Select Committee on European Scrutiny Second Report


COM(01) 333

Commission Communication on a Community strategy against antimicrobial resistance.

Draft Council Recommendation on the prudent use of antimicrobial agents in human medicine.

Legal base: Article 152 EC; co-decision; qualified majority voting
Document originated: 20 June 2001
Forwarded to the Council: 21 June 2001
Deposited in Parliament: 10 July 2001
Department: Health
Basis of consideration: EM of 19 July 2001
Previous Committee Report: None
To be discussed in Council: No date set
Committee's assessment: Politically important
Committee's decision: Cleared


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 Community.

37.3 The Communication goes on to identify four key areas of action forming the major elements of the strategy:

— Surveillance

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 feed additives).

— Prevention

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.

— International co-operation

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 des Epizooties.

(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 measures.

  • 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.

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Prepared 2 November 2001