The EU - active on AMR for more than 15 years - strives to bring about behaviour change and tackle this pressing issue within a "One Health" approach.
Reducing the overuse and misuse of antimicrobial medicines is vital to stop the appearance of resistant microorganisms. Among other good practices, the following ones are key to tackle this problem:
To raise awareness about this issue, the European Centre for Disease Prevention and Control (ECDC) founded the European Antibiotic Awareness Day (EAAD) which aims to provide a platform and support for national campaigns about prudent antibiotic use. Over the years, European Antibiotic Awareness Day - marked annually in November together with the World Antibiotic Awareness Week organised by WHO - has developed into a platform of global reach, partnering up with many countries outside the EU as well as relevant stakeholders, in line with the Commission's "One-Health" approach to AMR.
The Commission will continue and scale up its fight against antimicrobial resistance (AMR), with the launch in 2017 of a second Action Plan (Roadmap). The new Action Plan will take the form of a Commission communication to the European Parliament and the Council. It will focus on supporting Member States, particularly in establishing, implementing and monitoring their National Action Plans, bringing together EU funds and instruments in order to promote innovation and research against AMR and strengthening its leading role in global fora, notably within the international organisations and with major trade partners.
The Commission's 2011 Action Plan against the rising threats from AMR contains 12 actions for implementation with EU Member States and identifies 7 areas where measures are most needed:
The evaluation of the Action Plan - published in October 2016 by the Commission (please find here the Executive Summary) - shows that this had a clear added value acting as a symbol of political commitment, stimulating several actions within Member States, and has served to strengthen international cooperation. The Action Plan has also provided a framework to guide and coordinate activities on AMR at international level in the area of monitoring and surveillance and on R&D. This factsheet summarizes the main points of this evaluation.
Furthermore, there is also an external report available regarding the Evaluation of the EC Action Plan against the rising threats from antimicrobial resistance (and appendices).
Prior to this evaluation a Progress Report on the AMR Action Plan (2011-2016) was published in February 2015 which showed the state of play of the steps taken to address this issue.
The Commission has also compiled a detailed overview of the 12 Actions covered by the Action Plan in a Road Map (updated on November 2016), including the operational objectives, the concrete activities and the deadlines.
The Commission aims to substantially reinforce existing good practices and support Member States in preventing the further spread of resistances and preserve the ability of antibiotics to combat microbial infections. Over the years, the EC has endorsed the following key initiatives:
One of the main activities on AMR performed at EU level is surveillance. The European Centre for Disease Prevention and Control (ECDC) coordinates and funds two networks of surveillance:
Furthermore, ECDC also publishes Eurosurveillance, a peer-reviewed scientific journal providing information on communicable diseases, to accelerate effective prevention and to promote international awareness across Europe.
The European Medicines Agency (EMA) is also a main player regarding monitoring and evaluating the AMR risks to human and animal health. In 2010, EMA presented the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) project that collects information on how antimicrobial medicines are used in animals across the EU. The latest annual ESVAC report was published in October 2016.
The European Food Safety Agency (EFSA) is also involved in the surveillance efforts across the EU. EFSA publishes yearly - since 2010 - specific summary reports on the occurrence of AMR in both zoonotic and indicator bacteria from food-producing animals and foodstuffs in the EU. Prepared in joint collaboration with ECDC since 2011, the summary reports have also addressed the resistance in zoonotic isolates from human cases since then.
In order to improve the surveillance systems on AMR, the Commission asked EFSA to revise the existing technical specifications on the monitoring of AMR and issue scientific reports, as it has been laid by the Commission Implementing Decision 2013/652/EU39 (which entered into force on 1 January 2014). The new legislation ensures harmonised monitoring systems in Europe, fosters comparability between the Member States and between the human and veterinary sectors and facilitates the monitoring of patterns of multi-drug resistance in the EU.
In September 2009, EMA published a joint report together with ECDC and the international network ReAct - Action on Antibiotic Resistance . This report highlights the gap between infections due to resistant bacteria and the development of new antibiotics.
Audits are another important part of the EU activity on tackling AMR. The DG Health and Food Safety has launched in September an audit series to verify the implementation of the legislation concerning the monitoring of AMR in certain animal species. The preparatory work for this series was carried out in close cooperation between the relevant units in Directorate General for Health and Food Safety (DG SANTE), the EURL (EU Reference Laboratory) and EFSA.
For example, the Commission allocated funds (by the European Parliament) for a preparatory action to promote the appropriate use of antimicrobials in human medicine: the ARNA project (Antimicrobial Resistance and causes of non-prudent use of antibiotics in human medicine).
Since 2005, the Executive Agency for Health and Consumers (CHAFEA) manages calls for proposals for projects and organises grants, conferences and relations with the beneficiaries of health programme funding.
Furthermore, within the scope of the Innovative Medicines Initiative (IMI) - a partnership between the EU (through the Commission) and the European pharmaceutical industry - funds are also being allocated to research on antimicrobial resistance.