What is the issue?
Foodborne pathogens (FBP) cause an estimated 2.4 million cases of illness each year in the UK alone, with the World Health Organization (WHO) reporting 420,000 deaths annually from foodborne pathogens. With the increasing prevalence of antimicrobial resistance (AMR), models suggest that the impact of AMR on the agricultural sector alone could jeopardise food security for 2 billion people by 2050.
Against this backdrop, the UK Biological Security Strategy and the AMR National Action Plan have highlighted the urgency of pathogen surveillance. The Pathogen Surveillance in Agriculture, Food and the Environment (PATH-SAFE) Programme was launched in 2021 as a pilot of a cross-government approach to surveillance of FBPs and AMR in the food system and the environment, funded by the Shared Outcomes Fund (SOF). RAND Europe conducted an evaluation of the first phase of PATH-SAFE, focusing on the first phase of funding until March 2024. PATH-SAFE then received continuation funding for one additional year, until March 2025.
How did we help?
The UK Food Standards Agency commissioned RAND Europe to conduct an evaluation of the second phase of PATH-SAFE. This evaluation focused on the final year (March 2024-2025) of PATH-SAFE’s funding to investigate the extent to which PATH-SAFE has contributed to outcomes related to improved surveillance of FBPs and AMR, as well as factors affecting the realisation of outcomes and impacts.
This evaluation took a theory-based approach, guided by a logic model and an outcome measurement framework. Evidence to support this evaluation comes from desk research looking at PATH-SAFE documentation and publications, interviews with PATH-SAFE delivery partners, a survey of PATH-SAFE partners and external stakeholders, and case studies of PATH-SAFE projects. This evaluation built on our evaluation of the first phase of PATH-SAFE. While it provides useful evidence as to the outcomes of PATH-SAFE to date, it took place prior to all of the outputs from PATH-SAFE being made available, and we are unable to assess outcomes and impact after the evaluation ended in March 2025.
What did we find?
Overall, we found that PATH-SAFE helped improve surveillance in the UK, but that in many areas, additional follow-up action and investment are needed to influence practices. Specifically, PATH-SAFE has:
- Sequenced over 13,000 isolates from animal, food, environmental and wastewater sources, representing multiple foodborne pathogens including Salmonella, E. coli, and Campylobacter across all four UK nations.
- Collected over 9,000 wastewater samples and conducted metagenomic sequencing, helping to characterise AMR gene prevalence in diverse environments and expand understanding of One Health transmission dynamics.
- Produced knowledge about methods and tools for surveillance and developed several methods that are being incorporated into business as usual. For instance, the programme tested new workflows for harmonised data integration across agencies, enabling standardised data sharing on a common genomic platform.
- Validated rapid metagenomic methods for AMR detection directly from environmental samples without culturing, demonstrating feasibility for incorporation into ongoing surveillance operations.
- Developed relationships between different surveillance partners that are valuable in improving surveillance in the UK.
- Likely informed decisions about surveillance in the UK, through forums such as the National Biosurveillance Network (NBN), and raised awareness of the importance of the agricultural and food system in AMR surveillance and the UK Biological Security Strategy.
- Produced valuable knowledge about what works in coordinating across surveillance partners and conducting One Health surveillance of FBPs and AMR in the UK.
What can be done?
To maximise the impact of the PATH-SAFE programme, the following actions are needed:
- Dedicated long-term investment to support further investigation, implementation and scale up of PATH-SAFE methods and tools, characterised by clear departmental ownership of follow-up actions.
- A cross-government surveillance knowledge repository to disseminate knowledge and insights generated by PATH-SAFE, such as methods, tools and surveillance strategies.
- An independent follow-up evaluation to assess long-term outcomes and impacts.
To improve the impact of surveillance pilots and One Health surveillance more broadly, the following actions are needed:
- Incorporation of PATH-SAFE organisational approaches into broader efforts to improve surveillance in the UK, including a central management team, ring-fenced funding and shared meetings and events to enhance coordination and relationship building across surveillance partners.
- Harmonising of cross-government approaches to data protection and data sharing to improve the efficiency of future biosurveillance initiatives in data collection, linking and sharing.
- Prioritisation of biosurveillance projects according to clearly defined and transparent criteria – for example, this might include the ability of specific surveillance methods or studies to inform decision making about prevention or mitigation, the cost-effectiveness of surveillance approaches and ability to integrate methods to existing surveillance programmes.
- Future surveillance programmes should include:
- A pilot phase with clear milestones and continuation criteria.
- Implementation funding contingent on meeting specific performance criteria.
- Sustainability plans detailing how methods will be incorporated into business-as-usual operations.
