The global problem of Antimicrobial Resistance (AMR) demands the continuous attention of the public health community beyond the annual focus of the European Antibiotic Awareness Day (marked annually on 18 November). EPHA is committed to raising awareness of AMR-related concerns, including the reduction of antibiotics use, to ensure that people living in Europe can continue to benefit from life-saving antibiotics. Moreover, it is important to promote policy coherence, as well as effective, coordinated and transparent communication about Antimicrobial Resistance (AMR).
As a long-standing supporter of the annual European Antibiotic Awareness Day (EAAD) organised by the European Centre for Disease Prevention and Control (ECDC) and taking place simultaneously in Brussels and in the Member States, it goes without saying that EPHA endorses all the key EAAD messages pertaining to prudent use of antibiotics and hygiene. However, the EAAD does not take place in a vacuum, and it is important to maintain the discussion over AMR throughout the year.
In light of this, the present article will be updated throughout 2014 in line with ongoing developments of relevance to AMR.
WHO Global Action Plan on AMR
Faced with growing global concern over microbial resistance to antibiotic treatments, the annual World Health Assembly adopted a resolution in May for the WHO to establish a global action plan on AMR. It calls for multisectoral collaboration between the WHO, the UN Food and Agriculture Organization and the World Organization for Animal Health in the developing the action plan.
Moreover, the resolution contains a list of actions for WHO member states, including, inter alia:
Low-to middle-income countries underlined the need to take their particular condition into account, and that new medicines developed should be accessible.
A summary of the declaration issued by the Antibiotic Resistance Coalition, a civil society coalition including Health Action International and the Save our Antibiotics Alliance, was also presented at the WHA.
Transatlantic Taskforce progress report
In May, the European Commission and the US Department of Health and Human Services (HHS) published a progress report on the Transatlantic Taskforce on AMR (TATFAR), which was created following the 2009 EU-US Presidential Summit. The report renews their commitment to pursue specific goals in their joint battle against AMR. Notable outcomes of TATFAR activities for the reporting period include:
TATFAR aims to improve collaboration in three key areas:1) appropriate therapeutic use of antimicrobial drugs in medical and veterinary communities, 2) prevention of healthcare and community-associated drug-resistant infections, and 3) strategies for improving the pipeline of new antimicrobial drugs.
Although significant progress in reducing specific types of infections has been made, the global problem continues to grow. Therefore, TATFAR’s original mandate has recently been extended to at least 2015. It originally identified and adopted 17 recommendations for collaboration to achieve best results in the prevention and control of AMR.
On 7 April, an event at the International Auditorium in Brussels entitled ’Ensuring Health & Sustainability in Europe: Doctors and Veterinarians emphasize prevention is better than cure’, organised by the Federation of Veterinarians of Europe (FVE) in collaboration with the Standing Committee of European Doctors (CPME) and supported by the Greek Presidency brought together the medical and veterinary community to highlight the importance of following a ’One Health’ approach. The event had a particular emphasis on zoonotic diseases and the presentations and agenda are available on the FVE website.
Joint Report EFSA & ECDC
The most recent Joint Summary Report by the European Food Safety Authority (EFSA) and the ECDC released on 25 March 2014 (analysing 2012 data) states that bacteria most frequently causing food-borne infections, such as salmonella and campylobacter, show significant resistance to common antimicrobials. AMR in humans, animals and food remains commonly detected, which is a big concern. However, combined resistance (co-resistance) to critically important antimicrobials is low. Treatment options for serious infections with zoonotic bacteria are available in most cases.
Moreover, an event organised in the European Parliament on 1 April by the Interest Group on Complementary and Alternative Medicine (CAM) - hosted by MEPs Aloiz Peterle (EPP, Slovenia) and Sirpa Pietikainen (EPP, Finland) - served to highlight the potential contributions CAM can make to reduce the overuse of antibiotics in both humans and animals. The session offered a forum for speakers from the CAM professional community and researchers to present findings regarding the development of novel antimicrobial therapies that are not susceptible to developing microbial resistance.
This event also included a presentation by Herta Adam, Deputy Head of Unit, Health Threats, DG SANCO on the state of play of the European Commission’s Action Plan to combat AMR (activities in the human sector), as well as presentations on the use of herbal medicines and homeopathy and an overview of the integrative approach taken in anthroposophic hospitals in Germany and Switzerland, where traditional medicine and CAM co-exist. More information is available here.
AMR: What is it?
As described in the EPHA Briefing on AMR, antimicrobials (including antibiotics) are substances used to kill micro-organisms or to stop them from growing and multiplying. They are commonly used in human and veterinary medicine to treat a wide variety of infectious diseases.
AMR refers to the ability of micro-organisms to withstand antimicrobial treatments, for example due to the overuse or misuse of antibiotics. This is creating and spreading micro-organisms which are resistant to them, rendering treatment ineffective and posing a serious risk to public health. As noted on the EFSA website, a well known example of a bacterium that has acquired resistance to multiple antibiotics is Meticillin-resistant Staphylococcus aureus (MRSA).
If bacteria become clinically resistant to several antimicrobials (multidrug-resistant), treating the infections they cause can become more difficult or even impossible. In addition, the development of AMR in zoonotic bacteria (present in animals and food) can also compromise the effective treatment of human infections if AMR is transmitted via the food chain.
Find out more: