Reducing Antimicrobial Discharges from Food Systems, Manufacturing Facilities and Human Health Systems into the Environment
减少从食品系统、生产设施和人类卫生系统排放到环境中的抗微生物药物
Call to Action by the Global Leaders Group on Antimicrobial Resistance
抗微生物药物耐药性全球领导人小组的行动呼吁
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.
处置来自食品系统、生产设施和人类卫生系统等各种来源的未经处理或管理不当的废物和径流时可能将具有生物活性的抗微生物药物、抗微生物药物耐药微生物、未代谢的抗微生物药物以及抗微生物药物耐药性决定因素（如赋予耐药性的基因）释放到环境中。这些排放物会污染环境，并导致抗微生物药物耐药性的传播。控制抗微生物药物耐药性从食品系统和人类卫生系统传播的最重要方法是在人类、陆地和水生动物以及植物/作物中负责任和可持续地使用抗微生物药物。此外，需要采取适当措施处理和安全处置废物，包括人类、动物和制造业废物。
antimicrobial [ˌæntɪmaɪˈkrəʊbɪəl] n. 抗微生物药物
contaminate [kənˈtæmɪneɪt] v. 污染
aquatic [əˈkwætɪk] adj. 水生的，水栖的
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.
全球领导人小组赞扬当前为解决向环境中排放抗微生物药物问题所做的努力，特别是七国集团国家的努力，并鼓励各国执行食品法典《最大限度减少和控制食源性抗微生物药物耐药性操作规范》以及2021年11月批准的《食源性抗微生物药物耐药性综合监测和监督准则》。
foodborne ['fuːdbɔːn] adj. 食源性的，食物传染的
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:
为更好地管理排放到环境中可能导致抗微生物药物耐药性出现和传播的废物，全球领导人小组呼吁：
1. STRENGTHENED GOVERNANCE AND OVERSIGHT
1. 加强治理和监督
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.
总体上，各国应当：
制定或依赖和落实监管框架、指南、标准操作程序和标准，以确立安全水平，对源自食品系统、生产设施和人类卫生系统的抗微生物药物、抗微生物药物耐药细菌以及抗微生物药物耐药性决定因素在环境中的分布和释放情况进行更好地控制和监测；和
将预防和管理措施纳入国家抗微生物药物耐药性行动计划，以最大限度减少环境中排放物的影响。
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.
具体在制造部门，各国应当:
制定和实施法律和政策框架，对抗微生物药物制造采取生命周期方法。这种方法能考虑到药物具有活性并能影响周围系统的整个时间跨度，可帮助有效解决抗微生物药物耐药性的环境风险，确保抗生素供应链的复原力，并刺激必要的新抗生素和抗微生物药物替代品的设计、开发、制造和商业化；
认识到当前供应链的脆弱性和获取方面的显著差距，促进和制定平衡的、分阶段的环境政策和方法，以管理和规范生产设施并支持环境检查；
激励行业追求合规和卓越，包括突出其对实现可持续发展目标的贡献；和
根据现有的最佳证据、处理技术和情况分析，制定国家抗微生物药物生产的污染标准，并加强环境主管部门进行审计和监测合规性的能力。
pharmaceutical [ˌfɑːməˈsuːtɪkl] n. 药物
fragility [frəˈdʒɪləti] n. 脆弱，易碎
compliance [kəmˈplaɪəns] n. 合规，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.
具体在人类卫生部门，各国应当:
在人类卫生系统中制定和实施抗微生物药物管理政策和规程，包括负责任和可持续地使用和采购抗微生物药物，以及采取有效的废物管理方法；和
实施和执行法律和政策，以减少或消除在无训练有素的卫生保健人员指导下使用抗微生物药物的情况，同时确保公平获得优质的抗微生物药物。
stewardship [ˈstjuːədʃɪp] n. 管理
procurement [prəˈkjʊəmənt] n. 采购，购买
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.
具体在食品系统中，各国应当：
制定或依赖和落实监管框架、指南、标准操作程序和标准，以有效处理和/或管理食用动物养殖场、水产养殖场和农田的废物排放，以及用于灌溉作物的废物和农田径流；和
在固定和流动的动物卫生设施中制定和实施抗微生物药物管理政策和规程，包括负责任和可持续地使用抗微生物药物以及采取有效的废物管理方法。
aquaculture [ˈækwəkʌltʃə(r)] n. 水产养殖
irrigate [ˈɪrɪgeɪt] v. 灌溉；冲洗
2. IMPROVED SURVEILLANCE AND DATA AVAILABILITY
2. 改进监测和数据可得性
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.
各国应当：
加强对食品系统、人类卫生系统和生产设施以及污水系统中抗微生物药物的使用以及抗微生物药物和抗微生物药物耐药性决定因素的排放的一体化卫生监测。这样做时应考虑到各种因素，如加强现有系统的必要性、成本效益、数据可比性以及关于排放物的结局、浓度及其对环境和环境中生物（如土壤微生物、水生生物）的影响等方面的重要知识空白。应优先考虑收集数据以帮助采取有针对性的行动，如提高对人类和动物健康风险、环境风险以及向环境释放的途径的认识，并支持就废物管理方法和抗微生物药物排放限值制定指导；和
鼓励行业披露数据、促进透明度和向公众提供废物和废水管理数据及缓解措施，以建立可信度和公众信心。最初可以向监管机构和独立的第三方披露数据（例如作为认证计划的一部分），然后努力向更广泛的公众普及，以提高认识和理解，促进正在进行的研究，并在采购实践中反映环境标准。
sewage [ˈsuːɪdʒ] n. 污水，污物
concentration [ˌkɒns(ə)nˈtreɪʃ(ə)n] n. 浓度；专心；集中
mitigation [ˌmɪtɪˈgeɪʃn] n. 减轻，缓解
3. IMPROVED DISCHARGE MANAGEMENT
3. 改进排放管理
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.
总体上，各国应当：
通过在所有部门实施有效的感染预防和控制措施，包括水、环境卫生和个人卫生服务（水卫项目）、疫苗接种、生物安保以及畜牧业和福利措施，减少对抗微生物药物的使用需求；
开发、实施和监测用于妥善分离、处理和/或处置所有部门的抗微生物药物和含抗微生物药物物质的系统（包括含抗微生物药物的饲料以及人畜粪便）；
建立机制以收集和适当处置来自个体和机构的未使用和过期抗微生物药物；和
确保提供负担得起且环保的焚烧炉和创新技术，用于销毁和降解未使用或过期的抗微生物药物。
sanitation [ˌsænɪˈteɪʃn] n. 公共卫生
hygiene [ˈhaɪdʒiːn] n. 个人卫生；卫生学
husbandry [ˈhʌzbəndri] n. 饲养业，农牧业
segregation [ˌsegrɪˈgeɪʃn] n. 隔离，分离
incinerator [ɪnˈsɪnəreɪtə(r)] n. 焚烧炉
In general, relevant international technical organizations and their partners should develop guidance and showcase best practices on proper waste management practices across sectors.
总体而言，相关国际技术组织及其合作伙伴应制定指导，并展示各部门妥善管理废物的最佳做法。
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.
在食品系统中：
各国应当：
创建并实施粪肥、废水、径流和农场废物管理计划、标准操作程序、指南、标准和措施，如粪肥堆肥及其在农业领域的应用等；和
实施基于证据的粪肥管理方法，以便粪肥可以继续作为天然肥料安全地用于农业领域，支持符合农业生态的耕作办法，同时最大限度降低抗微生物药物耐药细菌或抗微生物药物耐药性决定因素转移的风险。
manure [məˈnjʊə(r)] n. 肥料，粪肥
composting ['kɔmpɔstiŋ] 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.
国际技术组织应当：
加快制定工具和指导，以支持沿食物链（如食品加工和生产设施、生鲜市场、屠宰场等）实施食品法典《最大限度减少和控制食源性抗微生物药物耐药性操作规范》和《食源性抗微生物药物耐药性综合监测和监督准则》，从而尽量减少抗微生物药物排放对环境的影响。
expedite [ˈekspədaɪt] v. 加速，促进
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.
从事屠宰和食用动物加工的公司应当：
评估现行食品生产规范，以采取措施减少向环境中排放包括生物杀虫剂等副产品，并遵守法律标准和要求。
biocide [ˈbaɪəsaɪd] n. 杀虫剂
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.
在制造部门：
制造公司应当：
承诺采取预防和管理措施，尽量降低制造过程中的排放物对环境的影响。为此可采用有效的废物管理技术和做法、采纳和实施共同抗生素生产框架以及抗微生物药物耐药性问题行业联盟的拟议独立认证计划。
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.
所有利益攸关方应当：
评估各种备选方案并支持努力创造有利的环境，在不妨碍获得抗微生物药物的情况下，激励并努力管理制药业废物，并由此影响和支持投资。此类评估可能包括对可持续采购政策的评估，良好生产规范对环境因素的考虑，批准抗微生物药物前的环境风险评估以及独立的产品认证计划。
jeopardize [ˈdʒepədaɪz] n. 危及，危害
4. RESEARCH AND DEVELOPMENT
4. 研究与开发
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.
国际技术、融资和研发组织及合作伙伴应当：
加强和协调研究，以全面了解环境中存在的抗微生物药物、耐药微生物及排放物中的可移动遗传元件对人类和动物健康的风险，以及潜在的热点、环境影响和抗微生物药物耐药性途径及缓解措施；
促进公共和私营部门研发成本效益高、更环保的废物管理技术，包括去除抗微生物药物残留物、耐药基因和耐药微生物的方法以及其他工具（例如，注重气候影响的焚烧炉和测量技术）和标准化监测方法，并支持将最佳做法纳入各部门的流程和废物管理主流；和
制定关于抗微生物药物耐药性的政策简报，并组织决策者之间的政策对话，以支持循证决策。
comprehensive [ˌkɒmprɪˈhensɪv] adj. 综合性的，全面的
