Thank you very much John. I would also like to take a moment to welcome all the participants here today. Particularly, we are delighted to see so many representatives from the European Parliament, the Commission and the Member States, including so many colleagues from the Permanent Representations.
We at the ECDC certainly agree that the growing resistance of microbes to commonly used antibiotics is a major threat to public health. Indeed, if you look at the diseases that people in Europe are dying from, drug resistant microbes, such as MRSA and Clostridium difficile – are among the top killers.
Drug resistance is a phenomenon that affects nearly all micro-organisms. You treat infectious diseases by using drugs to kill the microbes that cause them. When you do this, those variants of the microbe which are least susceptible to the drug will be the ones that survive and prosper. By a process of natural selection, drug resistance emerges.
Proper surveillance of antibiotic resistance and of antibiotic consumption is now available in the EU and the demands on effective surveillance systems are immense. However, surveillance is essential as recent data shows that both the number of infections due to resistant bacteria and antibiotic consumption are on the increase across Europe.
The bacterium that has received prime attention is methicillin-resistant hospital bacteria Staphylococcus aureus (MRSA), which has become a healthcare problem in most Member States.
The incidence of MRSA is going up almost everywhere. It is important to note however that two Member States have been able to successfully reverse this trend. We will hear a speaker from one of those countries in a few minutes.
Every year approximately three million people in the European Union catch a healthcare-associated infection. That means that one patient out of every 10 that is treated in an EU hospital acquires such an infection. As a result, 50,000 of these patients will die.
Infections with resistant bacteria are a huge and rapidly growing problem not only in our hospitals, but also in more everyday settings in the community.
Drug resistance is a major concern when it comes to global killer diseases such as TB, Malaria, HIV and pneumococcal infections. The emergence of TB strains resistant to the two most effective agents against the infection, as well as to second line antibiotics, poses a serious challenge to TB control today. Multi-drug resistant TB was present in 15-20% of cases reported in the Baltic States in 2005.
The situation is variable across Europe
Resistance levels are not even across the European Union. AMR reflects the diversity of Europe! For bacteria other than tuberculosis, the problem of resistance is generally much greater in southern Europe than in the north. It has also been shown that the amount of antibiotic consumed per inhabitant varies three-fold between Member States. There is a direct correlation between the amount of antibiotics consumed and the incidence of antibiotic resistant microbes.
The variations in antibiotic use are due to differences in attitude to use of antibiotics which may have a number of causes: it may be due to a difference in political grasp of the problem; it may be differences in cultural perceptions about the relative benefits and harms of antibiotic use; it may be related to differences in national income and health systems, which allow some countries to deal with these problems more easily than others.
Success stories – national campaigns
The strategy for containment of antibiotic resistance should be simple: use antibiotics less often; use them in the correct way; and block the spread of resistant strains between persons.
However, despite considerable focus on the issue by national, EU-level and international bodies over recent years, antibiotic resistance is still not being tackled effectively across Europe.
I am glad to tell you that there are some rays of hope! Research published last week in ECDC’s scientific journal Eurosurveillance shows that antibiotic use is actually declining in seven Member States (1). This seems largely to be due to national awareness campaigns on rational antibiotic use and other such measures. You will hear from two of the successful countries in a minute.
Launch of European Antibiotic Day
ECDC believes it is necessary to increase public awareness about antibiotic resistance throughout the EU. We need to build on existing success stories such as France, Belgium and Slovenia. It is important that people understand when they should use antibiotics and when it is not appropriate.
That is why, inspired by what is happening at national level, ECDC is proposing to launch a first European Antibiotic Day in Autumn 2008. This day will be an opportunity for public health authorities in all Member States to raise awareness with the public and the media about the issue of rational antibiotic use. Though the main focus would be on national level events, ECDC would also want to see an EU level event. This should involve some or all of the partners in this room today. The EU Institutions have shown leadership on this issue in recent years, and it is important for this progress to continue in the years ahead.
In conclusion, today we are seeking your support for the launch of the European Antibiotic Day in 2008. I look forward to discussing it further with you in a few moments.
(1) Belgium, Czech Republic, France, Netherlands, Slovakia, Slovenia, Sweden