About Antimicrobial Resistance
Antimicrobial resistance (AMR) is the ability of micro-organisms to survive or grow in the presence of an antimicrobial agent that normally inhibits or kills that micro-organism.
AMR is one of the top global public health and development threats. In July 2022, the Commission and Member States identified AMR as one of the top three priority health threats, requiring coordinated action at the EU level to strengthen preparedness and response.
AMR is responsible for more than 35,000 deaths every year in the EU/EEA, as a direct consequence of an infection due to antibiotic-resistant bacteria. This health impact is comparable to that of influenza, tuberculosis and HIV/AIDS combined.
Data from the European Centre for Disease Prevention and Control (ECDC) show significantly increasing trends in the number of infections and attributable deaths for almost all bacterium–antibiotic resistance combinations, especially in healthcare settings. It is estimated that around 70 % of cases of infections with antibiotic-resistant bacteria were healthcare-associated infections.
Between 2025-2050, 39 million deaths are projected to be directly attributable to bacterial AMR.
AMR has also significant costs, including on healthcare systems and the economy. The Organisation for Economic Co-operation and Development (OECD) estimates that every year, higher health expenditure and reduced workforce productivity due to AMR costs to the EU/EEA countries nearly EUR 11.7 billion.
Globally, AMR could result in US$ 1 trillion of additional health-care costs per year by 2050 and US$ 1 trillion to 3.4 trillion of gross domestic product losses per year by 2030.
Antimicrobial resistance is a threat to human and animal health, as well as the environment, as micro-organisms such as bacteria spread in and between all sectors. Therefore, this issue needs to be addressed with integrated action from multiple sectors, known as the One Health approach.
Stepping up EU actions
On 13 June 2023, the Council adopted the Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach, following a proposal from the European Commission as part of the pharmaceutical package.
The Council Recommendation extends and complements the 2017 EU One Health Action Plan against AMR in all three dimensions of the One Health spectrum (human health, animal health and the environment) to maximise synergies and attain a strong and effective response against AMR across the EU.
The objectives of the Council Recommendation are to:
- strengthen One Health national action plans on AMR
- reinforce surveillance and monitoring of AMR and antimicrobial consumption
- strengthen infection prevention and control
- strengthen antimicrobial stewardship and prudent use of antimicrobials
- recommend targets for AMR and antimicrobial consumption in human health
- improve awareness, education and training
- foster research & development, and incentives for innovation and access to antimicrobials and other AMR medical countermeasures
- increase cooperation
- enhance global actions.
To assess the progress and results achieved in implementing the 2017 AMR Action Plan and the Council Recommendation on AMR, the European Commission commissioned a study to design a monitoring framework.
On 1 June 2023, the European Parliament adopted a resolution on EU action to combat antimicrobial resistance.
2017 EU One Health Action Plan against AMR
In June 2017 the European Commission adopted the EU One Health Action Plan against AMR, as requested by the EU countries in the Council conclusions of 17 June 2016.
The key objectives of this plan are built on 3 main pillars:
- Making the EU a best practice region
- Boosting research, development and innovation
- Shaping the global agenda.
The plan outlines over 70 actions covering human health, animal health and the environment, whose progress is regularly monitored.
As part of the implementation of the action plan, the Commission adopted EU Guidelines on the prudent use of antimicrobials in human health. The guidelines aim to reduce inappropriate use and promote the prudent use of antimicrobials in people.
They target all actors responsible for or playing a role in antimicrobial use. This complements the EU Guidelines on the prudent use of antimicrobials in animal health.
Between the adoption of the 2017 AMR Action Plan and the adoption of the Commission proposal for a Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach, some major initiatives have contributed to further strengthening the EU’s response to AMR.
These include:
- Regulation (EU) 2022/2371 of the European Parliament and of the Council of 23 November 2022 on serious cross-border threats to health
- Regulation (EU) 2019/6 of the European Parliament and of the Council on veterinary medicinal products
- Regulation (EU) 2019/4 of the European Parliament and of the Council on medicated feed
- Commission Implementing Decision (EU) 2020/1729
- Pharmaceutical Strategy for Europe
- Strategic Approach to Pharmaceuticals in the Environment
- the target to reduce overall EU sales of antimicrobials for farmed animals and aquaculture by 50% by 2030, as outlined in the Zero Pollution Action Plan and Farm to Fork Strategy
Both the EU4Health programme and the Horizon Europe programme provide funding in the field of AMR research, projects and studies.
- Past EU actions on AMR prior to 2017 highlight that AMR has long been a priority for the European Commission.
EU AMR One-Health Network
The AMR One Health Network, chaired by the European Commission, includes notably government experts from the human health, animal health and environmental sectors, the relevant EU scientific agencies, stakeholders and Commission experts.
Its mission is to enhance the coordination and dialogue between the human health, veterinary and environmental sectors in the EU institutions, Member States and with stakeholders, in policies to combat Antimicrobial Resistance.
This Network usually meets twice a year.
As a way to communicate among the AMR One Health Network members, the European Commission is hosting the EU Platform on Antimicrobial Resistance. This interactive digital network aims at promoting dialogue among competent authorities, businesses, civil society organisations and scientists on AMR issues that are relevant for the Union.
Raising awareness
To raise awareness about AMR, the European Centre for Disease Prevention and Control (ECDC) founded the European Antibiotic Awareness Day (EAAD) which aims to raise awareness about the threat to public health of antibiotic resistance and the importance of prudent antibiotic use.
Over the years, European Antibiotic Awareness Day - marked annually on 18 November together with the World AMR Awareness Week - has developed into a platform of global reach, partnering up with many countries outside the EU as well as relevant stakeholders, in line with the Commission's "One Health" approach to AMR.
Furthermore, the Commission launched a campaign in September 2024 to promote greater awareness of AMR amongst young people and tackle AMR through a whole of society approach. The EU is also a vocal advocate of a stronger One Health response to the threat of AMR globally.
