Coping with antimicrobial resistance

The European Union and the private sector are increasing efforts to tackle antimicrobial resistance (AMR), but greater scale and coordination are needed to fight a problem that is global in nature.

That was the conclusion of experts speaking at “Coping with Antimicrobial Resistance,” a Friends of Europe Café Crossfire event on 23 January. Some 50,000 people die every year in the EU and the United States from antimicrobial resistant infections, a figure that could rise to 10 million by 2050 if the problem is not properly addressed. AMR results in large part from overuse of antibiotics, which leads some bacteria to develop resistance, rendering the antibiotics ineffective. The EU has coordinated efforts to curb misuse of antibiotics, but in 2015 resistance to last-line antibiotics continued to increase.

“We should be very worried,” said Francesca Colombo, Head of the OECD Health Division. “We are probably not tackling these things as a planet. Resistant bacteria double the probability of dying and death,” compared to non-resistant forms, she said.

One contribution would be a greater focus on measures such as sanitation and basic healthcare. Better diagnosis of illnesses would mean fewer cases where antibiotics are prescribed even though they will not actually benefit the patient. “We can use appropriate diagnosis and stop infections to limit antibiotic treatment,” said Jean Lang, Associate Vice President at Sanofi Pasteur Research & Development. “We have to consider holistically what the appropriate measures are.”

A large part of the problem comes from giving antibiotics to farm animals, said Charles Price, Head of AMR at the Unit for Crisis management and preparedness in health in the European Commission Directorate-General for Health and Food Safety. “Fifty per cent of antibiotic use is inappropriate,” he said. “In animals the figures are even higher. The result is increasing levels of multi-resistant infection.” However, the EU has made some progress, he said. “We are not starting from square one. We have been struggling with this for 20 years, and some member states have been successful at cutting inappropriate antibiotic use.”

The European Commission issued an AMR action plan in 2017, in which it said it would provide incentives to increase the uptake of diagnostics, antimicrobial alternatives and vaccines. It also said it would analyse EU regulatory tools and incentives to use them for novel antimicrobials and innovative alternative products that do not currently generate sufficient returns on investment.

Public health measures should include battling against anti-vaccination campaigns, some of which claim that vaccinating children can lead to medical complications. The result of these campaigns can be a spread of bacterial infections that are then treated with antibiotics. “We have to tackle campaigns against vaccination,” said Cristian-Silviu Busoi, Member of the European Parliament Committee on Industry, Research and Energy. “We need to explain to citizens that they are false. And we need a multi-sectorial approach and new vaccines.”