Averting the next public health crisis

Parliament’s newly-formed Interest Group on AMR is committed to ensuring antimicrobial resistance remains high on the EU policy agenda, explain Sarah Wiener, Nicolae Ștefănuță and Tiemo Wölken.

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The COVID-19 pandemic has reminded the world of the serious threat that emerging infectious diseases can pose to human health and our economies.

It has highlighted the need for increased monitoring and surveillance tools, improved infection prevention and control practices, access to rapid diagnostic tests, and the development of effective and affordable medicines and vaccines.

The deficiencies revealed, however, have long been recognised in the fight against antimicrobial resistance (AMR), which represents a serious cross-border health challenge for Europe and the world.


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In fact, the WHO has identified it as one of the top ten global health threats in 2019 and it might well be the next wave crashing on our healthcare systems. If no effective action is undertaken, it is estimated that AMR could cause the death of 10 million people annually by 2050.

Without effective antibiotics, common infections that we can treat today would become fatal tomorrow. Treatments such as chemotherapy, diabetes management, major surgery or organ transplantation would put patients at increased risk.

The COVID-19 crisis also demonstrates the need for antibiotics to treat secondary infections when cells are badly damaged by viral infections. The European Parliament can play a key role in boosting actions to tackle AMR at EU level.

“The European Parliament can play a key role in boosting actions to tackle AMR at EU level. That is why we recently launched an Interest Group to address this urgent issue”

That is why we recently launched an Interest Group to address this urgent issue. Its secretariat is co-hosted by the European Public Health Alliance (EPHA) and Health Care Without Harm (HCWH) Europe, with the support of the AMR Stakeholder Network, the largest civil society-led network of more than 80 organisations on AMR.

The Interest Group now brings together 17 MEPs from across the political spectrum, committed to ensuring that AMR remains high on the EU policy agenda.

Its strategic work programme, which identified eight areas for action, was recently presented to EU Commissioner for Health and Food Safety, Stella Kyriakides.

Resistant bacteria can arise in humans, animals and the environment. AMR can therefore only be tackled through a multi-sectoral ‘One Health’ approach, integrating human, animal, and environmental health.

It is linked to fields as diverse as the economy, international trade and R&D, the environment, public health, and food safety, transport and tourism and agriculture and aquaculture.

Prevention must be at the heart of all AMR action. According to the OECD, three out of four deaths from drug-resistant infections could be averted by spending just €1.50 per person, per year, on measures as simple as hand-washing and more prudent prescription of antibiotics.

This is particularly necessary considering that up to 50 percent of antimicrobials employed in human healthcare may be used inappropriately.

The spread of AMR in healthcare facilities must be stopped through prevention and control practices.

Healthcare professionals and hospitals must be supported with antimicrobial stewardship programmes and continuous professional training to reduce the unnecessary prescription and use of antimicrobials.

There is a need to set quantitative targets and promote the use of performance indicators to measure this reduction at an EU level. The public health sector, however, is not the only one where the use of antimicrobials is often excessive and inappropriate.

In the livestock sector, aquaculture, crop production and intensive farming models rely on routine antibiotic use. Globally 70 percent of antibiotics are used on animals.

“The COVID-19 crisis has put our healthcare systems under extreme pressure, but this is only a taste of what we can expect in a world where antimicrobials are no longer effective”

Therefore, there is an urgent need to enforce more sustainable farming conditions and improve animal health and welfare standards to minimise the use of antimicrobials.

The flagrant market failures in antibiotic research and innovation represent another area that needs to be urgently addressed, while keeping the public interest at the heart of innovation and ensuring accessible, affordable, and quality antibiotics for all.

This implies increased funding under the Horizon Programme for the development of new antibiotics and alternatives, diagnostics, and vaccines.

Appropriate resources must also be mobilised to support the development and implementation of National Action Plans, especially for those Member States that do not possess the necessary financial backing to tackle this complex crisis.

This goes hand-in-hand with increased collaboration and knowledge sharing between Member States and the European Commission on EU funding available. Finally, the issue of pharmaceutical pollution needs to be properly addressed, in line with the European Commission’s zero-pollution ambition.

Pharmaceuticals are still largely excluded from EU environmental regulations. It is now time to set environmental quality standards and concentration limits for pharmaceuticals that can act as drivers for the development of resistance in water and soil.

We need to act now to safeguard the scientific achievements of the last century. The COVID-19 crisis has put our healthcare systems under extreme pressure, but this is only a taste of what we can expect in a world where antimicrobials are no longer effective.

The European Parliament is ready to play its role in preventing this nightmare scenario from happening. Cross-border challenges to public health, such as COVID-19 or AMR, need a coordinated, European answer.

European Commission President Ursula von der Leyen announced that healthcare would be one of her priorities during her term of office.

The newly-announced ‘white deal’, on better coordination and cooperation in the field of healthcare, should therefore not only improve the EU’s response to pandemics, but also boost action on cross-border health threats such as AMR.

For more information on the Interest Group, please visit epha.org/amr-interest-group/ and follow the hashtag #MEPvsAMR

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