Superbugs: MEPs advocate further measures to curb use of antimicrobials

Antibiotic Resistance Health 2018

Causes of antibiotic resistance
Image credit: World Health Organisation

This article is brought to you in association with the European Parliament.

The growing threat posed by antibiotic-resistant bacteria can be tackled through a “One Health” approach, MEPs said on Wednesday.

In their resolution Health Committee MEPs stress that the correct and prudent use of antimicrobials is essential to limiting the emergence of antimicrobial resistance (AMR) in human healthcare, animal husbandry and aquaculture. However, considerable differences remain in the way member states handle the issue, they say.

The “One Health” principle highlights that  the health of people, animals and the environment are interconnected and that diseases are transmitted from people to animals and vice-versa. Therefore, diseases have to be tackled in both people and animals, while also taking into special consideration the food chain and the environment, which can be another source of resistant microorganisms, say MEPs.

MEPs call on the Commission and member states to restrict the sale of antibiotics by human and animal health professionals, and to remove any incentives for prescribing them. Firm action should be taken against illegal sales, and sales without prescription of antimicrobials in the EU. They call on the Commission to consider mandatory routine collection and submission of monitoring data at EU level and to establish indicators to measure progress.

The European Commission should draft an EU priority pathogen list for both humans and animals, clearly setting the future R&D priorities. Incentives should be created to stimulate investment in new substances.

Preventive measures, such as good hygiene, should be scaled up in order to reduce the human demand for antibiotics. The Commission and member states should promote “health literacy” and raise awareness of the perils of self-medication and over-prescription, say MEPs.

Incentives for rapid diagnostic tests

As health professionals often need to make quick decisions, MEPs note that rapid diagnostic tests (RDT) could help reduce the use of antimicrobials. However, as RDT costs may, at the moment, exceed the price of antibiotics, industry should be given incentives to make them inexpensive and more widely available, say MEPs.

Labels referring to antibiotic use would also enable consumers to make informed choices, and the Commission should create a single system for labelling based on animal welfare standards and good animal husbandry practices, say MEPs.

Legislation on veterinary medicines

Health MEPs also backed the agreement reached with EU ministers on plans to curb the use of antibiotics on farms, so as to keep resistant bacteria out of human foods.

The law would limit the preventive and collective use of antimicrobials in animal husbandry, and empower the European Commission to draw a list of antibiotics reserved for human use.

The agreement with Council also imposes the reciprocity of EU standards in the use of antibiotics in imported foodstuffs.

Quotes

““If nothing is done, antimicrobial resistance might cause more deaths than cancer by 2050. We have to start by looking at the whole cycle, because the health of people and animals is interconnected. Diseases are transmitted from people to animals and vice versa, and that is why we support the holistic approach of the ‘One Health’ initiative” said rapporteur on the “One Health” action plan, Karin Kadenbach (S&D, AT).

“EU member states handle this problem in different ways, so we ask the Commission to consider mandatory routine collection and submission of monitoring data at EU level and to establish indictors to measure progress in the fight against antimicrobial resistance.”

Rapporteur on the veterinary medicinal products legislation, Françoise Grossetête (EPP, FR), said: “Beyond farmers or animal owners, the use of veterinary medicines concerns us all, because it has a direct impact on our environment and our food; in short, on our health. Thanks to this law, we will be able to reduce the consumption of antibiotics on livestock farms, an important source of resistance that is then transmitted to humans. Antibiotic resistance is a real sword of Damocles, threatening to send our health care system back to the Middle Ages”.

Next steps

Both reports were adopted unanimously, and will be put to a vote by the full House in the autumn.

Background

AMR is responsible for an estimated 25,000 deaths and €1.5 billion in extra healthcare costs every year in the EU alone. The rise in AMR is due to a number of factors, such as excessive and inappropriate use of antibiotics in humans, veterinary overuse in livestock, and poor hygiene conditions in healthcare settings or in the food chain. Lack of awareness also remains a key factor: 57% of Europeans are unaware that antibiotics are ineffective against viruses, 44% are unaware that they are ineffective against cold and flu. There are significant differences between EU countries in antimicrobial use, occurrence of resistance, and the extent to which effective national policies deal with AMR have been implemented.

With the new action plan, the Commission aims to reduce these gaps and raise the level of all EU member states to that of the highest performing country. The new action plan builds on the first AMR Action Plan, which ran from 2011 to 2016, its evaluation, the feedback on the roadmap and an open public consultation. In several resolutions, the EP called for more stringent measures, increased surveillance and monitoring, as well as for more research to be performed on new antimicrobials.

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