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 2 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 (2018) on the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) was published on October 2020 by EMA. The report shows that European countries continue to reduce the use of antibiotics in animals. The overall sales of veterinary antibiotics in European countries dropped by more than 34% between 2011 and 2018.
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 European 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 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).
The latest joint reports by EFSA, EMA and ECDC are the following:
- October 2017 - these 3 agencies established a set of indicators to help EU countries assess their progress in reducing the use of antimicrobials.
- June 2021 - Third joint inter-agency report on integrated analysis of antimicrobial agent consumption and occurrence of antimicrobial resistance in bacteria from humans and food-producing animals in the EU/EEA (JIACRA III) presented new data on antibiotic consumption and antibiotic resistance, reflecting improved surveillance across Europe. The report confirms the link between antibiotic consumption and antibiotic resistance in both humans and food-producing animals.