Antimicrobial Resistance in the EU/EEA - A One Health response

Publication

Joint report by ECDC, EFSA, EMA, and OECD on antimicrobial resistance in the EU/EEA and a One Health response. Antimicrobial resistance remains a serious challenge for everyone, a silent pandemic that calls for a One Health response in the EU/EEA.

Executive summary

Misuse of antibiotics is among the main drivers underpinning the development of antimicrobial resistance (AMR). Resistance to last-line antibiotics also compromises the effectiveness of life saving medical interventions such as intensive care, cancer treatment and organ transplantation. 

Overall consumption of antibiotics in humans in the European Union/European Economic Area (EU/EEA) decreased by 23% between 2011 and 2020, especially during the Coronavirus Disease 2019 (COVID-19) pandemic (between 2019 and 2020, the mean total consumption of antibiotics dropped by almost 18%). However, relative use of broad-spectrum antibiotics has increased and significant variability across countries suggests that reductions are still possible.

Efforts to reduce unnecessary use of antibiotics in food-producing animals have resulted in a 43% decrease in use between 2011 and 2020 in 25 countries with consistent reporting.

Despite reductions in antibiotic consumption in both humans and food-producing animals, AMR in bacteria from humans in the EU/EEA has increased for many antibiotic-bacterium combinations since 2011. Particularly worrisome is the rise in resistance to critically important antibiotics used to treat common healthcare-associated infections. 

While recent trends have been encouraging, resistance to commonly used antibiotics in bacteria from food-producing animals remains high (>20% to 50%) or very high (>50% to 70%), and there is significant regional variation across the EU/EEA region. 

Evidence that AMR can spread between animals, humans and the environment is mounting. Reducing the use of antibiotics in food-producing animals, replacing them where possible and rethinking the livestock production system in a One Health approach is essential for the future of animal and public health.

EU/EEA countries have made important strides in recent years in developing and implementing national action plans on AMR, but gaps remain. Analyses by the OECD suggest that top priorities for the EU/EEA include: 

  • Evaluation and monitoring of the implementation of national action plans.
  • Integrated and expanded surveillance of AMR in bacteria from humans, animals and the environment.
  • Investing in effective cost-saving interventions, such as antimicrobial stewardship programmes and infection prevention and control (IPC).

Plans for a new EU policy initiative to boost the implementation of the EU One Health Action Plan against AMR are a timely opportunity to:

  • Continue incentivising new vaccines, treatments (including new antibiotics) and tests while maximising access to existing resources such as antibiotics with low availability.
  • Target antibiotic consumption and AMR in long-term care facilities (LTCFs). A new OECD survey shows that very few countries have policies that specifically address AMR in LTCFs, with a majority of EU/EEA countries reporting they plan to include references to LTCFs in their next national action plan.
  • Establish a system to share and promote the implementation of best practices to tackle AMR.
  • Renew focus on international co-operation on surveillance and regulation, including with non-EU/EEA partners.

While available data suggests that there has been a reduction in antibiotic consumption in humans during the pandemic, AMR remains a serious challenge in the EU/EEA. AMR cannot be contained within borders or regions, underlining the need for concerted action throughout the EU/EEA.

Publication data