統(tǒng)傳播的最重要方法是在人類、陸地和水生動物以及植物/作物中負責任和可持續(xù)地使用抗微生物藥物。此外，需要采取適當措施處理和安全處置廢物，包括人類、動物和制造業(yè)廢物。
antimicrobial [??nt?ma??kr??b??l] n. 抗微生物藥物
contaminate [k?n?t?m?ne?t] v. 污染
aquatic [??kw?t?k] adj. 水生的，水棲的
The GLG commends ongoing efforts - particularly by the G7 countries - to address antimicrobial discharges into the environment and encourages countries to implement the Codex Code of practice to minimize and contain foodborne AMR and Guidelines on Integrated Monitoring and Surveillance of Foodborne Antimicrobial Resistance approved in November 2021.
全球領(lǐng)導(dǎo)人小組贊揚當前為解決向環(huán)境中排放抗微生物藥物問題所做的努力，特別是七國集團國家的努力，并鼓勵各國執(zhí)行食品法典《最大限度減少和控制食源性抗微生物藥物耐藥性操作規(guī)范》以及2021年11月批準的《食源性抗微生物藥物耐藥性綜合監(jiān)測和監(jiān)督準則》。
foodborne ['fu?db??n] adj. 食源性的，食物傳染的
To improve the management of discharges into the environment that may contribute to the emergence and spread of antimicrobial resistance, the Global Leaders Group calls for the following:
為更好地管理排放到環(huán)境中可能導(dǎo)致抗微生物藥物耐藥性出現(xiàn)和傳播的廢物，全球領(lǐng)導(dǎo)人小組呼吁：
1. STRENGTHENED GOVERNANCE AND OVERSIGHT
1. 加強治理和監(jiān)督
In general, countries should:
Develop or build on and implement regulatory frameworks, guidelines, standard operating procedures (SOPs) and standards to establish safe levels, better control and monitor the distribution and release of antimicrobials, antimicrobial resistant bacteria and antimicrobial resistance determinants from food systems, manufacturing facilities and human health systems into the environment; and
Include prevention and management measures in national action plans on AMR to minimize the impacts of environmental discharges.
總體上，各國應(yīng)當：
制定或依賴和落實監(jiān)管框架、指南、標準操作程序和標準，以確立安全水平，對源自食品系統(tǒng)、生產(chǎn)設(shè)施和人類衛(wèi)生系統(tǒng)的抗微生物藥物、抗微生物藥物耐藥細菌以及抗微生物藥物耐藥性決定因素在環(huán)境中的分布和釋放情況進行更好地控制和監(jiān)測；和
將預(yù)防和管理措施納入國家抗微生物藥物耐藥性行動計劃，以最大限度減少環(huán)境中排放物的影響。
In the manufacturing sector specifically, countries should:
Develop and implement legal and policy frameworks with a lifecycle approach for antimicrobials manufacturing. Such an approach considers the entire timespan that a pharmaceutical is active and can impact the surrounding systems, would help to effectively address AMR environmental risks and ensure resilient antibiotic supply chains and stimulate the design, development, manufacture, and commercialization of needed new antibiotics and alternatives to antimicrobials;
Promote and develop balanced and staged environmental policies and approaches to manage and regulate manufacturing facilities and support environmental inspections, recognizing the current fragility of supply chains and significant access gaps;
Incentivize industry for compliance and excellence, including highlighting their contribution to the achievement of the Sustainable Development Goals; and
Develop national antimicrobial manufacturing pollution standards based on best available evidence, treatment technology and situational analysis, and strengthen the capacity of environmental authorities to conduct audits and monitor compliance.
具體在制造部門，各國應(yīng)當:
制定和實施法律和政策框架，對抗微生物藥物制造采取生命周期方法。這種方法能考慮到藥物具有活性并能影響周圍系統(tǒng)的整個時間跨度，可幫助有效解決抗微生物藥物耐藥性的環(huán)境風險，確保抗生素供應(yīng)鏈的復(fù)原力，并刺激必要的新抗生素和抗微生物藥物替代品的設(shè)計、開發(fā)、制造和商業(yè)化；
認識到當前供應(yīng)鏈的脆弱性和獲取方面的顯著差距，促進和制定平衡的、分階段的環(huán)境政策和方法，以管理和規(guī)范生產(chǎn)設(shè)施并支持環(huán)境檢查；
激勵行業(yè)追求合規(guī)和卓越，包括突出其對實現(xiàn)可持續(xù)發(fā)展目標的貢獻；和
根據(jù)現(xiàn)有的最佳證據(jù)、處理技術(shù)和情況分析，制定國家抗微生物藥物生產(chǎn)的污染標準，并加強環(huán)境主管部門進行審計和監(jiān)測合規(guī)性的能力。
pharmaceutical [?fɑ?m??su?t?kl] n. 藥物
fragility [fr??d??l?ti] n. 脆弱，易碎
compliance [k?m?pla??ns] n. 合規(guī)，遵守
In the human health sector specifically, countries should:
Develop and implement antimicrobial stewardship policies and protocols in human health systems that include responsible and sustainable use and procurement of antimicrobials, and effective waste management approaches; and
Implement and enforce laws and policies to reduce or eliminate antimicrobial use that is not under the guidance of a trained health care provider, while ensuring equitable access to quality antimicrobials.
具體在人類衛(wèi)生部門，各國應(yīng)當:
在人類衛(wèi)生系統(tǒng)中制定和實施抗微生物藥物管理政策和規(guī)程，包括負責任和可持續(xù)地使用和采購抗微生物藥物，以及采取有效的廢物管理方法；和
實施和執(zhí)行法律和政策，以減少或消除在無訓(xùn)練有素的衛(wèi)生保健人員指導(dǎo)下使用抗微生物藥物的情況，同時確保公平獲得優(yōu)質(zhì)的抗微生物藥物。
stewardship [?stju??d??p] n. 管理
procurement [pr??kj??m?nt] n. 采購，購買
In food systems specifically, countries should:
Develop or build on and implement regulatory frameworks, guidelines, SOPs and standards to effectively treat and/or manage waste discharge from food-producing animal farms, aquaculture farms and crop fields, as well as waste used to irrigate crops and run-off from crop fields; and
Develop and implement antimicrobial stewardship policies and protocols in fixed and mobile animal health facilities that include responsible and sustainable use of antimicrobials and effective waste management approaches.
具體在食品系統(tǒng)中，各國應(yīng)當：
制定或依賴和落實監(jiān)管框架、指南、標準操作程序和標準，以有效處理和/或管理食用動物養(yǎng)殖場、水產(chǎn)養(yǎng)殖場和農(nóng)田的廢物排放，以及用于灌溉作物的廢物和農(nóng)田徑流；和
在固定和流動的動物衛(wèi)生設(shè)施中制定和實施抗微生物藥物管理政策和規(guī)程，包括負責任和可持續(xù)地使用抗微生物藥物以及采取有效的廢物管理方法。
aquaculture [??kw?k?lt??(r)] n. 水產(chǎn)養(yǎng)殖
irrigate [??r?ge?t] v. 灌溉；沖洗
2. IMPROVED SURVEILLANCE AND DATA AVAILABILITY
2. 改進監(jiān)測和數(shù)據(jù)可得性
Countries should:
Strengthen One Health surveillance of antimicrobial use in, and discharges of antimicrobials and AMR determinants from, food systems, human health systems and manufacturing facilities, as well as in sewage systems. This should be done taking into account factors such as the need to build on existing systems, cost-effectiveness, data comparability and key knowledge gaps relating to the fate, concentration and impact of discharges on the environment and organisms in the environment (e.g. soil microbes, aquatic organisms). Priority should be given to collecting data that can support targeted action, such as enhanced understanding of risks to human and animal health and the environment and release pathways into the environment, and supporting the development of guidance on waste management approaches and antimicrobial discharge limits; and
Promote industry data disclosure, transparency and public access to waste and wastewater management data and mitigation practices in order to build credibility and public confidence. Data disclosure could initially be made to regulators and independent third parties (for example as part of certification schemes), followed by efforts to enable wider public access to increase awareness and understanding, contribute to ongoing studies and reflect environmental standards in procurement practices.
各國應(yīng)當：
加強對食品系統(tǒng)、人類衛(wèi)生系統(tǒng)和生產(chǎn)設(shè)施以及污水系統(tǒng)中抗微生物藥物的使用以及抗微生物藥物和抗微生物藥物耐藥性決定因素的排放的一體化衛(wèi)生監(jiān)測。這樣做時應(yīng)考慮到各種因素，如加強現(xiàn)有系統(tǒng)的必要性、成本效益、數(shù)據(jù)可比性以及關(guān)于排放物的結(jié)局、濃度及其對環(huán)境和環(huán)境中生物（如土壤微生物、水生生物）的影響等方面的重要知識空白。應(yīng)優(yōu)先考慮收集數(shù)據(jù)以幫助采取有針對性的行動，如提高對人類和動物健康風險、環(huán)境風險以及向環(huán)境釋放的途徑的認識，并支持就廢物管理方法和抗微生物藥物排放限值制定指導(dǎo)；和
鼓勵行業(yè)披露數(shù)據(jù)、促進透明度和向公眾提供廢物和廢水管理數(shù)據(jù)及緩解措施，以建立可信度和公眾信心。最初可以向監(jiān)管機構(gòu)和獨立的第三方披露數(shù)據(jù)（例如作為認證計劃的一部分），然后努力向更廣泛的公眾普及，以提高認識和理解，促進正在進行的研究，并在采購實踐中反映環(huán)境標準。
sewage [?su??d?] n. 污水，污物
concentration [?k?ns(?)n?tre??(?)n] n. 濃度；專心；集中
mitigation [?m?t??ge??n] n. 減輕，緩解
3. IMPROVED DISCHARGE MANAGEMENT
3. 改進排放管理
In general, all countries should:
Reduce the need for antimicrobial use through implementation of effective infection prevention and control measures in all sectors, including water, sanitation and hygiene (WASH), vaccination, biosecurity and animal husbandry and welfare measures;
Develop, implement and monitor systems for proper segregation, treatment and/or disposal of antimicrobials and antimicrobial-containing substances in all sectors (including antimicrobial feed and human and animal waste);
Develop mechanisms for collection and proper disposal of unused and expired antimicrobials from individuals and organizations; and
Ensure availability of affordable and environmentally safe incinerators and innovative technologies for destruction and degradation of unused or expired antimicrobials.
總體上，各國應(yīng)當：
通過在所有部門實施有效的感染預(yù)防和控制措施，包括水、環(huán)境衛(wèi)生和個人衛(wèi)生服務(wù)（水衛(wèi)項目）、疫苗接種、生物安保以及畜牧業(yè)和福利措施，減少對抗微生物藥物的使用需求；
開發(fā)、實施和監(jiān)測用于妥善分離、處理和/或處置所有部門的抗微生物藥物和含抗微生物藥物物質(zhì)的系統(tǒng)（包括含抗微生物藥物的飼料以及人畜糞便）；
建立機制以收集和適當處置來自個體和機構(gòu)的未使用和過期抗微生物藥物；和
確保提供負擔得起且環(huán)保的焚燒爐和創(chuàng)新技術(shù)，用于銷毀和降解未使用或過期的抗微生物藥物。
sanitation [?s?n??te??n] n. 公共衛(wèi)生
hygiene [?ha?d?i?n] n. 個人衛(wèi)生；衛(wèi)生學
husbandry [?h?zb?ndri] n. 飼養(yǎng)業(yè)，農(nóng)牧業(yè)
segregation [?segr??ge??n] n. 隔離，分離
incinerator [?n?s?n?re?t?(r)] n. 焚燒爐
In general, relevant international technical organizations and their partners should develop guidance and showcase best practices on proper waste management practices across sectors.
總體而言，相關(guān)國際技術(shù)組織及其合作伙伴應(yīng)制定指導(dǎo)，并展示各部門妥善管理廢物的最佳做法。
In food systems:
All countries should:
Create and implement manure, wastewater, runoff and farm waste management plans, SOPs, guidance, standards and measures such as composting for manure and its application into agriculture fields; and
Implement evidence-based manure management approaches so that manure can continue to be safely used as a natural fertilizer in agriculture fields and support agro-ecological farming practices while minimizing the risks of transfer of antimicrobial resistant bacteria or antimicrobial resistance determinants.
在食品系統(tǒng)中：
各國應(yīng)當：
創(chuàng)建并實施糞肥、廢水、徑流和農(nóng)場廢物管理計劃、標準操作程序、指南、標準和措施，如糞肥堆肥及其在農(nóng)業(yè)領(lǐng)域的應(yīng)用等；和
實施基于證據(jù)的糞肥管理方法，以便糞肥可以繼續(xù)作為天然肥料安全地用于農(nóng)業(yè)領(lǐng)域，支持符合農(nóng)業(yè)生態(tài)的耕作辦法，同時最大限度降低抗微生物藥物耐藥細菌或抗微生物藥物耐藥性決定因素轉(zhuǎn)移的風險。
manure [m??nj??(r)] n. 肥料，糞肥
composting ['k?mp?sti?] n. 堆肥化，堆制肥料
International technical organizations should:
Expedite the development of tools and guidance to support the implementation of the Codex Code of practice to minimize and contain foodborne AMR and Guidelines on Integrated Monitoring and Surveillance of Foodborne Antimicrobial Resistance along the food chain (e.g. food processing and production facilities, wet markets, slaughterhouses) to minimize the impacts of antimicrobial discharge into the environment.
國際技術(shù)組織應(yīng)當：
加快制定工具和指導(dǎo)，以支持沿食物鏈（如食品加工和生產(chǎn)設(shè)施、生鮮市場、屠宰場等）實施食品法典《最大限度減少和控制食源性抗微生物藥物耐藥性操作規(guī)范》和《食源性抗微生物藥物耐藥性綜合監(jiān)測和監(jiān)督準則》，從而盡量減少抗微生物藥物排放對環(huán)境的影響。
expedite [?eksp?da?t] v. 加速，促進
Companies involved in the slaughter and processing of food animals should:
Assess current food production practices to implement measures to reduce discharges of by-products, including biocides, into the environment and comply with legal standards and requirements.
從事屠宰和食用動物加工的公司應(yīng)當：
評估現(xiàn)行食品生產(chǎn)規(guī)范，以采取措施減少向環(huán)境中排放包括生物殺蟲劑等副產(chǎn)品，并遵守法律標準和要求。
biocide [?ba??sa?d] n. 殺蟲劑
In the manufacturing sector:
Manufacturing companies should:
Commit to prevention and management measures to minimize the impacts of manufacturing discharges into the environment. This can be done through effective waste management technologies and practices, adoption and implementation of the common antibiotic manufacturing framework and the proposed independent certification schemes of the AMR Industry Alliance.
在制造部門：
制造公司應(yīng)當：
承諾采取預(yù)防和管理措施，盡量降低制造過程中的排放物對環(huán)境的影響。為此可采用有效的廢物管理技術(shù)和做法、采納和實施共同抗生素生產(chǎn)框架以及抗微生物藥物耐藥性問題行業(yè)聯(lián)盟的擬議獨立認證計劃。
All stakeholders should:
Evaluate options and support efforts to create an enabling environment that influences and supports investment through incentives and efforts in pharmaceutical waste management without jeopardizing access to antimicrobials. Such evaluations may include an assessment of sustainable procurement policies, inclusion of environmental considerations in good manufacturing practices, environmental risk assessment before antimicrobial authorization and an independent product-certification scheme.
所有利益攸關(guān)方應(yīng)當：
評估各種備選方案并支持努力創(chuàng)造有利的環(huán)境，在不妨礙獲得抗微生物藥物的情況下，激勵并努力管理制藥業(yè)廢物，并由此影響和支持投資。此類評估可能包括對可持續(xù)采購政策的評估，良好生產(chǎn)規(guī)范對環(huán)境因素的考慮，批準抗微生物藥物前的環(huán)境風險評估以及獨立的產(chǎn)品認證計劃。
jeopardize [?d?ep?da?z] n. 危及，危害
4. RESEARCH AND DEVELOPMENT
4. 研究與開發(fā)
International technical, financing and research and development organizations and partners should:
Enhance and coordinate research for a comprehensive understanding of risks to human and animal health from the environmental presence of antimicrobials, resistance microbes and mobile genetic elements in discharges, as well as potential hot spots, environmental impacts and antimicrobial resistance pathways, and mitigation measures;
Promote research and development across public and private sectors into cost-effective and greener waste management technologies including methods to remove antimicrobial residues, resistance genes and resistant organisms and other tools (e.g., climate-sensitive incinerators and measurement technologies) and standardized monitoring methods, and support mainstreaming of best practices in process and waste management across sectors; and
Develop policy briefs on antimicrobial resistance and organize policy dialogues among policymakers to support evidence-based policymaking.
國際技術(shù)、融資和研發(fā)組織及合作伙伴應(yīng)當：
加強和協(xié)調(diào)研究，以全面了解環(huán)境中存在的抗微生物藥物、耐藥微生物及排放物中的可移動遺傳元件對人類和動物健康的風險，以及潛在的熱點、環(huán)境影響和抗微生物藥物耐藥性途徑及緩解措施；
促進公共和私營部門研發(fā)成本效益高、更環(huán)保的廢物管理技術(shù)，包括去除抗微生物藥物殘留物、耐藥基因和耐藥微生物的方法以及其他工具（例如，注重氣候影響的焚燒爐和測量技術(shù)）和標準化監(jiān)測方法，并支持將最佳做法納入各部門的流程和廢物管理主流；和
制定關(guān)于抗微生物藥物耐藥性的政策簡報，并組織決策者之間的政策對話，以支持循證決策。
comprehensive [?k?mpr??hens?v] adj. 綜合性的，全面的
