01.08.2018 | Brussels Background The fight against AMR- A tale of missed chances?

There is one thing everyone can agree on: AMR is a tricky killer to tens and thousands every year all over the globe. AMR is also a health threat that does not stop at borders. To tackle and overcome this threat, effective and bold strategies are needed – but what is the right one and where do we stand?

Throughout the European Union, approximately 25.000 people die of the consequences of antimicrobial resistances – better known as AMR. By 2050 AMR might cause even more deaths than cancer , if the current trend continues according to recent studies. And although AMR seems to be on everyone’s radar in the health care community, many initiatives have been launched and national governments get involved across the globe, things only move forward slowly. It might be one of the rare topics that really everyone agrees on but still there is not much progress. Are the initiatives to vague, is there too much talk and too little action? 

In the past, there were a lot of isolated measures to tackle the issue until it became obvious that a more holistic approach was needed. Seventeen years ago, the European Commission launched its first initiative to raise awareness on AMR, the so-called “Community Strategy” which was then followed-up by a more structured approach, the 2011 “Action plan against the rising threats from Antimicrobial Resistance”. After a thorough analysis of this initiative’s flaws and short-comings, the Commission knew it had to do more. Yet again, the latest edition of the action plan launched by the Commission does not seem to be bold enough, or at least that is the opinion of the European Parliament and especially the lead committee on health issues, the ENVI Committee. In its “Initiative Report on a European One Health Action Plan against Antimicrobial Resistance (AMR)”, Rapporteur Karin Kadenbach and her fellow committee members criticised harshly the action plan. They urged the Commission to actually implement mandatory structures e.g. mandatory monitoring routines in all Member States. The committee wants: Less words, more action. Further to this the Committee’s report emphasised the importance of the “One Health Approach”. According to this approach, human and veterinary medicines and treatment have to be seen in conjunction, and unilateral measures won’t be successful. And it’s a no-brainer: promoting prudent use of antibiotics in human therapy, but then accepting overuse in the livestock sector cannot be the key. Looking at the aftermath of the Veterinary Regulation package that was finalised this year, this was also outlined by all parties involved. However, it was the same problem: they could have gone a step further with regards to the use of antibiotics. 

As usual when it comes to health and legislative measures, it gets complicated in Brussels. Certainly, some measures may be supported by EU law, others, however, need to reflect the specific situations in the Member States.  

A lot of Member States have already strategies in place which are also in line with the Commission’s approach. Germany, for example, launched its DART 2020 strategy in 2015. This strategy is very in line with the Commission’s action plan and also puts a strong emphasis on the “One Health Approach”, research, monitoring and public awareness campaigns. In its third report which was published in 2018 by the Federal Government, the outlook was optimistic. However, there was also a strong emphasis on the need for European and global cooperation to successfully tackle the issues at hand. Not only politics play a role in the fight against AMR, but also the industry has and should have a say. The quest for new antibiotics needs to be strengthened and alternatives should be explored. The pharmaceutical industry in Germany  and Europe widestrongly supports and acknowledges the need for action and there would be several ways to achieve this from the Industry’s perspective. A more prudent use of antibiotics is also promoted as well as the demand for better research conditions. In order to develop new antibiotics, a good economic foundation is needed as well as reasonable incentives. Moreover, the use of complementary therapies, such as phytopharmaceuticals, homeopathic and anthroposophical medicinal products should be encouraged and promoted as well, as they are a qualified contribution to reduce the use of antibiotics in human and veterinary use.

Assuming that no one wants to be thrown back to times where a simple operation was highly risky, all stakeholders involved need to step up their game. Less talk and more action is the only way to avoid the gloomy forecast for our health systems and human beings if AMR.