EUROPEAN COMMISSION
MEMO
Brussels, 16 November 2012
European Antibiotic Awareness Day 2012: Key Facts on
the Fight Against Antimicrobial Resistance (AMR)
The European Antibiotic Awareness Day is an annual European public health initiative that
takes place on 18 November. Ahead of this event, the European Centre for Disease
Control (ECDC) today released the latest data on antibiotic resistance and consumption in
the European Union and European Economic Area. In the past four years there has been a
significant increasing trend of combined resistance to multiple antibiotics in both Klebsiella
pneumoniae and E. coli in more than one-third of EU/EEA countries. Furthermore, the
ECDC data showed that consumption of carbapenems – a major last-line class of
antibiotics – increased significantly in EU/EEA countries from 2007 to 2010. Three
countries (Iceland, Latvia and United Kingdom) had growth in antibiotic consumption of
more than 5% between 2009 and 2010; while, during the same period, consumption fell
in three other countries (Austria, Lithuania and Poland).
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 on antimicrobial resistance (AMR). This action plan includes 12 key
actions involving many different sectors: human medicine, veterinary medicine, research,
animal husbandry, agriculture, environment, 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/11/1359.
What has already been achieved?
In the areas of human medicine and health, several EU-wide recommendations and
guidelines against AMR have been adopted in the past decade. For example, 26 countries
have implemented actions to prevent and control healthcare associated infections (HAI), in
most cases in the context of a national/regional strategy and/or action plan1. In the areas
of veterinary medicine and animal health, the Commission has adopted a Decision on
the prudent use of veterinary antimicrobials belonging to the class of 3rd and 4th
generation cephalosporins (considered as critically important by the WHO and the OIE). In
animal husbandry, a ban on the use of antimicrobials for growth promotion was introduced
in 2006. A reflection process on EU Guidance on prudent use of antimicrobials in
veterinary medicine in underway.
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Commission report on the implementation of the Council Recommendation (2009/C 151/01)
adopted in November 2012.
MEMO/12/868
What about research?
The European Commission has devoted some €1 billion into AMR-related research,
including drug projects. This includes three coordinated calls for project proposals with
strong emphasis on antimicrobial resistance2 published in July. They will result in new
investment of up to €147 million into research projects to use existing antimicrobials more
efficiently, to bring new antibiotics to patients, and to improve diagnostics to aid
prescription. In addition, the Innovative Medicines Initiative (IMI) - Europe's largest
public-private partnership to bring better medicines to patients – in June announced up to
€224 million in funding for projects to develop new antibiotics: €115 million via "in kind"
contributions from companies of the European Federation of Pharmaceutical Industries and
Associations (EFPIA), plus EU funding worth €109 million to bring other essential partners
- such as patient associations, universities, SMEs, hospitals and regulatory authorities –
into the research and development work. A new IMI call for proposals is due to be
published in the coming weeks with the aim of expanding this programme to include
additional clinical studies and the development of drugs against particularly dangerous
gram-negative infections. Lastly, the Commission is supporting Member States' efforts to
co-ordinate national research activities on AMR under the Joint Programming Initiative
"The Microbial Challenge – An Emerging Threat to Human Health" which has taken up
operations in early 2012. The final research agenda, expected to be ready in 2013, will be
the starting point for new joint projects and initiatives.
How is AMR monitored in the EU?
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) with a focus on monitoring the use of antimicrobials in animals, are in place.
At the request of the Commission, the European Food Safety Agency has published two
scientific opinions on how to improve and reinforce the EU surveillance systems on AMR in
animals and food. These opinions form the basis of an on-going discussion on a new
legislative framework for the EU monitoring of AMR.
What about international cooperation?
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 transAtlantic 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.
Under the specific work programmes "Health", "Knowledge Based Bio-Economy" and "Nanosciences,
Nanotechnologies, Materials and new Production Technologies"
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What is the role of the executive agencies in the fight against AMR?
The European Centre for Disease Prevention and Control (ECDC) collects and
analyses and collects 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 here and 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 second ESVAC Report published this year, includes
data on the consumption and sales of veterinary antimicrobials in 2010 in 19 Member
states, and reveals for example that there is a 30-fold difference between sales of
veterinary antimicrobial agents between the most and least-selling countries. In January
2012, the Agency updated its guidance to companies developing antibiotics, covering
how they should carry out studies to test these medicines' benefits and risks. 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:
Latest ECDC data:
http://www.ecdc.europa.eu/en/eaad/Pages/EAAD2012-multimedia-news-release.aspx
EU health policy:
http://ec.europa.eu/health/antimicrobial_resistance/policy/index_en.htm
EU health research policy:
http://ec.europa.eu/research/health/infectious-diseases/antimicrobial-drug-resistance/index_en.html
Innovative Medicines Initiative:
http://www.imi.europa.eu/sites/default/files/uploads/documents/Press%20Releases/IMIpressRelease6thCallFINAL.pdf
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