Reducing AMR for sustainable food systems - Interview with Marmar Nekoro


Marmar NekoroAt the upcoming Uppsala Health Summit on food systems, Marmar leads the workshop Reducing Antimicrobial Resistance (AMR) for Healthy and Sustainable Food Systems. This interview with Marmar tells us about her reflection on the public health issues surrounding unsustainable food systems, critical changes that need to be made, and inspiring reflections based on her past experiences. 

To begin with, we'll learn how the collaborative process went about arriving at their workshop topic;

Marmar: Me and my colleagues at the MPA started by mapping potential ideas for an MPA workshop for UHS 2022 and decided to continue with the topic of how to reduce antimicrobial resistance (AMR) in the food system. Following internal discussions where we developed our ideas, we have continued this process with external experts and stakeholders in our network. We are fortunate to attract interest from highly experienced experts in the field, several of whom will also join our workshop. Our moderator and inspirational speakers have extensive experience working on the topic, within research, policy-making and with stakeholders from different sectors and disciplines, including practitioners from around the world.

In your opinion, what are the leading public health concerns in relation to food systems, and what needs to be done to achieve sustainable, equitable food systems promoting our health?

Marmar: It is impossible to choose only one main public health concern in relation to food systems as the issue is complex and multifaceted. Globally millions of people lack access to food and affordable healthy food, which worsens by rising food prices connected to e.g. climate changes and different conflict areas. Meanwhile, millions struggle with obesity and diet-related diseases. Environmental pollution, including pesticide residues and the spread of antibiotic and antimicrobial substances are other key issues.

To achieve sustainable, equitable food systems, we need urgent and bold actions to transform the systems to not only provide food, promote health, and achieve sustainable development globally. Keeping within the planetary boundaries is key to safeguarding the resilience of our ecosystems and halting the depletion of natural resources and ecosystem services, climate change, land erosion and water scarcity, as well as to decreasing environmental pollution from, e.g., pesticides, and fertilisers and antibiotics. To succeed in providing a growing world population with healthy diets from sustainable food systems, changes on many levels and participation from many stakeholders are needed. These include changes on both the production and consumption side, thus across the entire supply chain to ensure food safety and food security. Actions needed include reductions in GHG emissions, a circular economy coupled to, e.g. water use and fertilisers, and dietary shifts, including diversifying foods to enhance and safeguard biodiversity (both terrestrial and aquatic). Lastly, we need to reduce food loss and waste substantially.

What are your expectations for Uppsala Health Summit 2022 and your involvement?

Marmar: To foster dialogues and meet participants willing to share knowledge, ideas and best practices for how we can jointly increase the necessary action for the transformative and urgent changes that are needed to safeguard our health, food systems and the underlying ecosystem services we depend on. Regarding our own workshop, I hope that we succeed in proposing actions to further develop antimicrobial stewardship policies and collaborative partnerships to implement the needed changes.

Can you tell us about an ‘Aha moment’ that you have had in your research?

Marmar: It is so difficult to choose only one, but my work with BalticSTERN (Systems Tools and Ecological-economic evaluation – a Research Network) is absolutely one. BalticSTERN combined ecological and economic models to make a cost-benefit analysis and identify cost-effective measures to improve the environmental state of the Baltic Sea. When published in 2012, it was the first-ever cost-benefit analysis for reducing eutrophication in the Baltic Sea published, in which we showed how important the Baltic Sea is to the inhabitants of all nine countries surrounding it. To be able to show also in numbers that the benefits outweighed the costs with 1000-1500 million Euros annually was ground-breaking. To see how our results were highlighted by researchers, policymakers, media, the general public and decision-makers at the highest national and international government levels was very rewarding. Being active throughout the whole process, from finding experts and funding to communicating our findings, BalticSTERN gave me a profound understanding of the decision-making processes and negotiations done on the highest political level, and knowledge that I have carried with me and used ever since.

Marmar Nekoro has an MSc in Systems- and Marine ecology from Stockholm University, where she worked with transdisciplinary environmental research between 2004 - 2019. In addition to being active in education, research, politics and communication at, for example, the Stockholm Resilience Centre, the Royal Swedish Academy of Sciences and the Baltic Sea Centre, she has also, on behalf of various authorities, municipalities, country boards and the private sector, built triple spiral platforms for research, innovation and leadership to achieve Agenda 2030. In 2019 she started as an accessor at the Swedish Medical Products Agency (MPA), assigned to build the Swedish Knowledge Centre on Pharmaceuticals in the Environment following a commission by the Swedish Government. Her workshop partner, Krister Halldin, has a PhD in Environmental toxicology from Uppsala university. He has been a researcher in environmental medicine at the Institute of Environmental Medicine at Karolinska Institute. From 2010 to 2022, he was actively engaged as a project coordinator within medicine and pharmacy at Uppsala University. Since early 2022 he is an accessor at the Swedish Medical Products Agency, focusing on pharmaceuticals in the environment.