Europe’s role in the global challenge of AMR (Guest blog)
The discovery of antibiotics is one of the true human success stories of the 20th century. Many of the medical developments and advances that we today take for granted would not be possible without antibiotics. But this advancement is under threat from antimicrobial resistance (AMR) that is posing a significant risk to human health all over the world. Already 25,000 people in Europe and 700,000 globally are dying as a consequence of antimicrobial resistance. If nothing is done, those numbers may rise to a staggering 10 million by 2050.
We need to take a hard stance against AMR both in the EU and globally, otherwise we risk facing a situation in which healthcare effectively cannot treat infections that previously were considered simple. We have already reached a point at which multi-resistant bacteria, in many cases, are hard to treat.
Member states have taken different actions and made varying degrees of progress in the fight against AMR. My own country, Sweden, has done fairly well, with relatively low levels of resistance and a responsible use of antibiotics. Here, you need a prescription to get hold of antibiotics, while at the same time healthcare professionals are guided by straightforward routines, with an emphasis on washing hands and keeping clean and tidy. Although it is a good thing that the issue of AMR often is in the spotlight in both Sweden and the EU, too much focus is put on the aspect of animal health.
More antibiotics are used in animals than in humans – and reducing animal use is of course very important. But with all too much focus on this aspect, we risk missing an issue of even greater importance - how to find innovative solutions for new antibiotics.
Reducing antibiotic use is also a significant task that must not be neglected. But no matter how few antibiotics we use, resistance will eventually develop. It is a process that can be checked – however it cannot ever be brought to a complete halt.
The number of new antibiotics developed in the last couple of decades is, unfortunately, rather few. Although there are solutions that have benefited public health in the world, it takes a very long time before they actually are used and make a difference to patients. The AMR threat is cross-boundary and as such it cannot be tackled by countries alone. On the contrary, I have a hard time thinking of any other area in which the EU can play as an important role. The new action plan on AMR that the European Commission has adopted is a good starting point for this work. But there is further room for improvement and it is obvious that the EU has to get its priorities straight and make different choices in the next long-term budget. More money must be directed towards research into new antibiotics, rather than supporting factories and farmers that have ceased to be productive a long time ago.
It is evident that a closer collaboration between academia, industry and the EU is desirable. We need to make a thorough examination of the regulatory framework, to strengthen incentives to develop and increase the availability of new antibiotics. Guidelines for patents and reimbursement schemes also need to be reviewed, in order to foster the development of new antibiotics. But not even Europe is large enough to handle this alone. In the end it will take resources and competence from all parts of the world to quickly get more antibiotics to patients in need.