Health First Europe and the European Patient Group on Antimicrobial Resistance welcome the opportunity to contribute to the Commission’s Call for Evidence.
The AMR Patient Group includes 16 national patient associations from across Europe. The Group is united to empower European citizens & patients to speak with one voice when sharing personal and group insights and experiences regarding the real-world impact of antimicrobial resistance (AMR) and healthcare-associated infections (HAIs). It is now more urgent than ever to step up actions to prevent HAIs and AMR-related development throughout the patient journey.
In line with our 2021 Declaration, we call upon European policymakers and national governments to urgently commit to a full range of interventions and to consider including the following action points in their upcoming Recommendation to have a common approach across Member States:
The COVID-19 pandemic has underlined the need to understand the complex connections between bacterial and viral infections. AMR will likely increase through the heavy use of antibiotics in COVID-19 patient treatment. Hence, it is essential to diagnose, encourage more responsible behaviour, and promote the optimal prescription and sustainable use of antibiotics. As a result, there will be stronger preparedness for our healthcare systems and timely responses to this public health challenge.
Health First Europe (HFE) together with the members of the European Patient Group on Antimicrobial Resistance (AMR Patient Group) are delighted to announce the creation of a new group of Members of the European Parliament (MEP) who have agreed to become the new MEP Ambassadors of the AMR Patient Group.
Health First Europe and the AMR Patient Group representatives are committed to raising awareness about the real-world impact of antimicrobial resistance and healthcare-associated infections (HAIs) that have become a bane for public health and lives. This will ultimately empower patients across Europe with the necessary knowledge about AMR so that everyone understands when it is appropriate to take antibiotics and how to take them responsibly, by addressing the gap in awareness at the patient-level about the danger of antibiotic misuse and the lack of effective infection prevention measures.
We welcome MEPs Manuela RIPA (Greens/EFA, Germany); Brando BENIFEI (S&D, Italy); Tilly METZ (Greens/EFA, Luxembourg); Cyrus ENGERER (S&D, Malta); Piernicola PEDICINI (Greens/EFA, Italy); Sirpa PIETIKÄINEN (EPP, Finland); Tomislav SOKOL (EPP, Croatia); Sara CERDAS (S&D, Portugal); Nicolás GONZÁLEZ CASARES (S&D, Spain); Jessica POLFJÄRD (EPP, Sweden); István UJHELYI (S&D, Hungary); Frances FITZGERALD (EPP, Ireland); Pernille WEISS (EPP, Denmark); Susana SOLÍS PÉREZ (Renew Europe, Spain); Ondřej KNOTEK (Renew Europe, Czechia); Dominique RIQUET (Renew Europe, France); Michèle RIVASI (Greens/EFA, France); and Emma WIESNER (Renew Europe, Sweden).
These MEPs were selected based on their advocacy and active participation in the legislative chamber on matters of health. In furtherance of our objectives, the MEP Ambassadors of the AMR Patient Group will help champion our initiatives in the fight against antimicrobial resistance, sustain political interest and mobilise change by calling for more investment in key areas, such as in the field of education, prevention, and investment, among others.
There is a salient need for action on antimicrobial resistance (AMR) because it is, currently, one of the most serious threats to public health globally. It is responsible for an estimated 33,000 deaths per year in the EU and is estimated to cost the EU €1.5 billion annually in healthcare costs and productivity losses.
The members of the AMR Patient group are delighted to officially welcome the new Members of the European Parliament as MEP Ambassadors of the AMR Patient Group and look forward to future collaboration with a view to prevent healthcare-associated infections and the related development of AMR throughout the patient journey.
The members of the European Patient Group on Antimicrobial Resistance (AMR Patient Group), are truly committed to raising awareness about the real-world impact of antimicrobial resistance (AMR) and healthcare-associated infections (HAIs). Consequently, we strive to help reduce the inappropriate use of existing antibiotics, promote antimicrobial stewardship and infection prevention and control measures across Europe, and develop novel antibiotics where needed.
The European AMR Patient Group has developed a pan-European survey to assess the level of knowledge and awareness of antimicrobial resistance (AMR) and health-associated infections (HAIs) among 5 European countries, namely Italy, France, Germany, Spain and the UK.
The survey has close-ended questions and it will take only 15 minutes to be completed.
The overarching objective of this questionnaire is to arm all European citizens with the necessary knowledge about antimicrobial resistance and healthcare-associated infections to ensure the appropriate use of antibiotics as well as the knowledge of other existing tools that can prevent, monitor, detect and diagnose infections.
The AMR Patient Group kindly invites you to reply to and increase participation in the survey among your network. Although voluntary, the participation of patient representatives based in the afore-mentioned countries will be highly appreciated and will enrich the results in a meaningful way.
Please find the links to fill in the survey as follows
Kindly note that all contributions to this survey will be treated anonymously and in full compliance with the GDPR.
It is now more urgent than ever to step up actions to prevent HAIs and the related development of AMR throughout the patient journey.
To learn more, please find our 2021 Declaration on AMR and infographics here.
Patient safety is an essential metric when it comes to building resilient public healthcare systems both at the European and global level. It is also indispensable in the provision of health care in all settings including hospitals and long-term care facilities. The lack of proper adherence to patient safety manuals undermines public confidence and trust in health systems, increases mortality and morbidity due to unsafe care, and increases the burden on the public purse in terms of healthcare costs. Unfortunately, patient harm resulting from safety lapses, though avoidable in most cases, is a growing canker that threatens global public health. Safety lapses lead to healthcare-associated infections (HAIs), which result in prolonged hospital stays, long-term disability and high costs for patients, family and healthcare providers.
Health First Europe and the members of the European Patient Group on Antimicrobial Resistance (AMR Patient Group) are committed to raising awareness about the real-world impact of antimicrobial resistance and healthcare-associated infections (HAIs) that have become a bane for individual and public health. The HFE-led initiative’s overarching objectives are to help reduce the inappropriate use of existing antibiotics, promote antimicrobial stewardship and infection prevention and control measures across Europe, and develop novel antibiotics where needed. The AMR Patient Group empowers patients across Europe with the necessary knowledge about antimicrobial resistance so that everyone understands when it is appropriate to take antibiotics and how to take them responsibly by addressing the gap in awareness at the patient level about the danger of antibiotic misuse and the lack of effective infection prevention measures.
The European Centre for Disease Control (ECDC) estimates that a total of 8.9 million HAIs occur each year in European hospitals and long-term care facilities combined, with more than half of certain HAIs considered preventable. HAIs represent a common pathway that often leads to sepsis, which in turn contributes to approximately 37,000 deaths directly resulting from HAIs. This is devasting for patients and caregivers alike.
HAI prevention and control is a core element in tackling AMR. HAIs are often caused by resistant bacteria, but the occurrence of an infection in the first place may also increase the risk of developing resistant strains. Even though antibiotics have played a central role in the treatment of human infections, the lack of awareness on the general health risk associated with the excessive and inappropriate use of antibiotics menaces public health and patient safety. Antimicrobial resistance alone is responsible for approximately 33,000 deaths per year in the EU and is estimated to cost the EU €1.5 billion annually in healthcare costs and productivity losses. These figures and the general trend paint a bleak picture of the public health system. The situation is dire.
AMR will likely increase through the heavy use of antibiotics in COVID-19 patient treatment. Hence, the importance of diagnosing and implementing digital technologies, encouraging behavioural compliance in hand hygiene, checklists and safety protocols, and promoting the optimal prescription and sustainable use of antibiotics. As a result, there should be stronger preparedness for our healthcare systems and timely responses to this public health challenge.
Going forward we face an urgent need to arm ourselves with effective tools to improve patient safety in all healthcare settings. “In order to effectively fight healthcare-associated infections and antimicrobial resistance, there is a need to not just raise awareness and promote education, but, rather, a new paradigm shift – one that is patient-centered. The genesis of the European Patient Group on Antimicrobial Resistance is in line with this patient-centered paradigm shift as it includes many active patient groups coming from all over Europe,” says Ms Laura Cigolot, coordinator of the AMR Patient Group.
On 7 April 2021, the group launched a Declaration on AMR, calling on European and national authorities to commit to a full range of interventions in the field of education, prevention and investment. Currently, the AMR Patient Group is undertaking a major pan-European survey to assess awareness and knowledge of antimicrobial resistance and HAIs among the general public in five European countries: France, Germany, Italy, Spain and the UK. The findings of this questionnaire will be collected in five national reports which will be used to identify best practices and address current gaps in the implementation of national action plans on AMR.
It is now more urgent than ever to step up actions to prevent HAIs and the related development of antimicrobial resistance throughout the patient journey.
 ECDC, 2018. “Infographic: Healthcare-associated infections – a threat to patient safety in Europe”.
On the World Health Day 2021, Health First Europe along with the members of the European Patient Group on Antimicrobial Resistance (AMR Patient Group), launched their 2021 Declaration on AMR, being truly committed to raising awareness about the real-world impact of antimicrobial resistance (AMR) and healthcare-associated infections (HAIs). Consequently, we strive to help reduce the inappropriate use of existing antibiotics, promote antimicrobial stewardship and infection prevention and control measures across Europe, and develop novel antibiotics where needed.
Unfortunately, AMR remains one of the biggest threats to public health today and a challenge for Europe. Data from the European Centre for Disease Control and Prevention (ECDC) on AMR in 2019 demonstrated that percentages of resistance to vancomycin – a last-line antibiotic – in Enterococcus faecium bloodstream infections almost doubled between 2015 and 2019. Resistance to carbapenems – another group of last-line antibiotics – also remains a serious concern. Indeed, even as we continue to develop new and effective antibiotics, appropriate antimicrobial stewardship of existing antibiotics as well as regular diagnostic testing remains highly important.
The COVID-19 pandemic has underlined the need to understand the complex connections between bacterial and viral infections. AMR will likely increase through the heavy use of antibiotics in COVID-19 patient treatment. Hence, the importance of diagnosing, encouraging a more responsible behaviour and promoting the optimal prescription and sustainable use of antibiotics. As a result, there will be stronger preparedness for our healthcare systems and timely responses to this public health challenge.
AMR is driven by interrelated dynamics in the human, animal and environmental health sectors, hence the importance of implementing national “One Health” action plans against AMR.
The purpose of this Declaration is to empower European citizens and patients to speak with one voice when sharing personal and group insights and experiences regarding the real-world impact of AMR and HAIs. The Declaration further calls upon European and national authorities to urgently commit to a full range of interventions in the field of education, prevention and investment. It is now more urgent than ever to step up actions to prevent HAIs and the related development of AMR throughout the patient journey.
You can find the Declaration and a new infographic attached below.
The first virtual workshop of Europe’s first AMR Patient Group entitled, ‘Addressing antimicrobial resistance and healthcare associated infections through patient empowerment’ took place on Wednesday 16 December 2020 from 10:00 to 12:30 Brussels time. The purpose of the workshop was to provide participants with a comprehensive overview of the issues of antimicrobial resistance (AMR) and healthcare associated infections (HAIs), the state of play in Europe, and discussion around the best approach we can take to tackle these deeply concerning problems at the patient-level. The workshop was moderated by Laura Cigolot from Health First Europe (HFE) and participants were given presentations from high-level speakers as well as opportunities to raise questions and have an open discussion to further the group’s mission and objectives.
Ms Cigolot opened the virtual workshop on behalf of HFE, outlining the purpose and mission statement of the new AMR Patient Group: to educate and raise patient awareness about AMR, to build a consistent patient voice on AMR across Europe, and to broaden the AMR debate to include infection prevention control measures.
The first presentation was given by Dr Dominique L Monnet, Head of Disease Programme, Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) at the European Centre for Disease Control (ECDC). Dr Monnet gave a comprehensive overview of AMR to help participants understand all the areas that AMR encompasses. Interestingly, Dr Monnet said he prefers not to use the ‘AMR’ acronym himself as it makes the concept too abstract. Dr Monnet’s presentation also provided case studies and the latest Eurosurveillance statistics on AMR from Europe, which are all available on the ECDC website. He advised on the most effective AMR prevention methods, which included the prudent use of antimicrobial agents and good hand hygiene practices. Dr Monnet noted the ongoing studies into the effects of the Covid-19 pandemic on antimicrobial resistance.
The second speaker was Dr Massimo Sartelli from Macerata Hospital in Italy. Dr Sartelli presented the workshop with an excellent overview of infection prevention and control measures from a clinical perspective. Participants learned the incidence rates of HAIs, how they are contracted in healthcare settings and best practices to help avoid them. Dr Sartelli highlighted that hands are the most common vehicle to transmit health care-associated pathogens, and the necessity of strict hand hygiene practices. His key message was that hand hygiene is a simple and effective solution to protect patients from HAIs and to reduce both the spread of infection and multi-resistant germs.
Ms Annabel Seebohm, Secretary General of the Standing Committee of European Doctors (CPME) was the third speaker to take the floor. Ms Seebohm’s presentation centred around the role of doctors in fighting AMR at the primary care level. She noted that doctors in primary care settings are on the frontline of efforts to improve the responsible use of antibiotics and it is paramount that they promote and implement the prudent use of antibiotics, i.e., only when needed, in correct dose intervals and in correct duration. Ms Seebohm also highlighted the CPME’s policy recommendations to Member States and doctors across Europe to help streamline a European approach to prescribing antibiotics responsibly, as well as CPME’s active engagement in promoting the ‘One Health’ approach, which looks at AMR prevention from an interdisciplinary perspective (i.e., an approach which combines the medical, dental, animal and environmental sectors).
Finally, Ms. Seebohm provided participants with an overview of what European doctors know about antibiotics and antibiotic resistance based on the latest statistics from the ECDC. Optimistically, more than 70% of doctors agreed to having good opportunities to provide advice on prudent use of antibiotics to patients, however 45% of doctors said they have insufficient time and no resources available for not being able to give out advice or resources to patients. Ms Seebohm emphasised that these figures show that not only do we need action in terms of developing guidelines and strategies on the prudent use of antibiotics, but also in the organisation of primary care so that doctors have sufficient time and resources to properly share information with patients.
Ms Emma Kollatou, Manager of Government Affairs and Public Policy at MedTech Europe spoke next about the role of medical technologies in the fight against AMR and HAIs. Ms Kollatou emphasised how medical technologies can help fight AMR throughout the patient pathway, from prevention to diagnosis, to controlling infection spread through tracking and monitoring to stop the spread of resistant bacteria. In her presentation, Ms Kollatou spoke in particular about how In Vitro Diagnostics can help patients at the community level by differentiating between a viral and bacterial infection, and at the hospital level through faster diagnosis which leads to more timely and appropriate treatement and better patient outcomes. In all, medical technologies can help society as a whole through more accurate infection diagnoses which will help to ensure the efficacy and prudent use of antibiotics for generations to come.
Among her recommendations, Ms Kollatou noted that at the European level, the joint action group EU-JAMRAI is coming to an end soon, which means there is a need for joint-action guidelines to be issued. She echoed Ms Seebohm’s call to engage with the ‘One Health’ approach, and also advocated for promoting a prevention culture.
The final speaker of the workshop was Ms Sian Williams, Policy and Advocacy Adviser at Wellcome Trust, UK. Ms Williams talked about the political will on AMR, warning that although it is strong, it is still at risk. She highlighted how we can help to reinforce a mandate for change through collective action, which requires better understanding of antimicrobial resistance at the public level. However, awareness alone is not enough to spark collective action and behavioural change, but rather, people may need a deeper connection to the issue in order to bring about real change. Ms Williams provided the participants with knowledge on how to approach effective patient education and messaging on AMR based on the latest research.
Framing is key in public education on AMR, and Ms Williams advised the Patient Group members on key framing advice from the Wellcome Trust, which included the recommendation that the fundamentals of AMR should be explained succinctly. AMR needs to be emphasised as a universal issue that is solvable, but which requires immediate action. She also highlighted the power of human-focused patient stories and noted the opportunity that the AMR Patient Group provides to encourage patient voices within AMR advocacy.
The workshop included questions and answers sessions and open group discussion where we heard from our members about their concerns regarding AMR and the biggest issues they face as patient representative groups. From the discussion, a recurring issue was raised regarding the difference in approach to antibiotics regulations across borders. This concern further added weight to recommendations that were heard from multiple speakers to adopt a joint ‘One Health’ approach to AMR in Europe at the political, medical and community policy action levels. The work of EU-JAMRAI needs to be carried forward into the future. Overall, the group was in agreement that patients tend to trust their doctors and healthcare professionals, and education on AMR needs to come from all levels. Patients can be both leaders and supporters in the fight against AMR.
In terms of messaging on AMR, the most effective approach is evidence-based and simple messaging, with a focus on human stories to aid understanding and encourage collective action. Ms Sian Williams also gave a prudent example of why AMR concepts need to be clearly explained: many people do not realise that the “resistance” element of AMR applies to the bacteria or microbe, and not to the person themself. This understanding enables people to see that AMR is not an individual or personal problem, but a global community health crisis. Another key recommendation that came from the workshop was the necessity of educating children and their parents to ensure the next generation has a full understanding of the concepts relating to AMR and effective infection prevention measures, especially that of good hand hygiene practices. The effects of the Covid-19 pandemic on AMR rates are still unknown and may overall be contextual. However, it is crucial that good hygiene practices remain into the future and that the importance of AMR action must stay firmly on the global health agenda. The first workshop successfully laid out the groundwork and tools needed to succeed in achieving the AMR Patient Group mission: to educate and raise patient awareness about AMR, to build a consistent patient voice on AMR across Europe, and to broaden the AMR debate to include infection prevention control measures.
To conclude this event summary, here is a great analogy that our AMR Patient Group member Neda Milevska-Kostova from the International Alliance of Patients’ Organizations (IAPO) contributed to the workshop: “Antibiotics are like a fire extinguisher. You need to have one, but you hope you never need to use it”.