Today, one in five bacterial infections in Europe is caused by a pathogen that is resistant to antibiotics
Photo: iStock Antimicrobial resistance (AMR) causes more than 35,000 deaths and costs European Union (EU) / European Economic Area countries around €11.6 billion ($12.66 billion) each year. The AMR health crisis can no longer be called a silent pandemic. It is a very real and present threat throughout the globe. We need to act right away.
This is why fighting AMR with a One Health approach is a firm priority of the European Commission and the EU Member States now more than ever. The good news is that we don’t need miracles to change things.
The World Antimicrobial Resistance Awareness Week takes place from November 18-24 every year.
New data released by the Organization for Economic Cooperation and Development (OECD) showed that every European country needs to spend just €3.4 per capita every year on a mix of hospital and community-based AMR interventions. This could prevent more than 10,000 deaths, avoid over 600,000 new infections and save more than €2.5 billion for their health systems. Every Euro invested in prevention would bring nearly €3 in economic benefits. At the OECD level, this ratio goes up to 1 to 5.
Today, one in five bacterial infections in Europe is caused by a pathogen that is resistant to antibiotics. In about 10 years, nine out of 10 of hospital-acquired bacterial infections will be multi-resistant, if nothing is done. By 2035, it might be more dangerous to go to a hospital than to get treatment at home if we do not tackle AMR as a matter of urgency.
Events like European Antibiotic Awareness Day and World AMR Awareness Week certainly have their impact. But, unfortunately, these are not enough to reach the general public. Today 40 per cent of Europeans still think that antibiotics kill viruses.
For this reason, we must urgently raise awareness of AMR in Europe and across the world. Clinicians, healthcare professionals, veterinarians, and farmers must speak out about it because they are on the front lines of tackling it. AMR champions, such as public figures and celebrities who advocate for the fight against it, should also bring this to the public's attention. At the same time, we must also work to address misinformation and misconceptions about AMR.
Effective policy measures — human, animal and environmental — are needed to respond to the AMR challenge in the EU and globally. In June this year, EU health ministers agreed on an ambitious plan to step up actions to combat AMR through a One Health approach.
They agreed on several targets to be achieved by 2030. Most significantly, we are working to reduce the total consumption of antibiotics in humans by 20 per cent in the EU by 2030, compared to 2019. Such targets allow us to monitor and compare progress across EU countries and to adjust and intensify measures if necessary.
The EU also has clear goals to reduce the sales of antimicrobials for farmed animals and aquaculture by 50 per cent. Here, the European Union is making good progress. The 13th European Surveillance of Veterinary Antimicrobial Consumption report showed that by 2022, EU countries were over halfway to reaching this target. In addition, sales of antimicrobials for farmed animals and aquaculture fell by over 28 per cent in 2022.
However, targets alone are not enough. The EU is also undertaking a range of other actions, including enhanced monitoring and surveillance, better prevention and control measures, boosting research and development and incentives for innovation.
The European Commission’s proposal to revise the EU’s pharmaceutical legislation also puts forward specific solutions to stimulate the development of novel antibiotics, ensure access to existing ones and improve the prudent use of all antimicrobials.
On the veterinary side, in addition to the target, EU legislation also bans the use of antibiotics for prophylactic purposes or as growth promotors in certain farmed animals. The European Commission organises hands-on training sessions for farmers and veterinarians to raise awareness on the measures to fight AMR and we provide direct grants to EU countries to help them improve their data collection and reporting on veterinary antimicrobials.
On the environmental side, last year the European Commission proposed to strengthen environmental monitoring of AMR in ground and surface waters. Our pharmaceutical reform will extend the environmental risk assessment of medicines to cover antibiotic manufacturing.
Last but not least, the European Commission provides considerable financial support under EU funding programmes. For example, the EU is investing €50 million to support a new Joint Action on AMR early next year to help all EU countries tackle it through a One Health approach. This is in addition to €22 million to bring AMR countermeasures to the market and support Member States in their procurement.
Since AMR does not recognise national borders, we clearly need a global vision and response for it. This is what the European Commission is striving for in all international fora, as outlined in the EU Global Health Strategy. The European Commission is leading discussions at the G7 and G20, pushing for a global health agenda based on a One Health approach with AMR at its core. This is also at the heart of the EU’s position in the ongoing negotiations for the World Health Organization’s pandemic agreement.
In parallel, the Commission provides significant funding to low- and middle-income countries to support their AMR agendas, for example through projects on antimicrobial stewardship in hospitals in Sub-Saharan African countries and by supporting surveillance programmes and technology. The EU also cooperates with these countries on food safety and animal health, given that 10 per cent of the world’s population still eats food that was produced with contaminated water.
A major challenge for 2024 will be to make the upcoming United Nations high-level meeting on AMR action-oriented and not simply declaratory. AMR is a global problem that needs global solutions. It is only by acting together in a One Health approach that we will curb its tide.
Kris De Smet is Head of team at SANCO (European Commission), Belgium
Views expressed are the author’s own and don’t necessarily reflect those of Down To Earth
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