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EU falling behind 2030 antimicrobial consumption targets, health agency finds

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The EU is falling short of reaching the antimicrobial consumption targets for 2030 with some member states even backtracking from 2019 numbers, a new report by the European Centre for Disease Prevention and Control has found.

Antimicrobial resistance (AMR) kills 33,000 people every year in the European Union and more than 670,000 infections are registered due to bacteria resistant to antibiotics.

The so-called ‘silent pandemic’ is making noise in the EU as the ECDC published a new report on the consumption of antibiotics and the burden of AMR in Europe on Friday (17 November).

“Antimicrobial resistance remains a major public health threat in Europe and globally,”  Andrea Ammon, director of the ECDC, said while presenting the report on 20 November. 

AMR occurs when bacteria, viruses, fungi and parasites change over time and stop responding to medicines, which complicates the treatment of infections. The main cause of this resistance is the overuse or misuse of antibiotics across the European Union. 

The World Health Organisation estimates that about half of all antibiotic use worldwide is inappropriate in some way. This can be due to the use of antibiotics when they are not indicated, the choice of an antibiotic with too broad a spectrum, and the use of the wrong dose or duration of the treatment. 

The ECDC report, focusing on the levels of antimicrobial consumption across the EU, showed that progress towards the 2030 targets is still slow among member states. 

Increasing consumption of antibiotics

The Council of the EU adopted in June 2023 recommendations for stepping up the actions against AMR.

This includes two targets related to antimicrobial consumption that should be reached by 2030 using 2019 as a baseline: a 20% reduction in the total consumption of antibiotics in humans, with 65% of total human antibiotic consumption coming from the so-called Access group of the WHO’s AWaRe system

“Access” antibiotics are those with a narrow spectrum of activity and good safety profile in terms of side effects, these should be the first choice for common infections.

These recommendations, according to Ammon, “show that there is a high level of consensus among EU member states, that all understand that it is a serious health threat and immediate actions are needed”. 

According to the report, the total consumption of antibiotics in humans decreased by 2.5% between 2019 and 2022, “indicating slow progress towards the 20% reduction target by 2030”.

This number comes after unprecedented reductions in 2020 and 2021, which can now be seen as back to “normal” after the COVID-19 pandemic. ECDC attributed this rebound to patterns of winter respiratory viruses, social contacts, hygiene habits and antibiotic-prescribing practices being back to what they were before 2020. 

“Targets help us focus our energies and action. What gets measured gets done,” said Dominique Monet from ECDC on behalf of Health Commissioner Stella Kyriakides during the presentation of the report.

The ECDC report shows that only nine EU member states met or exceeded the target of at least 65% of antibiotic consumption being from the “Access” group, with the EU overall reaching 59.8%. 

Another figure that the report highlights is that the number of EU countries at or above the 65% target has not changed since 2019 and twelve member states had a higher total antimicrobial consumption in 2022 than in 2019, including Bulgaria (+24%), Malta (+15%) and Lithuania (+13.5%).

There are big differences between member states, from the worrying numbers of Bulgaria to the promising figure of Finland, where consumption decreased by 15%.

“EU progress can only be as good as the sum of the progress of each individual member state,”  Andrea Ammon said while presenting the data. 

Need to step up the EU’s efforts

Therefore, ECDC is calling for urgent action across the European Union, ensuring measures to support the prudent use of antimicrobials and promoting the development of novel antimicrobials and other alternatives.

Commissioner Kyrakides announced that the EU will allocate €50 million to co-found a new joint action on AMR that will launch in early 2024, and an extra €17 million to improve access to newly developed antibiotics. 

The Commission’s proposal for the new pharmaceutical regulation already tackles this issue, aiming to boost innovation and development of novel antibiotics in the EU. 

The proposed solution is a 15-year trial of a ‘transferable data exclusivity voucher scheme’ for novel antibiotics to incentivise their developers.

This voucher will grant an additional year of regulatory data protection to the developer of the novel antibiotics, which can either be used for one of its own products or sold to another marketing authorisation holder.

While the pharmaceutical industry welcomed the proposal, it is still a sore subject in the negotiations inside the EU institutions as the member states are sceptical about its implementation. 

[Edited by Giedrė Peseckytė/Zoran Radosavljevic]

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