About Antimicrobial Resistance
Antimicrobial resistance (AMR) is the ability of micro-organisms to survive or grow despite antimicrobial agent that normally inhibits or kills that micro-organism.
AMR is responsible for more than 35.000 deaths every year in the EU/EEA.
AMR has also significant costs, including on healthcare systems.
In 2019, the World Health Organization (WHO) declared antimicrobial resistance as one of the top 10 global public health threats facing humanity. In July 2022, the Commission and the Member States, identified AMR as one of the top three priority health threats.
Overall, the latest data show significant increasing trends in the number of infections and attributable deaths for almost all bacterium–antibiotic resistance combinations, especially in healthcare settings.
- Around 70% of cases of infections with antibiotic-resistant bacteria were healthcare-associated infections
- A continued rise in resistance would result in an estimated 10 million deaths globally each year, reducing 2% to 3.5% in global gross domestic product
- By 2050, the world economy could face a cost of up to USD 100 trillion.
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Stepping up EU actions
On 13 June 2023, the Council adopted the Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach
On 1 June 2023, the European Parliament adopted a resolution on EU action to combat antimicrobial resistance.
On 26 April 2023, the European Commission adopted a proposal for a Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach, accompanied by a Commission Staff Working Document, as part of the pharmaceutical package.
This proposal for a Council Recommendation extends and complements the 2017 EU One Health Action Plan against AMR in all three dimensions of the One Health spectrum to maximize synergies and attain a strong and effective response against AMR across the EU.
The objectives of this proposal for a Council Recommendation are to:
- strengthen One Health national action plans on AMR
- reinforce surveillance and monitoring of AMR and antimicrobial consumption
- strengthen infection prevention and control
- strengthen antimicrobial stewardship and prudent use of antimicrobials
- recommend targets for AMR and antimicrobial consumption in human health
- improve awareness, education and training
- foster research & development, and incentives for innovation and access to antimicrobials and other AMR medical countermeasures
- increase cooperation
- enhance global actions
Input for the proposal was gathered from the following consultation, studies and reports:
- a call for evidence on a “Recommendation for greater action on antimicrobial resistance”, which ran from 24 February 2022 to 24 March 2022, with 161 qualitative feedbacks and 28 relevant documents
- a study on a future proofing analysis of the EU AMR Action Plan (i) to identify current and future challenges and opportunities for the fight against AMR and identify areas for EU action and (ii) to perform a preliminary outcome assessment of some of the activities of the 2017 AMR Action Plan
- two studies to support the Commission services (i) on AMR feasibility on stockpiling and (ii) on bringing AMR medical countermeasures to the market
- the opinion on “Managing antimicrobial resistance across the health system” from the independent expert panel on effective ways of investing in health
- the overview report on Member States’ One Health National Action Plans against AMR
- the results of the 2022 Eurobarometer on AMR
- the report from the subgroup under the EU AMR One Health Network
2017 EU One Health Action Plan against AMR
In June 2017 the European Commission adopted the EU One Health Action Plan against AMR, as requested by the EU countries in the Council conclusions of 17 June 2016.
The key objectives of this plan are built on 3 main pillars:
- Making the EU a best practice region
- Boosting research, development and innovation
- Shaping the global agenda
The plan outlines over 70 actions covering human health, animal health and the environment, whose progress is regularly monitored.
As part of the implementation of the action plan, the Commission adopted EU Guidelines on the prudent use of antimicrobials in human health. The guidelines aim to reduce inappropriate use and promote the prudent use of antimicrobials in people.
They target all actors responsible for or playing a role in antimicrobial use. This complements the EU Guidelines on the prudent use of antimicrobials in animal health.
Between the adoption of the 2017 AMR Action Plan and the adoption of the Commission proposal for a Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach, some major initiatives have contributed to further strengthening the EU’s response to AMR.
These include:
- the Strategic Approach to Pharmaceuticals in the Environment
- the Farm to Fork Strategy
- the Zero Pollution Action Plan
- the Regulation (EU) 2019/6 of the European Parliament and of the Council on veterinary medicinal products
- the Regulation (EU) 2019/4 of the European Parliament and of the Council on medicated feed
- the Commission Implementing Decision (EU) 2020/1729 and
- the Pharmaceutical Strategy for Europe
Both the EU4Health programme and the Horizon Europe programme provide funding in the field of AMR.
Previous Commission's Action Plan (2011-2016)
The Commission's 2011 Action Plan against the rising threats from AMR contained 12 actions for implementation with EU Member States and identified 7 areas where measures were most needed:
- making sure antimicrobials are used appropriately in both humans and animals
- preventing microbial infections and their spread
- developing new effective antimicrobials or alternatives for treatment
- cooperating with international partners to contain the risks of AMR
- improving monitoring and surveillance in human and animal medicine
- promoting research and innovation
- improving communication, education and training
The evaluation of the Action Plan published in October 2016 by the Commission and the contributions received during the public consultation have shown that this had a clear added value acting as a symbol of political commitment, stimulating several actions within Member States, and had served to strengthen international cooperation.
The Action Plan has also provided a framework to guide and coordinate activities on AMR at international level in the area of monitoring and surveillance and on R&D. This factsheet summarises the main points of this evaluation.
Furthermore, an external report is available regarding the Evaluation of the EC Action Plan against the rising threats from antimicrobial resistance (and appendices).
Before this evaluation, a progress report on the AMR Action Plan (2011-2016) was published in February 2015 which showed the state of play of the steps taken to address this issue.
The Commission has also compiled a detailed overview of the 12 Actions covered by the Action Plan in a Road Map (updated on November 2016), including the operational objectives, the concrete activities and the deadlines.
EU AMR One-Health Network
The AMR One-Health Network, chaired by the European Commission, includes notably government experts from the human health, animal health and environmental sectors, the relevant EU scientific agencies, stakeholders and Commission experts.
Its mission is to enhance the coordination and dialogue between the human health, veterinary and environmental sectors in the EU institutions, Member States and with stakeholders, in policies to combat Antimicrobial Resistance.
This Network usually meets twice a year.
Raising awareness
To raise awareness about AMR, the European Centre for Disease Prevention and Control (ECDC) founded the European Antibiotic Awareness Day (EAAD) which aims to provide a platform and support for national campaigns about prudent antibiotic use.
Over the years, European Antibiotic Awareness Day - marked annually in November together with the World Antimicrobial Awareness Week organised by WHO - has developed into a platform of global reach, partnering up with many countries outside the EU as well as relevant stakeholders, in line with the Commission's "One-Health" approach to AMR.
Furthermore, the Commission launched a campaign in September 2024 to promote greater awareness of AMR amongst young people and tackle AMR through a whole of society approach. The EU is also a vocal advocate of a stronger One Health response to the threat of AMR globally.
