Annexes to COM(2017)339 - European One Health Action Plan against Antimicrobial Resistance (AMR) - EU monitor

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Annexes to COM(2017)339 - European One Health Action Plan against Antimicrobial Resistance (AMR)

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Agreement with the EU. The Commission – with the help of EU agencies – will continue to support these countries through visits, best practice exchanges and capacity building.


As one of the largest markets for agricultural products, the EU can play a major role in promoting its AMR-related standards, measures in food production, and standards on animal welfare, e.g. through its bilateral Free Trade Agreements (FTAs). The systematic inclusion of AMR-related provisions is now a current practice for the Commission in all new FTAs. Further actions may also be considered to ensure a level playing field between EU producers and EU trading partners, e.g. so that efforts made by EU farmers are not compromised by the non-prudent use of antimicrobials in EU trading partners. This could include linking concessions made to EU trading partners with compliance with specific EU AMR policy objectives.


The Commission will:

-advocate EU standards and measures for tackling AMR in trade agreements and incorporate them into cooperative arrangements in trade agreements;

-engage with major global players and strategic countries (e.g. Brazil, China, India), contributing towards achieving objectives of the WHO Global Action Plan on AMR by sharing experiences, advocating best practices and thus stimulating actions outside the EU;

-support EU candidate countries, potential candidate countries and neighbouring countries to which the ENP applies in the alignment with, and capacity building for the implementation of EU legislation related to AMR and EU standards;

-invite the European Parliament, Member States and stakeholders to share views on actions to be taken to ensure that efforts to combat AMR made by EU producers, including farmers, do not place them at a competitive disadvantage.

4.3Cooperating with developing countries

The AMR threat to public health and the social and economic burden it entails is even greater in developing countries. This is due to political, social, epidemiological and economic factors which may vary from those in developed countries. The EU’s development policy can play an important role in raising awareness, sharing experiences and supporting capacity building in developing countries in order for them to be better equipped to control infectious diseases and prevent AMR. This process can be supported through dialogue, aid and cooperation activities, taking account of partner countries’ individual policy priorities to strengthen health systems and implement the sustainable development goals, in particular the third goal on good health and well-being. Particular attention should be given to lower income countries, where support is most needed.


The Commission will:

-continue to contribute to reducing AMR in least developed countries through infectious disease programmes such as the Global Alliance for Vaccines and Immunisations (GAVI);

-assist in the development of AMR strategies in the areas of food safety and animal health through regional training workshops on AMR organised under the BTSF World initiative;

-support partner countries’ policy initiatives on AMR, where appropriate, through international cooperation and development instruments (e.g. Global Public Goods & Challenges, the European Development Fund);

-support the development of resilient health systems in partner countries, e.g. by strengthening the knowledge and evidence base, infection prevention and control and the quality and use of antimicrobials.


4.4Developing a global research agenda

A stronger, more interconnected and more globally oriented AMR research environment is needed. There are great benefits to be gained from further coordination between the European research agenda and its global counterparts. Many international initiatives have been launched during the last few years that would benefit from stronger collaboration in order to increase their impact, as expressed by the G739 and G20 40 Health Ministers.

The Commission will:

-improve global coordination of research activities by promoting dialogue and collaboration between international research initiatives;

-support the establishment of a virtual research institute under JPIAMR;

-continue collaborative research with Sub-Saharan Africa in the context of the European and Developing Countries Clinical Trial Partnership (EDCTP) in particular in relation to tuberculosis, HIV/AIDS, malaria and neglected infectious diseases;

-foster international research collaboration on AMR in the animal health sector in the STAR-IDAZ International Research Consortium. 41

5measuring success

To obtain the desired effect, it will be important to closely monitor the effectiveness and performance of certain key actions under this action plan at regular intervals and to modify them if necessary.


The WHO, the OIE, the FAO, and the Codex Alimentarius are setting up systems and developing standards to monitor global effects.


The EU systems will measure EU and Member State effects. This can be done by determining a limited number of key outcome indicators, based on data already collected. These indicators will be developed with the support of the EU scientific agencies (see point 2.1) and will enable Member States to assess, in a clear and simple way, the progress made in the implementation of their national One Health action plans on AMR. The indicators will also help Member States to set measurable goals to reduce infections by key antimicrobial resistant microorganisms in humans and food-producing animals, to improve the appropriateness of the use of antimicrobials in the human and veterinary sectors and to combat AMR in all sectors.


This progress will be discussed at regular intervals in the One Health network on AMR, to guide individual Member States and to determine if new actions are needed at EU level.

6Conclusion

This Communication provides a framework for future actions against AMR and aims to make the best possible use of the EU legal framework and policy instruments, focusing on the real added value the EU can bring to the fight against AMR.

Most of the actions can be done by adapting and reinforcing existing actions for a more integrated, comprehensive and effective approach to combating AMR. Other actions focus on identified gaps in the EU response so far that requires new activities, the discovery of new knowledge and the creation of new partnerships.

The Commission is confident that this new One Health action plan can make a difference and will improve the EU performance in combatting AMR.

The action plan will strengthen collaboration and surveillance, will reduce data gaps and allow for the sharing of best practices within the EU. It will create more synergies and coherence between different policies according to the One Health approach. The action plan will thus support the EU and its Member States in delivering innovative, effective and sustainable responses to AMR.

The action plan will also strategically reinforce the research agenda on AMR and actively promote global action.

The Commission invites the European Parliament and the Council to endorse this One Health action plan and calls on Member States and all those involved to ensure that measures to combat AMR are swiftly implemented. Only sustained ambition, continued commitment and concerted action can turn the tide and diminish this global threat.

(1)

  http://www.who.int/entity/drugresistance/documents/surveillancereport/en/index.html  

(2)

United Nations, 2016. Political Declaration of the high-level meeting of the General Assembly on antimicrobial resistance. New York, USA.

(3)

WHA 68.7

  http://www.wpro.who.int/entity/drug_resistance/resources/global_action_plan_eng.pdf

(4)

http://ecdc.europa.eu/en/publications/Publications/0909_TER_The_Bacterial_Challenge_Time_to_React.pdf

(5)

  https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf

(6)

World Bank, 2016, ‘Drug-Resistant Infections: A Threat to Our Economic Future’, Washington, DC.

(7)

  http://www.un.org/sustainabledevelopment/sustainable-development-goals

(8)

COM (2001) 333 final

(9)

COM (2011) 748

(10)

  http://www.imi.europa.eu/content/nd4bb

(11)

  http://www.imi.europa.eu

(12)

  http://www.jpiamr.eu

(13)

Treatments that are tried after all other options have failed to produce an adequate response in the patient

(14)

  http://ecdc.europa.eu/en/publications/Publications/antimicrobial-resistance-europe-2015.pdf

(15)

Payne et al. Drugs for bad bugs: confronting the challenges of antibacterial discovery Nature Reviews Drug Discovery 6, 29-40 (January 2007)

(16)

http://www.consilium.europa.eu/en/press/press-releases/2016/06/17-epsco-conclusions-antimicrobial-resistance

(17)

 SWD(2016) 347 final

(18)

  http://ec.europa.eu/smart-regulation/roadmaps/docs/2016_sante_176_action_plan_against_amr_en.pdf

(19)

  https://ec.europa.eu/health/amr/consultations/consultation_20170123_amr-new-action-plan_en

(20)

World Health Organization, 2015. 68th World Health Assembly: WHA resolution 68.7. Geneva, Switzerland; the commitment to have national AMR action plans in place before mid-2017 was confirmed in the Council conclusions on the next steps under a One Health approach to combat antimicrobial resistance.

(21)

Regulation (EU) 2016/429 of the European Parliament and of the Council of 9 March 2016 on transmissible animal diseases and amending and repealing certain acts in the area of animal health (‘Animal Health Law’), OJ L 84, 31.3.2016, p.1.

(22)

Commission Implementing Decision 2013/652/EU of 12 November 2013 on the monitoring and reporting of antimicrobial resistance in zoonotic and commensal bacteria, OJ L 303, 14.11.2013, p. 26.

(23)

Commission Decision 2002/253/EC of 19 March 2002 laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council, OJ L 86, 3.4.2002, p. 44.

(24)

Special Eurobarometer 338 (April 2010), Special Eurobarometer 407 (November 2013) and Special Eurobarometer 445 (June 2016)

(25)

Decision 1082/2013/EU of the European Parliament and of the Council of 22 October 2013 on serious cross-border threats to health and repealing Decision 2119/98/EC, OJ L 293, 5.11.2013, p.1

(26)

JA-04-2016 - Antimicrobial resistance and Health Care Associated Infections

(27)

Commission Implementing Decision 2013/652/EU of 12 November 2013 on the monitoring and reporting of antimicrobial resistance in zoonotic and commensal bacteria, OJ L 303, 14.11.2013, p. 26.

(28)

  http://www.gavi.org/about/value/

(29)

  http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52015XC0911(01)&from=EN

(30)

COM(2014) 558 final, COM(2014) 556 final

(31)

Directive 2013/39/EU of the European Parliament and of the Council of 12 August 2013 amending Directives 2000/60/EC and 2008/105/EC as regards priority substances in the field of water policy, OJ L 226, 24.8.2013, p. 1

(32)

Directive 2000/60/EC of the European Parliament and of the Council of 23 October 2000 establishing a framework for Community action in the field of water policy, OJ L 327, 22.12.2000, p. 1

(33)

  https://ipchem.jrc.ec.europa.eu/RDSIdiscovery/ipchem/index.html  

(34)

  http://www.ifpma.org/partners-2/declaration-by-the-pharmaceutical-biotechnology-and-diagnostics-industries-on-combating-antimicrobial-resistance-amr/  

(35)

Commission Delegated Regulation (EU) 2016/161 of 2 October 2015 supplementing Directive 2001/83/EC of the European Parliament and of the Council by laying down detailed rules for the safety features appearing on the packaging of medicinal products for human use, OJ L 32, 9 February 2016, p. 1.

(36)

https://ec.europa.eu/digital-single-market/en/innovation-procurement

(37)

Such as researchers in academia and industry, regulators, etc.

(38)

http://www.saicm.org/EmergingPolicyIssues/Pharmaceuticalnbsp;Pollutants/tabid/5477/language/en-US/Default.aspx

(39)

  http://www.mhlw.go.jp/seisakunitsuite/bunya/hokabunya/kokusai/g7kobe/KobeCommunique_en.pdf

(40)

  https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/G/G20-Gesundheitsministertreffen/G20_Health_Ministers_Declaration_engl.pdf

(41)

  http://www.star-idaz.net/