COMMUNITY STRATEGY FOR THE PRUDENT USE
OF ANTIMICROBIAL AGENTS
Commission Communication on a Community strategy against antimicrobial resistance.
Draft Council Recommendation on the prudent use of antimicrobial agents in human medicine.
||Article 152 EC; co-decision; qualified majority voting
||20 June 2001|
|Forwarded to the Council:
||21 June 2001|
|Deposited in Parliament:
||10 July 2001|
|Basis of consideration:
||EM of 19 July 2001
|Previous Committee Report:
|To be discussed in Council:
||No date set|
37.1 The Community Network for the epidemiological
surveillance and control of communicable diseases, which came
into operation in July 1999, lists antimicrobial resistance as
a priority health issue. The Commission has therefore sought in
these documents to address the issue, first by means of a Communication
outlining a strategy to contain the spread of antimicrobial resistance,
and secondly by proposing in a draft Recommendation a number of
specific measures to be implemented by the Member States in order
to achieve this.
(a) The Commission Communication
37.2 This notes that the problem of antimicrobial
resistance has been recognised and addressed for several years,
and that, although the phenomenon existed even before antimicrobial
agents were introduced into medical treatment, it is generally
accepted that there is an association between the quantities of
such agents used and an increase in resistant organisms. This
in turn has led to fears that the excessive and uncontrolled use
of these agents could jeopardise the progress made in previous
decades in the treatment of infectious diseases. The issue of
resistance therefore forms an integral part of the Community's
health strategy, and comprises science-based actions in a number
of relevant sectors, notably public health and the veterinary
and phytosanitary areas. In particular, the Commission notes that
the Scientific Steering Committee delivered an opinion in May
1999 stating that prompt action was needed to reduce the overall
use of antimicrobial agents in a balanced way in all these areas,
and that the most effective strategies were likely to be those
capable of being introduced speedily in all Member States without
undue costs, and which can be monitored and enforced across the
37.3 The Communication goes on to identify four
key areas of action forming the major elements of the strategy:
37.4 This will entail monitoring the evolution and
effects of interventions through establishing and strengthening
Community surveillance networks on antimicrobial resistance in
the human and veterinary sectors and the consumption of antimicrobial
agents by humans and animals (including, in the latter case, through
37.5 The Commission points out that the prevention
of communicable diseases and control of infection would reduce
the need for antimicrobial agents. This in turn would entail improved
product information for authorised antibacterial products used
in both human and veterinary medicine, and educating and influencing
the behaviour of professionals and the general public.
Research and product development
37.6 The Commission suggests the need for new procedures
for the prevention and treatment of infections, and continued
support of research into new vaccines, drugs and alternatives.
37.7 The Commission points out that antimicrobial
resistance does not respect frontiers, particularly with the expansion
of global trade and travel. It therefore suggests that an effective
strategy requires close co-operation and consultation between
itself, the Member States and other involved parties, especially
at international level through such bodies as the World Health
Organisation, Codex Alimentarius, and the Office International
(b) Proposed Council Recommendation
37.8 The Commission says that the purpose of this
is to recommend a number of specific measures aimed at containing
the spread of antimicrobial resistance by prudent use of antimicrobial
agents. It cites the over-use and inappropriate use of antibiotics,
especially in children with respiratory infections, as being of
major concern. In particular, it suggests:
- Collection and analysis of data on antimicrobial
resistant micro-organisms and on the consumption of antimicrobial
agents available to prescribers, pharmacies, industry, health
insurance providers etc, to detect potential links for intervention
- Enforcing the principle that antibacterial agents
should be available by prescription only, and evaluating whether
this rule should be applied to all antimicrobial agents as a precaution.
- Developing guidelines and principles on the prudent
use of antimicrobial agents, including principles for evaluation
of applications for marketing authorisations.
- Improving prevention of infections to reduce
the need for antimicrobial agents.
- Enhancing knowledge of the problem by specialised
education programmes for health professionals.
- Raising awareness of the problem of antimicrobial
resistance by informing the general public.
- Encouraging research on the development of antimicrobial
resistance and the development of rapid diagnostics to enable
efficient early treatment of communicable diseases.
- Identify or establish, for these purposes, national
organisations with effective co-ordination between the Member
States and the Commission to achieve Community results.
The Government's view
37.9 In his Explanatory Memorandum of 19 July 2001,
the Parliamentary Under- Secretary of State at the Department
of Health (Lord Hunt) says that antimicrobial resistance is a
major public health issue which the Government takes very seriously.
He adds that the Communication closely mirrors the UK's own strategy
and action plan in this area, published in June 2000, and places
little extra burden on this country as action in most of the suggested
areas is already underway. In particular, the Communication reinforces
existing UK action by giving further impetus to those issues it
has flagged up; by highlighting in Europe the need to tackle resistance
and to work globally; and by establishing an advisory group through
the Community network to support Member States' efforts and ensure
a co-ordinated approach, both within Europe and more widely.
37.10 Although neither the Commission Communication
nor the draft Council Recommendation are legally binding, they
do nevertheless deal with a subject of obvious, and growing, importance.
Consequently, although we see no need to withhold clearance, we
are drawing the document to the attention of the House.