Evaluating the EC Action Plan Against Antimicrobial Resistance (AMR)

Background

Through overuse and misuse of antibiotics and other antimicrobial agents, many micro-organisms have become resistant to them. The European Commission in 2011 announced an Action Plan against the rising threats from antimicrobial resistance (AMR) that contains 12 actions for implementation with EU member countries to achieve progress on six objectives: the appropriate use of antimicrobials, infection prevention, research and innovation on new antimicrobials and treatment alternatives, international collaboration, monitoring and surveillance, and awareness.

On behalf of the Directorate-General for Health and Food Safety of the European Commission (DG SANTE), RAND Europe conducted an evaluation of the EC Action Plan from 2011 to 2015.

Goals

The evaluation aimed to assess:

1. Whether the key strategic actions contained in the Action Plan were the most appropriate actions to be taken to combat AMR;
2. Which elements worked well or not (and why);
3. Whether the objectives are still relevant to the needs of tackling AMR; and
4. Whether the approach was appropriately holistic.

The Action Plan expires in 2016. The results of this evaluation provide an evidence base for the Commission to make informed decisions on additional policy measures that should be taken in the medium and long term to combat AMR in the EU and globally.

Methods

Methods employed in the evaluation included document review, key informant interviews, stakeholder workshops, a survey and case studies. The evaluation also included an open public consultation lasting 12 weeks, hosted online by the European Commission.

Further information and background documentation for the evaluation:

• Action Plan (PDF)
• Action Plan Progress Report 2015 (PDF)
• Public Consultation
• Evaluation Roadmap (PDF)

Findings

• The Action Plan played an important role in symbolizing EU political commitment to AMR, galvanised action on AMR issues within the EU, and encouraged engagement with third countries and the international community to tackle AMR.
• The holistic approach adopted by the Action Plan was essential to tackling AMR, and it should be reinforced and could be strengthened through cross-sector initiatives.
• The 2014 proposals on veterinary medicine and medicated feed and the 2013 proposal for a new Animal Health Law represented major achievements of the Action Plan. There was an overall decrease in the volume of antimicrobials sold for use in animals annually in the EU since 2011.
• Member State policies to address the use of antimicrobials in human medicine improved overall since 2011. There was no change in the volume of antimicrobials sold annually in the EU for use in humans since 2011, but consumption patterns shifted towards greater dependence on broad- relative to narrow-spectrum antibacterials in humans.

Recommendations

• One opportunity to expand the reach and relevance of the ‘One Health’ and holistic approaches under the Action Plan would be to dedicate resources (human and financial) to a coordinating mechanism for the EU to prompt action on AMR.
• The Commission and agencies should continue providing support to encourage good practice in public health services and surveillance in Member States.
• The EU should consider how to focus more attention on the development of alternative treatments in addition to new antimicrobials.
• The EU could build a more holistic system for monitoring AMR issues, linking data on resistance, consumption and sales of antimicrobials to prescribing trends and other factors.
• Targeted attention could be paid to specific areas where a Member State is struggling and understanding the specific challenges that are blocking progress in that context.