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Europe and the fight against Antimicrobial Resistance

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ECDC, EMEA, EFSA, JRC, non food scientific committees, community ... Clostridium difficile, MRSA. DSN: EARSS, ESAC, IPSE/HELICS. First EU Antibiotic day ... – PowerPoint PPT presentation

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Title: Europe and the fight against Antimicrobial Resistance


1
Europe and the fight against Antimicrobial
Resistance
  • Vincent Houdry DG SANCO C3 Health Threats Unit

2
Intersectoral mechanism
  • SANCO health, food, feed, animals, plants
  • ENV biocides, agriculture, residues
  • ENTR pharmaceutical products, biocides
  • RTD basic research, new antibiotics and tests
  • ECDC, EMEA, EFSA, JRC, non food scientific
    committees, community reference laboratory for
    AMR

3
Feed/animal/food
  • Zoonoses Monitoring directive (2003)
  • Decisions (2007) on Salmonella, Campylobacter,
    MRSA
  • RASFF Rapid Alert System on Food and Feed
  • Prohibition of the use of antibiotics as feed
    additives (2003)

4
Community reference laboratory on AMR
  • Directive on the monitoring of zoonoses and
    zoonotic agents
  • Monitoring of antimicrobial resistance
  • Ensure quality of antimicrobial susceptibility
    testing and harmonise procedures and
    methodologies

5
DG Environment
  • Biocidal products directive (1998)
  • Revision of all active substances regarding safe
    use for human health and environment (before
    2010)
  • SCENIHR scientific opinion to assess AMR effects
    of biocides
  • Cross resistance to antibiotics as a new criteria
    in evaluation of biocidal products?

6
DG Research
  • 5th FP 1999-2002 20M/year
  • 6th FP 2003-2006 40M/year
  • Translational research Grace and Mosar
  • Animal health alternatives to antibiotics and
    transmission of AMR
  • 7th FP 2007-2013 First call
  • AMR in human health
  • Biocides and AMR in food and animal health

7
EFSA
  • Food as a vehicle for antimicrobial resistance
    EFSA Q 2007 089
  • Antimicrobial resistance of decontaminants
    substances (poultry carcasses)/SCENIHR
  • Data on AMR in zoonotics agents (salmonella,
    campylobacter) in animals and food of animal
    origin (Zoonoses directive)

8
EMEA
  • Guideline to applicants to obtain more useful
    prescribing information
  • SPC info on prudent use, prevalence of
    resistance
  • Veterinary unit
  • Guidance on preauthorisation requirements for
    authorisation of antimicrobials potential to
    select for resistance
  • Considerations on use of Fluoroquinolones for
    food producing species (cephalosporins,
    macrolides, lincosamines, streptogramins)

9
ECDC
  • 3 meetings of NFP for AMR
  • Country visits on AMR
  • Working groups
  • Clostridium difficile, MRSA
  • DSN EARSS, ESAC, IPSE/HELICS
  • First EU Antibiotic day

10
DG SANCO Human Health
  • EU Network for surveillance and control of
    communicable diseases
  • (Decision 2119/98/EC)
  • Antimicrobial Resistance
  • Nosocomial Infections
  • Surveillance of specific pathogens

11
EU Public Health Programme 2003-2008
  • EUCAST developing common methodology, case
    definitions and data to be collected for the
    surveillance on AMR
  • ESAC monitoring the level of consumption of
    antibiotics in the EU.
  • EARSS surveillance of AMR in the EU

12
EU Public Health Programme 2003-2008
  • IPSE development of guidelines and educational
    tools to better and effectively manage the risk
    of HCAI and AMR - Surveillance of AMR in
    intensive care units
  • ABS INTERNATIONAL implementing strategies for
    the appropriate use of antibiotics in hospitals
  • BURDEN information (morbidity, mortality and
    economic impact) on the burden of disease and
    resistance across Europe
  • E-Bug development of educational programmes on
    antibiotics in schools

13
EU Public Health Programme 2008-2013
  • Work plan 2008 "Improve citizen's health
    security"
  • Promotion of risk assessment thematic networks
    for exchange and collaboration on critical issues
    (AMR)

14
Community Strategy against AMR
  • Council recommendation on the prudent use of
    antimicrobial agents in human medicine 2001
  • Intersectoral mechanism
  • Strategies towards the prudent use
  • Surveillance Systems on usage of ATB and AMR
  • Control and preventive measures
  • Promote education and training of HCW and Inform
    the general public
  • First implementation report 2005
  • Commission staff working document

15
First implementation report
  • Appropriate Intersectoral Mechanism
  • Development of Strategies and action plans
  • Lack of data at lower level feedback to
    prescribers
  • Collaboration human/animal health
  • Ban OTC/Self medication
  • Prescription guidelines monitoring impact
  • Hygiene and infection standards in health care
    institutions
  • Enlarge surveillance activities to antivirals and
    antiparasitic agents
  • Campaigns toward the general public

16
Planned Actions in Human Health
  • Second implementation report on the Council
    recommendation on the prudent use of
    antimicrobial agents in human medicine (2009)

17
Planned EU Actions in Human Health
  • Patient safety proposal
  • Commission Communication on Patient Safety
  • Council Recommendation on
  • patient safety and quality of health services
  • the prevention and control of healthcare
    associated infections

18
Recommendation on HCAI
  • Healthcare-associated infections (HCAIs) affect
    an estimated 4.1 million patients and cause an
    estimated 37,000 deaths in the EU every year.
  • HCAIs lead to increase in length of stay,
    illness, mortality and costs.
  • Infections caused by these pathogens are often
    difficult to treat due to antimicrobial
    resistance (Council Recommendation 2002/77/EC).
  • Organisational and behavioural changes are needed
    to make an impact.
  • Studies and impact assessments show that
    intervening is cost-effective !
  • However, a strong political commitment is needed
    !!!
  • ?
  • EU initiative for a proposal for a Council
    Recommendation

19
Content of recommendation on the prevention and
control of HCAIs national level
  • At the national level
  • National strategy for prevention and control of
    HCAIs
  • National dedicated multidisciplinary Committee
    for implementation of national strategy
  • Senior management of healthcare institutions bear
    responsibility for quality of care
  • Recommended objectives of national strategy
  • Implement control and preventive measures.
  • Organise infection prevention and control
    programmes.
  • Establish or strengthen active surveillance
    systems on HCAIs.
  • Foster education, training, research and
    information exchange.

20
Content of recommendations on the prevention and
control of HCAIs EU level
  • Facilitate mutual information, consultation,
    cooperation and action.
  • Develop scientific guidance (ECDC).
  • Consider with Member States how to publicly
    report data on HCAIs.
  • Strategies for reduction of exposure of
    healthcare staff to HCAIs ( safety at work).
  • Funding research.
  • Cooperation with WHO and others.
  • Revise/update recommendations.
  • Submit regular implementation reports to the
    Council, on the basis of Member States reports
    on their follow-up to the Council Recommendation.

21
EU action plan to fight TB
  • MDR and XDR TB
  • Framework action plan published next week
  • Next step
  • Who does what ?
  • timetable
  • indicators

22
AMR on the political agenda
  • Council conclusions on AMR
  • Community
  • Hospital
  • New antibiotics
  • .

23
Thank you for your attention! Commissi
on Public Health website http//ec.europa.eu/heal
th/index_en.htm EU Health Portal
http//ec.europa.eu/health-eu
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