Transcript Process of asessment

Europe
and the fight against
Antimicrobial
Resistance
Vincent Houdry
DG SANCO C3
Health Threats Unit
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…
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)
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
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?
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
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)
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)
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
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
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
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
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)
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
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
Planned Actions in Human Health
Second implementation report on
the Council recommendation on the
prudent use of antimicrobial agents
in human medicine (2009)
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
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
Content of recommendation on the prevention
and control of HCAIs – national level
At the national level:
1.
National strategy for prevention and control of HCAIs
2.
National dedicated multidisciplinary Committee for
implementation of national strategy
3.
Senior management of healthcare institutions bear
responsibility for quality of care
Recommended objectives of national strategy:
1.
Implement control and preventive measures.
2.
Organise infection prevention and control programmes.
3.
Establish or strengthen active surveillance systems on HCAIs.
4.
Foster education, training, research and information exchange.
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.
EU action plan to fight TB
MDR and XDR TB
Framework action plan published
next week
Next step
Who does what ?
timetable
indicators
AMR on the political agenda
Council conclusions on AMR
Community
Hospital
New antibiotics
….
Thank you for your attention!
Commission Public Health website: http://ec.europa.eu/health/index_en.htm
EU Health Portal: http://ec.europa.eu/health-eu