EC/ECDC/EFSA Country visit to North Macedonia to advance One Health responses against antimicrobial resistance
Antimicrobial resistance represents a serious threat to people’s health and to economies around the world. Recent estimates of the burden of AMR in the World Health Organization (WHO) European region indicated that, in 2019 alone, nearly 700 000 deaths were associated with or attributed to bacterial AMR. A study estimated that between 2016 and 2020 in the European Union and European Economic Area (EU/EEA), 70% of antibiotic-resistant bacterial infections were healthcare-associated infections (HAIs), and the number of deaths ranged from 30 730 in 2016 to 38 710 in 2019. With the current increasing trends of AMR, it also has significant costs, especially for healthcare systems, which could cost the world economy up to 100 trillion USD by 2050 .
In line with the Global Action Plan on AMR, adopted in May 2015 by the World Health Assembly and subsequently by the World Organisation for Animal Health and the Food and Agriculture Organization, the European Commission published its own EU One Health Action Plan against AMR in 2017. The key objectives of this
plan are built on three main pillars:
- making the EU a best-practice region;
- boosting research, development and innovation;
- shaping the global agenda.
As part of this agenda, and more specifically the third pillar, the EC commits to supporting candidate countries for accession to the EU in aligning and implementing the EU legislation on AMR.
One of the five strategic objectives of the ECDC Strategy 2021-2027 is dedicated to increasing health security in the EU through international collaboration and alignment regarding infectious disease policies and practice by strengthened cooperation and coordination between ECDC and partners in non-EU countries, especially EU enlargement countries. On 10 December 2019, the EU Contribution Agreement No 2019/409-781 was signed between ECDC and the European Commission and amended on 23 December 2020 to implement the ECDC Action ‘Preparatory measures for the participation of the Western Balkans and Türkiye in the ECDC with special focus on One-Health against AMR and enhanced severe acute respiratory infections surveillance, 2020 – 2024’ (ECDC-IPA6 project) with external financial assistance under the Instrument of Pre-accession Assistance (IPA).
The Joint ECDC and EFSA regional workshop on the One Health approach against AMR for EU pre-accession countries, held in 2019 in Belgrade, Serbia, recognised an urgent need to boost the advancement of AMR responses and to attain a certain level of implementation of related EU legislation in the region. National
governments need to put in place regulatory requirements, necessary laboratory infrastructure and techniques, efficient comprehensive and interoperable electronic surveillance systems, training, additional human workforce in the human and animal health fields, as well as awareness raising and commitment to ensure sustainability of efforts.
Work Stream 2 of the ECDC-IPA6 project focuses on the advancement of a One Health approach against AMR in the Western Balkans. It includes One Health country visits to discuss AMR issues, identify gaps and support the development of roadmaps on AMR in different sectors: human health, animal health, food safety and the environment. In addition, to align with previous One Health country visits on AMR organised in the EU/EEA countries, the visits to countries under pre-accession assistance include experts from ECDC, the Directorate- General for Heath and Food Safety and EFSA. The experts cover areas relevant for AMR surveillance, IPC and
antimicrobial use under a One Health perspective.
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