The MATRIX project was guided by the principle of building on existing systems in order to improve them. Coordinated by the Istituto Superiore di Sanità, Italy's leading public health research organisation, and funded by the One Health European Joint Programme (EJP), it sought to improve collaboration between the players involved in the surveillance of pathogens that can be transmitted through food of animal origin. "Surveillance systems for human health, animal health and food safety are still very compartmentalised", notes Renaud Lailler, Project Manager in ANSES's Laboratory for Food Safety and national coordinator of the surveillance platform for food-chain safety, one of the project participants. "At the Agency, we instead seek to promote more integrated surveillance, through a One Health approach."
ANSES contributed to the MATRIX project alongside 18 other organisations from 11 European countries. In particular, it worked on developing a methodology for mapping the players involved in pathogen surveillance, and then a tool for assessing the strengths and areas needing improvement in the collaboration between these players.
Mapping all surveillance activities
The first step needed in working together is a shared vision of everyone's role and the interactions between all the players involved. "Despite it being essential, this is a prerequisite that is not always observed, because each player has their own expectations and constraints," confirm Renaud Lailler and his colleague Viviane Hénaux from ANSES's Lyon Laboratory, who was responsible for a work package in the MATRIX project.
Hence the importance of drawing up a map that shows at a glance the organisations involved in food surveillance for each step in the production chain, from farm to fork and including animal transport, slaughter, food production and distribution. This map identifies the analytical methods used, the types of samples taken and the surveillance context, for example whether it is a routine check or surveillance carried out only in the event of an epidemic.
To produce this map, a questionnaire was drawn up and tested with examples of the surveillance systems in place in several countries for four major pathogens for public health: the bacteria Salmonella, Campylobacter and Listeria monocytogenes and the hepatitis E virus. "This gives us a common representation that enables us to make easy comparisons and draw inspiration from what is being done in other sectors, for other pathogens, other foods or in other countries." explains Viviane Hénaux.
A tool to assess cross-sectoral links
Once the players have been identified, the next step is to assess the strength of their cooperation. To do this, ANSES and the University of Surrey (UK) created the OH-EpiCap tool. The principle was to assess the cross-sectoral activities implemented as part of the surveillance system under study, based on 48 indicators. These indicators target the organisation of the collaborative system, the functioning of joint work on operational activities and its impact on surveillance. In particular, they concern the sharing of documentation, the harmonisation of analytical procedures and the time taken to detect emerging threats.
OH-EpiCap can therefore be used to determine the strengths and weaknesses of surveillance systems and identify specific actions to improve collaboration at all stages. It is an open access tool designed to be applicable beyond food-related health threats. "When we tested the tool on around 10 examples in several European countries, we saw that there was a recurring need for more formalised collaborations," says Viviane Hénaux. "In addition, the benefits to surveillance systems of cross-sectoral functioning are rarely measured. This would be worthwhile, because objective evidence of the benefits of cross-sectoral functioning would provide leverage to promote application of the One Health principle."
Members of the MATRIX project have drawn up other guides, including on good practice to promote cross-sectoral surveillance systems. Now the health surveillance players in each country need to implement them.