TATFAR 2015 - The Transatlantic Task Force on Antimicrobial Resistance meets in Luxembourg to define its action plan for the next five years
As part of the Luxembourg Presidency of the Council of the European Union, the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) met in Luxembourg on 22 and 23 October 2015. This forum has enabled advances to be debated on the matter and priority actions for the next five years to be defined.
Lydia Mutsch, Vytenis Andriukaitis i, John F. Ryan and Jimmy Kolker at the opening session of the Meeting of the Transatlantic Taskforce on Antimicrobial Resistance in Luxembourg on 22 October 2015
The Minister i for Health, Lydia Mutsch, and the European Commissioner in charge of Health and Food Safety, Vytenis Andriukaitis, opened the debate on the first day of the forum. They were joined by the two co-presidents of TATFAR, John F. Ryan, Acting Director of the European Commission's Public Health Directorate, and Jimmy Kolker, Assistant Secretary for Global Affairs at the US Department of Health and Human Services (HHS).
Jimmy Kolker reminded those present that the TATFAR Group was set up in 2009 at a EU-USA summit with a view to improving cooperation between the United States and the European Union (EU) in three areas: the correct use of antimicrobial medicines in human and veterinary medicine, the prevention of drug-resistant infections in hospital and community health centre environments, and strategies aimed at improving the supply of new antimicrobials.
This was all done in a context where, as John F. Ryan pointed out, the challenges are huge. As a matter of fact, the global consumption of antibiotics in human medicine "increased by almost 40 % between 2000 and 2010", he said, adding that around 700,000 annual deaths are attributed to resistance worldwide, of which 50,000 are in the EU and USA. Furthermore, the costs involved are extremely high, he continued, revealing an annual expenditure of 1.5 billion in the EU alone, due to a loss of productivity and an increase in healthcare costs.
The way in which antibiotics are used needs to be changed
Pointing out that antibiotics are regarded as one of the major therapeutical innovations of the 20th century, Lydia Mutsch, emphasised that the current excessive and abusive use of these medicines in human and veterinary medicine is jeopardising their effectiveness.
For the Minister, antimicrobial resistance is a "serious threat to public health", since in the EU, 25,000 persons die each year due to an inability to treat some infections. "Today we are facing a situation where the use and resistance to antibiotics all over the world is alarming", said the Minister. In actual fact, antibiotics are among the most commonly used medicines around the world. So, the more they are used, the greater the probability of antimicrobial resistance, the Minister said. In veterinary matters as well, antibiotics are still overused, and in particular for non-therapeutic purposes in non-EU countries, she stated.
Against this background, the Minister highlighted the importance of changing the way in which antibiotics are used and improving awareness and the understanding of the subject of antimicrobial resistance. "An integrated and unique approach ("One Health Approach") should be defined for the human and animal sector which takes into account all dimensions of the problem", she said.
Furthermore, global solutions and a long-lasting global collaboration are required, said Lydia Mutsch, calling on governments to increase their level of commitment in the matter, to further coordinate and strengthen their capabilities so as to better educate and create awareness among professionals, patients and other stakeholders, setting up national monitoring programmes and enabling research communities to develop new drugs.
Antimicrobial resistance, a "time-bomb" for humanity
In his speech, Vytenis Andriukaitis expressed the hope that the working group would mark "a new stage" of international cooperation in the fight against antimicrobial resistance.
Remarking that not one new antibiotic has been developed since 1997 and that antibiotic resistance was growing, the European Commissioner pointed out that if this trend should continue, it would mean an extra "10 million deaths per year in 2050, more than the number of annual deaths from cancer". In the animal health area, 63,000 tonnes of antibiotics have been consumed worldwide by livestock to prevent illness and boost growth, which is as great a problem.
"Resistant organisms are everywhere, they form part of our environment and don't respect borders", he said. "This shows the need for a global approach between the human and animal health sectors", as well as "the need to act in all sectors", added the Commissioner, according to whom there must be more prevention and market control, more research and more incentives for the development of new antibiotics.
Vytenis Andriukaitis also added that "solid" international cooperation among all institutions active in this domain beyond the EU and USA was the "key" to success, a requirement that furthermore was to be found at the heart of the EU's action plan in the matter (2011), in the World Health Organisation's world action plan adopted in 2015 and in the conclusions from the meeting of G7 i Health Ministers held in September 2015.
Lastly, awareness had to be raised among the public on this poorly understood problem, Vytenis Andriukaitis stated. Poor perception and the misuse of antibiotics are "dangerous", as simple infections can prove fatal, he repeated, underlining that this represented a "time-bomb" and "one of the greatest challenges facing humanity".
The Commission takes stock of the actions undertaken in Member-States regarding the fight against antimicrobial resistance
John F. Ryan, Acting Director of the European Commission's Public Health Directorate, returned to the situation of antimicrobial resistance within the EU, as the EU's action plan against the threat of microbial resistance, which is currently the subject of an external assessment, comes to an end in 2016.
Furthermore, he pointed out that the Commission had in 2015 conducted a survey of European Economic Area states (EEA i) on the implementation of a Council recommendation, regarding the prudent use of antimicrobial agents in human medicine dating from 2001. It encouraged countries to implement an appropriate strategy and establish a cross-sectoral cooperation mechanism by the end of 2002.
To date, 26 out of 31 States that make up the EEA have responded to the survey, John F. Ryan said. From these 26 countries, 19 have adopted a national strategy, 5 indicated that it was being prepared and 2 said that they didn't yet have a strategy at present.
All the countries that responded participate in the European Antimicrobial Resistance Surveillance System Network (EARS-Net), and almost all also boast a national system which, however, needs to be improved, he added.
Most of the countries have also defined the guidelines for the responsible use of antimicrobials in human medicine. Only 17 countries have introduced an antimicrobial activities management programme in their hospitals, of which 10 have made it mandatory. Likewise, 17 countries have set out recommendations for infection control.
Lastly, 22 countries indicated that they have set up public awareness campaigns.
In conclusion, John F. Ryan pointed out the need to step up the EU's strategy and action plan based on the "One Health" approach, also taking measures to ensure that regulations and guidelines lead to positive changes, enforcing legislation governing consumption without a prescription, improving monitoring and reviewing the legal basis at EU level to prevent and report on antimicrobial resistance. "The TATFAR Group is playing an important role in this respect and can help us to develop suitable instruments", he concluded.
TAFTAR has enabled a common research agenda and a common vocabulary to be defined
Jimmy Kolker, the Assistant Secretary for Global Affairs at the US Department of Health and Human Services (HHS), from his side emphasised the "very strong commitment" of US President Barack Obama i, who describes this problem as a "global issue". He highlighted in this regard that "political commitment in this matter is as important as scientific research".
For four years, the work undertaken within TATFAR has according to him enabled a number of advances to be made, in particular a better mutual understanding of actions and approaches which are sometimes different between the EU and the USA as well as learning the best practices of each one. It has also enabled a research agenda and common vocabulary to be defined and identified gaps in scientific knowledge.