Is scientific evidence enough? Using expert opinion to fill gaps in data in antimicrobial resistance research.

BACKGROUND: Antimicrobial Resistance (AMR) is a global problem with large health and economic consequences. Current gaps in quantitative data are a major limitation for creating models intended to simulate the drivers of AMR. As an intermediate step, expert knowledge and opinion could be utilized to fill gaps in knowledge for areas of the system where quantitative data does not yet exist or are hard to quantify. Therefore, the objective of this study was to identify quantifiable data about the current state of the factors that drive AMR and the strengths and directions of relationships between the factors from statements made by a group of experts from the One Health system that drives AMR development and transmission in a European context. METHODS: This study builds upon previous work that developed a causal loop diagram of AMR using input from two workshops conducted in 2019 in Sweden with experts within the European food system context. A secondary analysis of the workshop transcripts was conducted to identify semi-quantitative data to parameterize drivers in a model of AMR. MAIN FINDINGS: Participants spoke about AMR by combining their personal experiences with professional expertise within their fields. The analysis of participants' statements provided semi-quantitative data that can help inform a future of AMR emergence and transmission based on a causal loop diagram of AMR in a Swedish One Health system context. CONCLUSION: Using transcripts of a workshop including participants with diverse expertise across the system that drives AMR, we gained invaluable insight into the past, current, and potential future states of the major drivers of AMR, particularly where quantitative data are lacking.

Four ways blue foods can help achieve food system ambitions across nations.

Blue foods, sourced in aquatic environments, are important for the economies, livelihoods, nutritional security and cultures of people in many nations. They are often nutrient rich1, generate lower emissions and impacts on land and water than many terrestrial meats2, and contribute to the health3, wellbeing and livelihoods of many rural communities4. The Blue Food Assessment recently evaluated nutritional, environmental, economic and justice dimensions of blue foods globally. Here we integrate these findings and translate them into four policy objectives to help realize the contributions that blue foods can make to national food systems around the world: ensuring supplies of critical nutrients, providing healthy alternatives to terrestrial meat, reducing dietary environmental footprints and safeguarding blue food contributions to nutrition, just economies and livelihoods under a changing climate. To account for how context-specific environmental, socio-economic and cultural aspects affect this contribution, we assess the relevance of each policy objective for individual countries, and examine associated co-benefits and trade-offs at national and international scales. We find that in many African and South American nations, facilitating consumption of culturally relevant blue food, especially among nutritionally vulnerable population segments, could address vitamin B12 and omega-3 deficiencies. Meanwhile, in many global North nations, cardiovascular disease rates and large greenhouse gas footprints from ruminant meat intake could be lowered through moderate consumption of seafood with low environmental impact. The analytical framework we provide also identifies countries with high future risk, for whom climate adaptation of blue food systems will be particularly important. Overall the framework helps decision makers to assess the blue food policy objectives most relevant to their geographies, and to compare and contrast the benefits and trade-offs associated with pursuing these objectives.

Governing Antimicrobial Resistance (AMR) in a Changing Climate: A Participatory Scenario Planning Approach Applied to Sweden in 2050.

Background: Antimicrobial resistance (AMR) is a growing global crisis with long-term and unpredictable health, social and economic impacts, with which climate change is likely to interact. Understanding how to govern AMR amidst evolving climatic changes is critical. Scenario planning offers a suitable approach. By envisioning alternative futures, stakeholders more effectively can identify consequences, anticipate problems, and better determine how to intervene. This study explored future worlds and actions that may successfully address AMR in a changing climate in a high-income country, using Sweden as the case. Methods: We conducted online scenario-building workshops and interviews with eight experts who explored: (1) how promising interventions (taxation of antimicrobials at point of sale, and infection prevention measures) could each combat AMR in 2050 in Sweden given our changing climate; and (2) actions to take starting in 2030 to ensure success in 2050. Transcripts were thematically analyzed to produce a narrative of participant validated alternative futures. Results: Recognizing AMR to be a global problem requiring global solutions, participants looked beyond Sweden to construct three alternative futures: (1) "Tax Burn Out" revealed taxation of antimicrobials as a low-impact intervention that creates inequities and thus would fail to address AMR without other interventions, such as infection prevention measures. (2) "Addressing the Basics" identified infection prevention measures as highly impactful at containing AMR in 2050 because they would contribute to achieving the Sustainable Development Goals (SDGs), which would be essential to tackling inequities underpinning AMR and climate change, and help to stabilize climate-induced mass migration and conflicts; and (3) "Siloed Nations" described a movement toward nationalism and protectionism that would derail the "Addressing the Basics" scenario, threatening health and wellbeing of all. Several urgent actions were identified to combat AMR long-term regardless which future un-folds, such as global collaboration, and a holistic approach where AMR and climate change are addressed as interlinked issues. Conclusion: Our participatory scenario planning approach enabled participants from different sectors to create shared future visions and identify urgent actions to take that hinge on global collaboration, addressing AMR and climate change together, and achieving the SDGs to combat AMR under a changing climate.

Economic incentives drive the conversion of agriculture to aquaculture in the Indian Sundarbans: Livelihood and environmental implications of different aquaculture types.

Expansion of aquaculture in the Sundarbans Biosphere Reserve (SBR) is irreversibly replacing agricultural land and the drivers of this change are disputed. Based on in-depth interviews with 67 aquaculture farmers, this paper characterizes major aquaculture types in the SBR, their impacts, and identifies drivers of conversion from agricultural land. Aquaculture types included traditional, improved-traditional, modified-extensive, and semi-intensive systems. Extensive capture of wild shrimp larvae is environmentally harmful but constitutes an important livelihood. Semi-intensive aquaculture of exotic shrimp (Litopenaeus vannamei) has much higher unit-area profitability than other types but involves greater financial risk. Profitability is the main driver for the transition from agriculture, but environmental factors such as lowered crop yields and cyclone impacts also contributed. Many conversions from agriculture to aquaculture are illegal according to the stakeholders. Existing legislation, if enforced, could halt the loss of agriculture, while the promotion of improved-traditional aquaculture could reduce the demand for wild seed.

Environmental performance of blue foods.

Fish and other aquatic foods (blue foods) present an opportunity for more sustainable diets1,2. Yet comprehensive comparison has been limited due to sparse inclusion of blue foods in environmental impact studies3,4 relative to the vast diversity of production5. Here we provide standardized estimates of greenhouse gas, nitrogen, phosphorus, freshwater and land stressors for species groups covering nearly three quarters of global production. We find that across all blue foods, farmed bivalves and seaweeds generate the lowest stressors. Capture fisheries predominantly generate greenhouse gas emissions, with small pelagic fishes generating lower emissions than all fed aquaculture, but flatfish and crustaceans generating the highest. Among farmed finfish and crustaceans, silver and bighead carps have the lowest greenhouse gas, nitrogen and phosphorus emissions, but highest water use, while farmed salmon and trout use the least land and water. Finally, we model intervention scenarios and find improving feed conversion ratios reduces stressors across all fed groups, increasing fish yield reduces land and water use by up to half, and optimizing gears reduces capture fishery emissions by more than half for some groups. Collectively, our analysis identifies high-performing blue foods, highlights opportunities to improve environmental performance, advances data-poor environmental assessments, and informs sustainable diets.

A 20-year retrospective review of global aquaculture.

The sustainability of aquaculture has been debated intensely since 2000, when a review on the net contribution of aquaculture to world fish supplies was published in Nature. This paper reviews the developments in global aquaculture from 1997 to 2017, incorporating all industry sub-sectors and highlighting the integration of aquaculture in the global food system. Inland aquaculture-especially in Asia-has contributed the most to global production volumes and food security. Major gains have also occurred in aquaculture feed efficiency and fish nutrition, lowering the fish-in-fish-out ratio for all fed species, although the dependence on marine ingredients persists and reliance on terrestrial ingredients has increased. The culture of both molluscs and seaweed is increasingly recognized for its ecosystem services; however, the quantification, valuation, and market development of these services remain rare. The potential for molluscs and seaweed to support global nutritional security is underexploited. Management of pathogens, parasites, and pests remains a sustainability challenge industry-wide, and the effects of climate change on aquaculture remain uncertain and difficult to validate. Pressure on the aquaculture industry to embrace comprehensive sustainability measures during this 20-year period have improved the governance, technology, siting, and management in many cases.

Compound climate risks threaten aquatic food system benefits.

Aquatic foods from marine and freshwater systems are critical to the nutrition, health, livelihoods, economies and cultures of billions of people worldwide, but climate-related hazards may compromise their ability to provide these benefits. Here, we estimate national-level aquatic food system climate risk using an integrative food systems approach that connects climate hazards impacting marine and freshwater capture fisheries and aquaculture to their contributions to sustainable food system outcomes. We show that without mitigation, climate hazards pose high risks to nutritional, social, economic and environmental outcomes worldwide-especially for wild-capture fisheries in Africa, South and Southeast Asia, and Small Island Developing States. For countries projected to experience compound climate risks, reducing societal vulnerabilities can lower climate risk by margins similar to meeting Paris Agreement mitigation targets. System-level interventions addressing dimensions such as governance, gender equity and poverty are needed to enhance aquatic and terrestrial food system resilience and provide investments with large co-benefits towards meeting the Sustainable Development Goals.

Recirculating Aquaculture Is Possible without Major Energy Tradeoff: Life Cycle Assessment of Warmwater Fish Farming in Sweden.

Seafood is seen as promising for more sustainable diets. The increasing production in land-based closed Recirculating Aquaculture Systems (RASs) has overcome many local environmental challenges with traditional open net-pen systems such as eutrophication. The energy needed to maintain suitable water quality, with associated emissions, has however been seen as challenging from a global perspective. This study uses Life Cycle Assessment (LCA) to investigate the environmental performance and improvement potentials of a commercial RAS farm of tilapia and Clarias in Sweden. The environmental impact categories and indicators considered were freshwater eutrophication, climate change, energy demand, land use, and dependency on animal-source feed inputs per kg of fillet. We found that feed production contributed most to all environmental impacts (between 67 and 98%) except for energy demand for tilapia, contradicting previous findings that farm-level energy use is a driver of environmental pressures. The main improvement potentials include improved by-product utilization and use of a larger proportion of plant-based feed ingredients. Together with further smaller improvement potential identified, this suggests that RASs may play a more important role in a future, environmentally sustainable food system.

Options for keeping the food system within environmental limits.

The food system is a major driver of climate change, changes in land use, depletion of freshwater resources, and pollution of aquatic and terrestrial ecosystems through excessive nitrogen and phosphorus inputs. Here we show that between 2010 and 2050, as a result of expected changes in population and income levels, the environmental effects of the food system could increase by 50-90% in the absence of technological changes and dedicated mitigation measures, reaching levels that are beyond the planetary boundaries that define a safe operating space for humanity. We analyse several options for reducing the environmental effects of the food system, including dietary changes towards healthier, more plant-based diets, improvements in technologies and management, and reductions in food loss and waste. We find that no single measure is enough to keep these effects within all planetary boundaries simultaneously, and that a synergistic combination of measures will be needed to sufficiently mitigate the projected increase in environmental pressures.

Does aquaculture add resilience to the global food system?

Aquaculture is the fastest growing food sector and continues to expand alongside terrestrial crop and livestock production. Using portfolio theory as a conceptual framework, we explore how current interconnections between the aquaculture, crop, livestock, and fisheries sectors act as an impediment to, or an opportunity for, enhanced resilience in the global food system given increased resource scarcity and climate change. Aquaculture can potentially enhance resilience through improved resource use efficiencies and increased diversification of farmed species, locales of production, and feeding strategies. However, aquaculture's reliance on terrestrial crops and wild fish for feeds, its dependence on freshwater and land for culture sites, and its broad array of environmental impacts diminishes its ability to add resilience. Feeds for livestock and farmed fish that are fed rely largely on the same crops, although the fraction destined for aquaculture is presently small (∼4%). As demand for high-value fed aquaculture products grows, competition for these crops will also rise, as will the demand for wild fish as feed inputs. Many of these crops and forage fish are also consumed directly by humans and provide essential nutrition for low-income households. Their rising use in aquafeeds has the potential to increase price levels and volatility, worsening food insecurity among the most vulnerable populations. Although the diversification of global food production systems that includes aquaculture offers promise for enhanced resilience, such promise will not be realized if government policies fail to provide adequate incentives for resource efficiency, equity, and environmental protection.

Fishing for prawn larvae in Bangladesh: an important coastal livelihood causing negative effects on the environment.

Freshwater prawn (Macrobrachium rosenbergii) farming in Bangladesh has, to a large extent, been dependent on the supply of wild larvae. Although there are 81 freshwater prawn hatcheries in the country, a lack of technical knowledge, inadequate skilled manpower, and an insufficient supply of wild broods have limited hatchery production. Many thousands of coastal poor people, including women, are engaged in fishing for wild prawn larvae along the coastline during a few months each year. On average, 40% of the total yearly income for these people comes from prawn larvae fishing activity. However, indiscriminate fishing of wild larvae, with high levels of bycatch of juvenile fish and crustaceans, may impact negatively on production and biodiversity in coastal ecosystems. This concern has provoked the imposition of restrictions on larvae collection. The ban has, however, not been firmly enforced because of the limited availability of hatchery-raised larvae, the lack of an alternative livelihood for people involved in larvae fishing, and weak enforcement power. This article discusses the environmental and social consequences of prawn larvae fishing and concludes that, by increasing awareness among fry fishers, improving fishing techniques (reducing bycatch mortality), and improving the survival of fry in the market chain, a temporal ban may be a prudent measure when considering the potential negative impacts of bycatch. However, it also suggests that more research is needed to find out about the impact of larvae fishing on nontarget organisms and on the populations of targeted species.

Ecosystem goods and services from Swedish coastal habitats: identification, valuation, and implications of ecosystem shifts.

Coastal areas are exposed to a variety of threats due to high population densities and rapid economic development. How will this affect human welfare and our dependence on nature's capacity to provide ecosystem goods and services? This paper is original in evaluating this concern for major habitats (macroalgae, seagrasses, blue mussel beds, and unvegetated soft bottoms) in a temperate coastal setting. More than 40 categories of goods and services are classified into provisional, regulating, and cultural services. A wide variety of Swedish examples is described for each category, including accounts of economic values and the relative importance of different habitats. For example, distinguishing characteristics would be the exceptional importance of blue mussels for mitigation of eutrophication, sandy soft bottoms for recreational uses, and seagrasses and macroalgae for fisheries production and control of wave and current energy. Net changes in the provision of goods and services are evaluated for three cases of observed coastal ecosystem shifts: i) seagrass beds into unvegetated substrate; ii) unvegetated shallow soft bottoms into filamentous algal mat dominance; and iii) macroalgae into mussel beds on hard substrate. The results are discussed in a management context including accounts of biodiversity, interconnectedness of ecosystems, and potential of economic valuation.