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EU Action on Antimicrobial Resistance

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Antimicrobial resistance (AMR) – the ability of microorganisms to resist antimicrobial treatments, especially antibiotics – has a direct impact on human and animal health and carries a heavy economic burden due to higher costs of treatments and reduced productivity caused by sickness. AMR is responsible for an estimated 33,000 deaths per year in the EU. It is also estimated that AMR costs the EU EUR 1.5 billion per year in healthcare costs and productivity losses.

The EU Action Plan against Antimicrobial Resistance

EU One Health Action Plan against AMR

In June 2017 the Commission adopted the EU One Health Action Plan against AMR, as requested by the Member States in the Council conclusions of 17 June 2016. It builds on the 2011 action plan (see below), its evaluation, the feedback received on a European Commission Roadmap on AMR and an open public consultation.

The key objectives of this new plan are built on three main pillars:

  1. Making the EU a best practice region

  2. Boosting research, development and innovation

  3. Shaping the global agenda

The Commission has also adopted the first deliverables of the plan, for example the EU Guidelines on the prudent use of antimicrobials in human health (all languages available). The guidelines aim to reduce inappropriate use and promote prudent use of antimicrobials in people. They target all actors who are responsible for or play a role in antimicrobial use.

The European Commission issues twice a year a progress report as regards the 2017 “EU AMR Action Plan”:

EU AMR One-Health Network

The EU AMR One-Health Network, chaired by the European Commission, includes government experts from the human health and animal health, the EU scientific agencies (ECDC, EMA, and EFSA) and Commission experts. The bi-annual EU AMR One-Health Network meetings provide members with a platform to present national action plans and strategies and keep each other up to date on their progress, to share best practices, and to discuss policy options and how to enhance cooperation and coordination.

A dedicated privacy statement providing information about the processing and the protection of personal data applies to the meetings of the AMR One Health Network.

Previous Commission's Action Plan (2011-2016)

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:

  • making sure antimicrobials are used appropriately in both humans and animals
  • preventing microbial infections and their spread
  • developing new effective antimicrobials or alternatives for treatment
  • cooperating with international partners to contain the risks of AMR
  • improving monitoring and surveillance in human and animal medicine
  • promoting research and innovation
  • improving communication, education and training

The evaluation of the Action Plan - published in October 2016 by the Commission (please find here the Executive Summary and the contributions received during the public consultation) - 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 summarises 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.

National action plans and strategies

In May 2015, the Sixty-eighth World Health Assembly adopted the global action plan on antimicrobial resistance. The World Health Assembly called all Member States of the World Health Organization to put in place by mid-2017 national action plans against AMR that are aligned with the objectives of the global action plan.

The Council conclusions adopted in June 2016 under the Dutch Presidency of the Council of the European Union reiterated the importance that Member States put in place national action plans against AMR, based on the One Health approach i.e. encompassing human health, animal health and the environment.

The available national action plans and strategies developed at national level in EU countries, Iceland, Norway, Switzerland and United Kingdom can be found here.

Raising awareness: communication resources

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:

  • Better prescribing practices (including prescribing antibiotics only when required)
  • Stop self-medication in countries in which antimicrobial medicines are freely available
  • Respect the dosages
  • Stop the overuse and misuse of antimicrobial medicines in agriculture and the veterinary field

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.

Surveillance and Audits

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:

  • EARS-Net: European Antimicrobial Resistance Surveillance Network
  • ESAC-Net: European Surveillance of Antimicrobial Consumption (includes data on antimicrobial consumption in human medicine in Member States between 1997-2012)

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 and information gathering activities are another important part of EU's work on tackling AMR. The Commission carries out regular audits to verify the execution of the mandatory monitoring of AMR in animals. The Commission also performs fact-finding missions on the prudent use of antibiotics in animals and carries out country visits on One Health aspects concerning AMR (jointly with ECDC). Analysis of the policies and measures to address AMR in non-EU countries is yet another activity executed by the Commission.

The outcomes of these actions are available at the overview reports and at the individual reports for the countries concerned. (NB: to facilitate the identification of the relevant overview and individual reports, we recommend inserting the term ‘AMR’ when using the Search engine).