Antimicrobial Resistance
Overview
Antimicrobial resistance (AMR) refers to the ability of microorganisms (such as bacteria, viruses, fungi and parasites) to prevent an antimicrobial (antibiotics, antivirals, antifungals and anthelminthics) from being effective against it. Microorganisms that develop AMR are sometimes referred to as "superbugs".
AMR is a serious threat to global public health. It requires a multi-sectorial and multi-disciplinary approach to tackle the problem as antimicrobial resistant microorganisms can be transmitted through the food supply chain, the environment and direct contact between animals and humans.
Importance of AMR
AMR occurs naturally over time, usually through genetic mutations. However, the rate of resistance development and spread has been accelerated by the misuse and overuse of antimicrobial agents. The development of resistance to existing antimicrobial agents is increasing at a faster rate than the development of new antimicrobial agents. Therefore, there is a dwindling availability of effective antimicrobials, which are important to protect human health, as well as animal health and welfare.
Many of the bacteria carried by animals can also cause disease in people. These bacteria can contaminate our food supply from farm to fork, such as through slaughtering and processing, or during production. Fruits and vegetables may also similarly be contaminated. As a result of ingestion of these bacteria, foodborne diseases may become impossible to treat if these bacteria are resistant to antibiotics. Therefore poor infection control, insanitary environment and inappropriate food handling can encourage the spread of AMR.
Singapore's Response to AMR
Singapore recognises that combatting the threat against AMR involves a One Health approach, and requires a coordinated effort involving the animal, human, food, and environment sectors. In 2017, the Ministry of Health (MOH), National Environment Agency (NEA), Agri-food & Veterinary Authority (AVA) and Public Utilities Board (PUB) developed and launched the National Strategic Action Plan on AMR.
The plan provides a framework to strengthen and enhance activities to combat AMR across the human, animal, food, and environment sectors. It is aligned with the World Health Organization's (WHO) Global Action Plan on AMR, as well as the standards and guidelines established by inter-governmental bodies such as the Food and Agriculture Organization of the United Nations (FAO) and World Organization for Animal Health (OIE).
With effect from 1 April 2019, the Agri-food & Veterinary Authority (AVA) was restructured to form the Singapore Food Agency (SFA) and the Animal & Veterinary Service (AVS) under the National Parks Board (NParks). SFA will continue to work with relevant agencies to combat AMR.
You can read more on the National Strategic Action Plan on Antimicrobial Resistance.
SFA's Efforts to Combat AMR
SFA has in place a food safety system based on science and risk analysis. All food products (both imported and locally produced) are required to comply with our food safety standards and requirements.
Working with local farms
SFA monitors the use of veterinary drugs in our farms. Antibiotics are not allowed to be used for promoting growth of animals in Singapore. Certain antibiotics are allowed to treat disease and prevent infections in animals but, for food safety reasons, SFA also bans a number of antibiotics from use in food-producing animals. If antibiotics are used to treat animals, farmers are required to observe a certain time period (known as withdrawal period) before the animals/animal products can be slaughtered or sold. This will ensure that the antibiotics are passed out of the animals’ physiological systems, and any residual antibiotics are trace levels below the maximum allowed residue levels. SFA regularly conducts tests to ensure that food products do not contain residues of banned substances and permissible substances do not exceed maximum residue limits.
In addition, SFA works with local farmers to implement good animal husbandry practices to prevent disease incursion and manage diseases, which would reduce use of antibiotics.
Regular inspections, sampling & monitoring
All imported and locally produced food products are subjected to regular inspections and sampling. Our sampling tests cover a wide range of hazards that are known to be associated with food (for e.g. pesticide, drug residues such as antibiotics, harmful bacteria like Salmonella and Listeria, etc.). Food products that do not comply with the Singapore Food Regulations will not be allowed for sale.
SFA also monitors the AMR profile in common food-borne pathogens, and our local poultry and ruminant farms. The information gathered will provide valuable insights on the development of AMR locally and help us to take appropriate precautionary measures. SFA is working with other agencies to implement a national integrated surveillance system to track the spread of AMR not only in food, but also humans, animals and the environment.
Regular inspections, sampling & monitoring
All imported and locally produced food products are subjected to regular inspections and sampling. Food products that do not comply with the Singapore Food Regulations will not be allowed for sale.
Antibiotics are the major groups of veterinary drugs globally used by livestock and aquaculture industry for prevention and treatment of infectious diseases. As Singapore imports over 90% of our food, it is important to have a robust drug residue monitoring system to ensure the safety of the imported meat products. NCFS has developed an extraction method which could test for more than 100 veterinary drugs in food from animal origins. This method has greatly enhanced the speed and efficiency at which we detect veterinary drug residues in meat, strengthening SFA's efforts in combatting AMR.
SFA also monitors the AMR profile in common food-borne pathogens, and our local poultry and ruminant farms. The information gathered will provide valuable insights on the development of AMR locally and help us to take appropriate precautionary measures. SFA is working with other agencies to implement a national integrated surveillance system to track the spread of AMR in not only food, but also humans, animals and the environment.
Accreditation and certification of food
SFA has accreditation and certification programmes, such as the Singapore Egg Quality Scheme and Good Aquaculture Practices certification, which emphasise quality management, good hygiene and farm management practices and monitoring of veterinary drug use on the farm. SFA will continue to promote its accreditation and certification schemes to advocate good husbandry practices and disease prevention to reduce use of antimicrobials, and promote its prudent and responsible use among local farmers.
Outreach and publicity
SFA Officers volunteering at this year’s World Antibiotic Awareness Week (WAAW) library outreach events, organised by Saw Swee Hock School of Public Health (SSHSPH) and supported by the Antimicrobial Resistance Coordinating Office (AMRCO) – National Centre for Infectious Diseases (NCID), to raise public awareness of antibiotics and antibiotic resistance.
SFA leverages on international events such as “World Health Day” and “World Antibiotics Awareness Week” to reiterate our messaging on AMR. In particular, for World Antibiotics Awareness Week held in November every year, SFA promotes AMR through social media and library outreach events organised by the Saw Swee Hock School of Public Health (SSHSPH). We also conduct learning journeys on food safety for preschools.
Like and follow us on SFA’s social media platforms at Facebook and Instagram for more content and updates on food supply resilience and food safety, including AMR.
Regional efforts
SFA coordinates efforts within the ASEAN region to combat AMR in the livestock and aquaculture sectors, through the development of regional guidelines on antimicrobial use in food producing animals. SFA also builds capabilities in the region by sharing technical expertise and experience with other countries, such as conducting regional training workshops for antibiotics residues testing.
What Can I Do
The assurance of food safety does not rest with the government alone. Food can be contaminated anywhere along the food chain. While SFA continues to be vigilant and works to ensure that regulatory measures are in place and properly enforced, we need the food industry and consumers to play their part too. To this end, we have been encouraging the industry to adopt in-house food safety assurance programmes and spreading the food safety message to our consumers.
As consumers, here’s what you can do:
- Adopt good food safety practices such as hand washing and separating raw and cooked food to prevent cross contamination. Although antibiotic-resistant bacteria may be found in raw meat, they can be eliminated by thorough cooking.
- Thoroughly wash and/or peel fruits and vegetables if eating them raw, as they can be contaminated by bacteria.
- Do not prepare food if you have diarrhea or if you are vomiting. Be especially careful when preparing food for vulnerable groups such as children, pregnant women, older adults and those in poor health.
Frequently Asked Questions
What are the sources of AMR microorganisms? Can antibiotic resistant bacteria be transmitted via consumption of food?
AMR microbes can be found in people, animals, food and the environment (for e.g. water and soil). They can spread from person to person, and between people and animals. Although the risk is low in Singapore, resistant foodborne bacteria can also be transmitted through consumption of inadequately cooked food. Adopting good food safety practices during food handling and preparation will further reduce the risk of contamination.
Does my food contain antibiotic resistant bacteria? What will happen if we consume food contaminated with AMR microorganisms?
Bacteria can be naturally found in the environment. Most are harmless and do not cause disease. However, raw food may contain certain bacteria which can cause food poisoning. Dangerous bacteria, whether resistant or not, are killed during thorough cooking. Adopting good food safety practices during food handling and preparation will further reduce the risk of contamination.
How do we know if our food is safe for consumption?
SFA has a food safety system in place to ensure that food is safe for consumption. All food products (both imported and locally produced) are required to comply with our food safety standards and requirements. SFA bans the use of certain antibiotics in food-producing animals, and places strict limits on antibiotic residues in food products. SFA monitors meat to ensure there are no residues of banned drugs, and those allowed are within the strict permissible levels.
Is it safer to eat food from animals raised without antibiotics?
Antibiotics are needed to control and treat diseases in animals. Livestock, poultry and fish treated with antibiotics for any reason may not be processed for food until a specified withdrawal period has been observed to allow antibiotic residues to be sufficiently cleared from the system. Prudent and appropriate use of antibiotics in food producing animals helps lower the prevalence of antimicrobial resistant pathogens. All meat and meat products in Singapore, regardless of whether the animals are raised with or without antibiotic, have to comply with Singapore’s strict food safety standards and are safe for consumption when good food safety practices are followed. Eating meat from animals treated with antibiotics does not cause antibiotic resistance in people.
Why do we not see “antibiotic-free” food products in Singapore?
SFA does not support the use of claims on the absence of hormones and antibiotics in food. However, the use of claims to indicate that the animal for food use are raised without antibiotics (e.g. "Raised without use of antibiotics") on prepacked food products are allowed, on the condition that the method of production/process is endorsed and verified with certifications issued by the competent authority. Click here for more information on the labelling requirements for food products in Singapore.
Can long-term consumption of food with AMR bacteria result in build-up of resistance? Can reduced consumption lower resistance over time?
People do not become resistant to antimicrobials, only bacteria and other microbes do. Consumption of food with harmful bacteria with AMR may result in foodborne infections that are harder to treat due to the reduced range of effective antimicrobials available. There is no conclusive evidence to show that the long-term consumption of food with AMR bacteria will result in an increased range of AMR in a person.
Will SFA be banning use of antibiotics in animals? Has any country banned them?
Antimicrobials are necessary for the treatment of bacterial infections in animals, and when used appropriately, contribute to the health of animals. SFA therefore encourages the prudent use of antimicrobials in animals. This means that antimicrobials should be used in a responsible and appropriate manner to reduce the development of resistance particularly against medically important antimicrobials. Antimicrobials are also not allowed for growth promotion in food producing animals in Singapore, but only for the treatment and prevention of diseases. Certain antibiotics are banned for use in food producing animals because it poses a direct health risk to consumers, and other countries are known to adopt similar measures.