By Melina Raso and Antonia Albrecht
“Antimicrobial resistance is a global growing threat, and if we do not step up our action and commitment now, by 2050 it could cause more deaths than cancer”
Vytenis Andriukaitis, European Commissioner for Health and Food Safety
In the aftermath of the riots alongside the G20 Summit in Hamburg, the G20 agenda topics received comparatively low media attention. Even though it was the first time that health topics found their way onto the agenda, the fight against antimicrobial resistances (AMRs) got side-lined, although the topic contains just as much socio-political dynamite. Not only is AMR a serious threat to public health worldwide, but also a global economic and societal challenge.
As a matter of fact, antibiotics’ efficacy is increasingly reduced because of excessive and inappropriate use of antibiotics on humans and animals. At the same time, the research pipeline for new antibiotics is almost dry. Without effective antibiotics, the treatment of antibiotic-resistant bacteria will require more intensive care with more expensive medicines. In the EU alone it is estimated that AMRs annually cost EUR 1.5 billion in healthcare costs and productivity losses. The World Bank warns that, by 2050, drug-resistant infections could cause global economic damage on a par with the 2008 financial crisis. Without effective antibiotics, we would return to the “pre-antibiotic era” when organ transplants, chemotherapy, intensive care and other medical procedures would no longer be possible. Time is pressing and a global and multi-sector joint effort to fight AMR is urgently required.
The One Health approach of the European Commission
On 29 June 2017 the European Commission adopted the new Action Plan, embracing the One Health approach – a collaborative effort at global, national and regional levels, involving different actors and sectors, such as human and veterinary medicine, agriculture, finance, environment and consumers. The action plan is based on three main pillars:
- Making the EU a best-practice region,
- Boosting research, development and innovation,
- Shaping the global agenda.
The plan sets out 75 ambitious actions to eliminate antibiotic misuse and prevent infection outbreak. Nevertheless, success is based on joint effort and target-driven approaches, which raises a few questions: Are countries willing to implement national action plans? Can progress be measured? How will the proposed 75 actions be funded?
Diseases don’t respect borders
Finding answers to these questions is not easy. It is common sense that infectious diseases do not respect borders and that Member States cannot succeed in the fight against AMR if they work in isolation. Despite the critical role of the EU in supporting its Member States, the countries themselves are responsible for the adoption and implementation of sound AMR action strategies. By the end of 2016, only 13 out of 27 EU Member States implemented national action plans. Germany has therefore taken one of the leading roles in pushing the topic on the international political agenda and citizens hope that G20 leaders will keep their intention to implement national action plans by the end of 2018.
To measure progress and success of any kind of initiative, a target-driven approach is essential. Key outcome indicators will be formulated to help the Member States assessing their progress by the European Commission and EU Agencies, but Member States are not obliged to share data or implement accurate monitoring programmes. It will be necessary to ensure the greatest national participation on each action adopted under the plan.
In this context, we call on the European Commission to step up and have a tangible impact on shaping the global agenda on AMR – by identifying key performance indicators, setting clear targets, engaging Member States to achieve reduction targets and mobilising funding for research and innovation to tackle this public health emergency. At the same time EU Member States need to work together to protect public health for this cross border emergency. AMR is estimated to be responsible for 25,000 deaths per year in the EU alone. The time to act is now.