Three EU agencies have announced they will work together in the hopes of better understanding one of today's most pressing global healthcare issues: Antimicrobial resistance (AMR).
Global and Historical Context
Resistance to antimicrobials is not a new phenomenon. Scientists have observed AMR as far back as the late 1930s, following the discovery and mass use of sulfanilamide. Alexander Fleming, the scientist who discovered penicillin, warned of the risk of AMR in his 1945 Nobel lecture.
In April 2014, the World Health Organization (WHO) published its Antimicrobial Resistance: global report on surveillance. The findings of the report are frightening: WHO says the rise of AMR is “so serious that it threatens the achievements of modern medicine.” One of the reasons the threat is so great is it has coincided with a significant decline in antibiotic development in recent decades.
The danger of AMR, combined with the development of fewer antibiotics, is seen clearly in the case of gonorrhea. According to WHO, 36 countries have reported cases of multidrug-resistant gonorrhea; in which even last-resort treatments were ineffective.
The Joint Report
The European Medicines Agency (EMA), European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) have now released the first of several planned reports to the European Commission (EC). The report, issued 30 January 2015 uses data from 2011 and 2012 to investigate the “possible relationships between the consumption of antimicrobial agents and the occurrence of [AMR] in humans and food-producing animals.”
To conduct the study, researchers gathered data from existing surveillance systems in all EU member states, as well as Iceland, Norway, Croatia and Switzerland. Analysis of the data showed an association “between antimicrobial consumption in food producing animals and the occurrence of resistance in bacteria … for most of the combinations investigated.”
The study also identified large variations in the consumption (measured in mg/kg) of antimicrobials in food producing animals relative to the amount consumed by humans among the countries reporting. Most countries used antimicrobials in food-producing animals less than in humans; however, in eight of the 26 countries reporting, antimicrobial consumption was found to be higher for food-producing animals than for humans.
The report recommends a number of actions that should be followed to improve the data gathered on AMR and argues the “need to promote responsible use of antimicrobials in both humans and animals.”
EU’s Action Plan
In 2011, the EC released its Action plan against the rising threats from Antimicrobial Resistance, detailing the commission’s plan to mitigate the threat of AMR. The EC plan consists of 12 key actions aimed at:
- “Mitigating the risk of developing AMR in humans from the use of antimicrobials both in humans and animals by effectively ensuring across the EU their appropriate use, and promoting microbiological diagnosis as the means to determine, to the extent possible, the need for antimicrobials.”
- “Putting in place effective ways to prevent microbial infections and their spread.”
- “Developing effective antimicrobials or alternatives for treatment of human and animal infections.”
- “Joining forces with international partners to contain the risks of spreading AMR from international trade and travel and via the environment.”
- “Reinforcing research to develop the scientific basis and innovative means to combat AMR.”
The joint report is a direct result of actions 9 and 10 of the action plan, which aim to “strengthen surveillance systems on AMR and antimicrobial consumption” in humans and animals.
ECDC/EFSA/EMA Joint Report