Antibiotics and their invisible threats 

Editorial word: Antibiotics and their invisible threats 

By Marta Iraola

You probably haven’t noticed that last Saturday (18 November) marked Antibiotic Awareness Day – and it is not surprising: no additional day off, no parade, no Black Friday discounts.

But it does mark a pressing issue in the EU and worldwide – antimicrobial resistance, responsible for the deaths of 33,000 people a year in the EU alone. And the entire week we are in is the World AMR Awareness Week.

Antimicrobial resistance (AMR) has been part of the EU’s agenda for the last few years, however, is still a big unknown outside health circles.

During the European Health Forum Gastein in September, which reunited lawmakers and health professionals from all over Europe, stakeholders warned that the lack of AMR awareness among the general public was worrying and asked for EU action.

This week, full of events and publications, aims to shine the light on the current situation in Europe, which according to the latest findings is not very optimistic.

A new ECDC report published on Friday (17 November) showed that antimicrobial resistance is still an increasing problem in the EU, which is far from reaching the 2030 targets set by the European Council, published earlier this year.

All EU institutions are doing their part – with recommendations from the Council, discussions in the Parliament and, the newest update, a €50 million fund the European Commission will allocate to co-fond a new joint action on AMR that will launch in early 2024, plus an extra €17 million to improve access to newly developed antibiotics.

However, the situation doesn’t seem to improve as fast as it should and if this pace of progress continues, it will be difficult to reach the 2030 targets.

For now, all eyes are on the conversations about the pharmaceutical legislation which aims to boost the innovation of novel antibiotics and other alternatives in Europe and give a break to the current consumption rates.

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EU News

• • The state of European Health Data Space (EHDS)
  • Spanish Presidency on European Health Data Space (EHDS)
  • Health needs more focus in green policy-making
  • Prevention and screening key to addressing cancer in the EU
  • EU falling behind 2030 antimicrobial consumption targets
  • Podcast: Situation in Gaza’s hospitals
• The state of EHDS. The time is coming closer to see the work of Parliament and the Council on the European Health Data Space (EHDS) file. The Parliament’s position is to be voted in the committee on 28 November, with the vote in the plenary foreseen for December. Initially, the final vote in the plenary was expected to take place in November, but there were delays, according to Croatian MEP Tomislav Sokol, due to “a lot of the technical work that had to be done on all of these details, detailed provisions of the regulation”. He hopes to reach a political agreement before the end of the mandate, despite acknowledging that “it won’t be easy”. “We should put pressure on both the political groups in parliament and the member states to put the focus on this so that we are able to finish this before the mandate of this Parliament and the Commission expires,” Sokol concluded.
• Spanish Presidency on EHDS. Euractiv had a sneak peek at the Spanish EU Council Presidency’s additional adjustments to the primary use of health data in the Presidency’s third compromise proposal. Among the provisions, the Presidency introduced an opt-out option for the primary use of health data in emergency situations. The presidency wants to see the electronic health record systems format split into two profiles: one for national use and one for cross-border use. The conformance assessment in the Presidency’s position remains that it should be done by means of self-certification, “given the low risk of these components and the wide scope of the definition of EHR systems”. This opposes the Parliament’s position, which is in favour of a third-party assessment mechanism. “The majority of the Parliament decided to have better control of the safety of these systems is to have the third party certification of these systems,” said Sokol.
  Read Giedre Peseckyte’s reporting on EHDS here.

• Health needs more focus on green policy-making. Cristina Pricop, policy manager at the European Public Health Alliance (EPHA),  argued that there “is a tremendous potential for health and climate co-benefits across many policy actions, which is currently not always reflected in EU frameworks,” following the release of the Lancet Countdown 2023 report last week. The report is an international research collaboration that monitors the impacts of climate change on health and includes 11 recommendations for a health-centred response to the climate crisis. The European Commission, however, argues that they have clearly stressed the importance of health as part of the European Green Deal, a spokesperson told Euractiv. 
  Read the article by Amalie Holmgaard Mersh here.
• Prevention and screening key to addressing cancer in the EU. Following the publication of the new European Cancer Manifesto and after initiatives like the BECA report from the European Parliament and the European Commission’s EU’s Beating Cancer Plan put cancer high on the EU agenda, EU lawmakers and stakeholders put their focus on prevention and screening policies across Europe. One of the main focuses of the conversation now is prevention and screening. Currently, EU efforts are concentrated on regulating cancer risk factors. “Primary risk factors are well known, yet most still lack appropriate policy response,” reads the European Cancer Organisation manifesto. The European Parliament is preparing a report on non-communicable diseases (NCDs) focusing on addressing the main risk factors associated with cancer: tobacco and alcohol consumption, unhealthy diets, environmental effects and lack of physical activity. To make sure EU action is coming to fruition, Health Commissioner Stella Kyriakides that the Commission will put forward a study in 2024 to assess the real impact of the Beating Cancer Plan.
  Marta Iraola has more on this here.
• EU falling behind 2030 antimicrobial consumption targets, health agency finds. A new study by the European Centre for Diseases Prevention and Control (ECDC) showed that the EU’s progress to tackle AMR still lags behind 2030 targets, in some cases even backtracking from 2019 numbers. The Council of the EU adopted in June 2023 recommendations for stepping up the actions against AMR, including two targets related to antimicrobial consumption that should be reached by 2030 using 2019 as a baseline: a 20% reduction in the total consumption of antibiotics in humans, with 65% of total human antibiotic consumption coming from the so-called Access group of the WHO’s AWaRe system. Currently, only nine member states reach these targets, with the EU average being 59.8%. With these results, the ECDC is calling for urgent action across the EU. ensuring measures to support the prudent use of antimicrobials and promoting the development of novel antimicrobials and other alternatives.
  Marta Iraola writes about it here.
• Podcast: Situation in Gaza’s hospitals. This week, the Beyond the Byline podcast looks into the critical situation unfolding in Gaza’s hospitals as Israel continues its military operations in the strip. Medical centres – once a refuge for civilians – have been struggling to continue to operate with their fuel, electricity and medical supplies cut off. On Wednesday, the Israel Defence Forces raided Gaza’s biggest hospital, Al-Shifa, saying that Hamas militants were hiding out beneath the building. Doctors and aid workers on the ground have put out calls for a ceasefire, with the United Nations relief chief stating that “hospitals are not battlegrounds”. Evi Kiorri discussed the critical situation in Gaza’s medical facilities with Christian Lindmeier, a spokesperson at the World Health Organisation (WHO).
  Listen to the podcast here. 

News from the Capitals

PRAGUE
The dispute is growing over transferable vouchers for developers of novel antimicrobial products, proposed by the European Commission in the EU pharma package, but Prague is particularly concerned about the potential impact on national health systems. Read more.

Czech auditors warn of delayed e-health implementation despite EU funding. Despite EU funding, the digitalisation of healthcare in the Czech Republic is delayed and critical components are still missing resulting in local doctors being unable to obtain information about patients in urgent situations, the National Audit Office has warned. Read more.

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WARSAW
A child in Poland has to wait 238 days to see a psychiatrist, activist says. Poland’s mental healthcare sector has improved in recent years, but there are still significant challenges to be overcome, with one activist highlighting a Polish child faces a waiting list of 238 days to see a psychiatrist. Read more.

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SOFIA
Bulgaria fails with vaccinations against cervical cancer. Fake news about vaccines, mistrust, and refusal of immunisation by parents, teachers, and the whole society led to a drastic drop in HPV immunisation coverage among girls in recent years, an investigation by Euractiv Bulgaria found. Read more.

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THE HAGUE
First e-information for EU-approved drugs: Beware of digital divides, Dutch say. The Netherlands is taking part in a pilot project for the online publication of drug information, together with three other EU countries. Coordinated by the European Medicines Agency (EMA), the programme has just released the electronic product information (ePI) for the first seven medicines out of 25. Read more.

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DUBLIN
Dublin boosts pharmacists in patients’ management. A new task force set up by the Irish government has recently suggested enhancing the role of pharmacists in healthcare while acknowledging their contribution during the COVID-19 pandemic and the lack of GPs. Read more.

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ATHENS
Greece adopts plan to prevent dementia ‘pandemic’. In what was described as a “legislative breakthrough”, the Greek government announced a comprehensive action plan to tackle dementia, considered by analysts as a significant challenge for the country’s ageing population. Read more.

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STOCKHOLM
Parents in Sweden confused over children’s vaccination against COVID. Although COVID vaccination of healthy children is not recommended by experts, the Swedish government confused parents after a minister said there were no legal barriers to vaccinating children, earning criticism from local authorities and doctors. Read more.

[Edited by Zoran Radosavljevic]

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