Romanian EU Presidency aims to strengthen Europe’s One Health approach to fighting antimicrobial resistance

Antimicrobial resistance (AMR) is widely recognized as one of the 21st century’s greatest threats to health, welfare and food security. Worldwide, an estimated 700 000 people die each year from drug-resistant infections. In the European Union (EU) and European Economic Area (EEA) alone, 33 000 lives are claimed each year, and these numbers are rising.

The economic impact is also significant – AMR costs the EU an estimated 1.5 billion euros per year in health-care costs and productivity losses.

Europe has long been a frontrunner in addressing AMR. For more than 2 decades, the European Commission and its agencies have worked closely with EU countries to combat this threat. Several countries have used their platform as host of the Presidency of the Council of the EU to bring greater focus to the strategies needed to stop AMR. These efforts have contributed to all EU/EEA countries having an AMR national action plan implemented or under development. However, there is still room for progress.

Romania, which currently holds the EU Presidency, aims to build on previous efforts by focusing specifically on combating AMR through a One Health approach. This approach recognizes that one sector cannot single-handedly ensure the proper use of antibiotics, and thus aims to bring together professionals in human, animal and environmental health as one force – collectively committed to keeping antibiotics working.

Identifying key priorities and next steps to combat AMR in Europe

Romania has identified 3 key objectives related to AMR:

1. to improve the quality of infection prevention and control measures and optimize antimicrobial use across human, animal and environmental health sectors;
2. to strengthen the implementation of One Health national action plans; and
3. to encourage solidarity between countries by working together to combat AMR.

The country hosted a meeting on 28 February and 1 March 2019 to determine the next steps towards making the EU a best-practice region in combating AMR through a One Health approach.

The meeting included the participation of high-level representatives from major European Commission agencies, such as the European Centre for Disease Prevention and Control (ECDC), the European Flood Awareness System (EFAS), the European Medicines Agency (EMA) and the Directorate-General for Health and Food Safety (DG SANTE), as well as delegates from EU countries and other experts, including from WHO/Europe.

Speaking at the event, Dr Nedret Emiroglu, Director of the Division of Health Emergencies and Communicable Diseases and Director of Programme Management at WHO/Europe, commended Romania for its decision to focus on the One Health approach, calling it “the only viable way to combat AMR”.

Dr Emiroglu highlighted that WHO has joined forces with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE) to urge governments to adopt such an approach.

She emphasized, “Having comprehensive national action plans is a great start but this is only the beginning, and the real work needs to start after the plan is in place. Our collective actions today in support of this work will shape public health for decades to come.”

The meeting included a 90-minute simulation exercise led by ECDC. It gave countries an opportunity to consider the response to a serious outbreak of AMR and suggest steps to enhance future practice. The exercise set the emergence and spread of a difficult-to-treat, extensively drug-resistant strain of bacteria in the same context as any highly infectious disease emerging in a population where quick and decisive action can help minimize impact.

A policy brief, produced jointly by the Romanian EU Presidency and the European Observatory on Health Systems and Policies, was also launched at the meeting. It offers analysis of the health and economic impact of AMR, but also examines the policy options and priority interventions that can be used to fight it. Additionally, the policy brief discusses the importance of governance in successfully implementing AMR national action plans based on the One Health approach.