Dutch presidency: 'One health' approach crucial to fighting antimicrobial resistance
Dutch EU Council presidency to focus on 'one health' approach in tackling AMR.
The first antibiotic, prontosil, was discovered in 1932 and changed the face of medicine. Previously life-threatening conditions became eminently treatable. Many major surgical procedures we now take for granted - heart bypasses, organ transplants and joint replacements - are only possible because of antibiotics.
Fast forward to 2016. Antimicrobial resistance is climbing, affecting four million people in the EU each year. There are many reasons for this. Diseases have always mutated, making antibiotics less effective.
However, widespread inappropriate use of antibiotics compounds the problem, and new antibiotics are few and far between. Yet as more strains of bacteria become resistant, the numbers infected and dying as a consequence can only increase.
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This is why the Dutch have made action against AMR a priority for their EU Council presidency. Health Minister Edith Schippers explains why. "If antibiotics lose their effectiveness, we risk undoing nearly a century of medical progress. A simple bladder infection or ear infection can become life threatening. Already, more than 25,000 Europeans are dying each year as a consequence of antibiotic resistance. These are European citizens like you and me."
"We need new antibiotics or other effective medicines to fight infections. This requires new business models. We also need to develop rapid and affordable diagnostics."
In the meantime, she says; "Preventing infection in the first place, coupled with the prudent use of antibiotics - both in human and animal healthcare - are crucial in the fight against AMR."
She explains the importance of a holistic approach. "A 'One Health' approach is crucial. Without the commitment of the veterinary world we cannot win this battle. This is why I will host the ministerial AMR conference on 9-10 February in Amsterdam jointly with my colleague from agriculture."
Martijn van Dam, Minister for agriculture, confirms that AMR is an animal health issue. "The growth in resistant bacteria partly results from antibiotic overuse in humans. However, this can also develop in livestock production through overuse in food-producing animals, leading to resistant bacteria in humans. If we allow the problem in animal healthcare to persist, then we cannot tackle the problem in human healthcare."
Van Dam explains that in 2009, his country became aware it was one of the highest users of veterinary antibiotics in Europe.
Once this was recognised, the government took action to substantially reduce this. In addition, levels of resistant bacteria in food-producing animals have declined in recent years.
However, there is still work to do; "Prevention is better than cure: the livestock sector must now focus on prevention. This is why the 'One Health' approach is pivotal. Human health is paramount; we set strict conditions for the use of antibiotics critical for public health."
One thing is clear; "It's a global problem. We need to tackle AMR in and outside the EU." He accepts there is no 'off the shelf' solution.
The ministerial EU conference will aim for, "political commitment for concrete national action plans, a firm next five year EU action plan AMR, legal requirements for prudent use and a strong EU One Health Network. We must join forces to fight AMR."
European health and food safety Commissioner Vytenis Andriukaitis agrees that tackling AMR is vitally important. Recalling his time as a medical student, he recalls being told that, "there would be no need to study infectious diseases because they would be treated without difficulty. If only this had been true."
He recalled that; "Alexander Fleming, the father of antibiotics, encouraged cautioned in using penicillin, since there were circumstances under which bacterial resistance to antibiotics may develop - and it did."
Observing the unfolding human and economic tragedy, he explains that; "EU action aims to involve all aspects of AMR: human and animal health, food and feed safety, bio-safety, environment, research and innovation and international cooperation. Our proposals include incentives to develop new antimicrobials and to increasing cooperation between EU agencies."
In addition, there is the issue of public awareness. "It is our duty", he says, "to educate the public on antibiotics overuse and misuse. Too often, people often think that antibiotics work against viruses; some also buy them without prescription or take them 'just in case.' If we do not change these misperceptions, we risk sending medicine back to the 18th century."
There is a weak correlation between animal consumption of antibiotics and human resistance, argues Rick Clayton.
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