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Brussels, 15 November 2013
European Antibiotic Awareness Day 2013: Key Facts on the Fight Against Antimicrobial Resistance in the EU
The European Antibiotic Awareness Day is an annual European health initiative that takes place on 18 November. Ahead of this event, the European Commission today published the 2013 Eurobarometer survey on antimicrobial resistance (AMR) and the European Centre for Disease Prevention and Control (ECDC) released the latest data on antibiotic resistance in the EU and European Economic Area.
What does the latest data reveal?
The 2013 Eurobarometer survey on AMR1 shows a modest positive evolution in EU citizens' use of and knowledge about antibiotics, since the last survey in 2009. For example:
However, EU-wide data on antibiotic resistance published today by ECDC paint a grimmer picture. It shows that resistance to the carbapenems, a last-line class of antibiotics to treat healthcare-associated infections, is increasing in Europe. A new serious concern is the emergence and spread of carbapenem-resistant Acinetobacter baumannii (CRAb), which is included for the first time in ECDC’s reporting. Results on CRAb show very large variations in Europe, with generally higher resistance percentages reported in southern Europe and lower percentages in the north of Europe. Infections with these multidrug-resistant bacteria are almost impossible to treat.
What is the Commission's current strategy on AMR?
The Commission takes a holistic approach to the problem, as set out in its 17 November 2011 Communication, or "Action Plan", on AMR. This five year plan sets out 12 key actions involving many different sectors: human medicine, veterinary medicine, research, animal husbandry, agriculture, trade and communication. It aims, over a period of five years, to substantially reinforce existing good practice and to introduce a new set of rigorous measures to prevent the further spread of resistance and preserve the ability to combat microbial infections. See IP/13/1359.
How is the Action Plan progressing?
The Roadmap on the implementation of the Action Plan gives a comprehensive and up-to-date record of the concrete activities and milestones for each of the actions. Progress has been made in all of the 12 actions outlined in the plan. Significant recent, and upcoming, achievements include:
Improved monitoring and surveillance: this week, the Commission adopted new legislation on the surveillance of AMR in animals and food, which will ensure harmonised monitoring systems in Europe. This is important for the comparability of data between Member States for both the human and veterinary sector.
Better use of antibiotics in animals and humans: Projects funded under the Health Programme address, for example, prudent use of antimicrobial agents in human medicine - particularly in children, and animal medicine, awareness of stakeholders – doctors, farmers, pharmacists and patients. Furthermore, the Commission is in the last phase of the revision of the legal tools for veterinary medicinal products and medicated feed which will address AMR in these areas. Early next year, recommendations on reducing the overall use of antimicrobials in veterinary medicine, will be adopted.
Preventing microbial infections and their spread: In May of this year, the Commission adopted a proposal for a single, comprehensive Regulation on animal health which focuses on the prevention of and fight against important communicable diseases. The aim is to give a more robust legal basis for the surveillance of animal pathogens of concern and to reduce the need for antibiotics by promoting better on-farm biosecurity overall. On the human health side, on-going projects and actions co-funded by the Health Programme support the implementation of the Council Recommendation on patient safety, including prevention and control of healthcare associated infections.
What about research?
Please see the separate MEMO (MEMO/13/996) dedicated to AMR-related research.
Why is the monitoring of AMR so important?
Reliable and comparable data are essential for evaluating the trends and sources of AMR, both for risk assessment and to be able to evaluate the effectiveness of the measures in place. The Commission works closely with the main relevant EU executive agencies (see below). Laws calling for the monitoring of zoonotic AMR (resistance transmissible between animals and humans), are in place. The recently adopted Commission Decision on the surveillance of AMR in animals and food provides a practical, legal tool to ensure harmonised monitoring systems in Europe.
What about international cooperation?
AMR is a worldwide public health threat and international cooperation in addressing this issue is vital. The European Commission and its agencies (EMA, EFSA and ECDC) are involved in international cooperation to address AMR, particularly with the United States via the trans-Atlantic taskforce on antimicrobial resistance (TATFAR). Instigated in 2009, the task force's objectives are to increase the mutual understanding activities and programmes relevant to AMR issues, to provide opportunities to learn from each other, and to promote information exchange, coordination and co-operation. A TATFAR progress report will be published early 2014.
The Commission is also working actively with international organisations in order to promote global awareness, e.g. by supporting the Organisation for Animal Health's conference on AMR. A first EU-China seminar on AMR was held in Beijing in March 2013. This was the first concrete action following the agreement on bilateral cooperation on AMR between China and the EU. Furthermore, AMR and healthcare associated infections are a topic in the on-going dialogue between the Commission and Russia on communicable diseases. The Commission is also strongly supporting the work of the World Health Organisation in this area.
What is the role of the EU agencies in the fight against AMR?
The European Centre for Disease Prevention and Control (ECDC) collects and analyses data on the occurrence and spread of AMR in EU/EEA countries, and publishes a report with the latest figures every November. In addition, since 1 July 2011, ECDC coordinates the European Surveillance of Antimicrobial Consumption Network (ESAC-Net) that collects and analyses data on human antibiotic consumption from EU/EEA countries, both in the community and in the hospital sector. Each year since 2008, ECDC coordinates the European Antibiotic Awareness Day (EAAD) on 18 November. More information on ECDC’s role in AMR can be found on ECDC’s website here and the EAAD website here.
The European Medicines Agency (EMA) works with its EU and international partners in a number of initiatives aiming to limit the development of antimicrobial resistance. It also monitors and evaluates the risks to human and animal health. The Agency plays a key role in the assessment of new antibiotics, because medicines with a significant therapeutic innovation or that are in the interest of public or animal health are authorised centrally in the EU. EMA's third ESVAC Report published last month, includes data on the sales of veterinary antimicrobials in 2011 in 25 European Union (EU)/European Economic Area (EEA) countries, and reveals that large differences in the sales and prescribing patterns are observed between Member States. As a next step, ESVAC is working on the collection of consumption data by species. More information on EMA’s role in AMR here.
The European Food Safety Authority (EFSA) provides independent scientific support and advice to risk managers on the risks to human and animal health related to the possible emergence, spread and transfer of antimicrobial resistance in the food chain and in animal populations. EFSA takes an integrated approach to its work on antimicrobial resistance involving a number of its Scientific Panels and Units as it is a concern for the entire food chain. In its work, EFSA cooperates closely with other relevant EU agencies such ECDC and EMA. More information on EFSA’s role in AMR here.
For Further Information:
Special Eurobarometer survey on Antimicrobial Resistance: