The EU must take the lead in preserving essential medicine for human use

A blog post by Erik Ruiz
Safer Pharma Project Officer – HCWH Europe

Antimicrobial resistance (AMR) claims the lives of 1.2 million people per year globally and the misuse and overuse of antimicrobials in food production contribute to the spread of resistant bacteria. In April 2022, to combat this growing health threat, the European Commission presented a draft list of antimicrobials to be preserved for human use only, i.e. banned in food production – but there are crucial omissions in this legally-binding list that will undermine both human and animal health.

The European Commission presented this list as a game changer, an instrument that would put the European Union at the forefront of the fight against AMR globally. However, none of the antimicrobials currently included in the draft list have been authorised for veterinary use in the EU. In other words, this proposal will absolutely not change the current use of antimicrobials in intensive food production in the EU.

We should leave no stone unturned. Health professionals can take part in the public consultation and give their feedback on the European Commission’s proposed list, demanding that crucial drugs for human health must be preserved.

The list does not live up to the expectations set in the Regulation that mandated its creation - to reserve medicines of vital importance for human health in the face of the growing threat of AMR. In a recent ENVI Committee meeting, no political group in the European Parliament took a positive view of the European Medicine Agency (EMA)’s advice (upon which the European Commission’s list is based). The European Commission, contrary to what was promised to the European Parliament, has come up with a very unambitious proposal.

The concerns of the human health and animal welfare sectors have also gone largely unheeded. In February, 150 health professionals, supported by 18 civil society organisations, called on the European Commission to include colistin on this list because of its importance for human health. Colistin is the last antimicrobial available to treat certain diseases in humans, and resistance to this drug has increased by 67% in European hospitals in the last 10 years.

In intensive livestock farming, antimicrobials are used irresponsibly to compensate for poor farming practices and increase profit margins, such as the early weaning of pigs. This practice often leads to infections that need to be treated with antimicrobials, the most effective of which is colistin. Something as simple as later weaning could reduce antimicrobial consumption by 20-30% and help curb the development of potentially lethal antimicrobial resistance.

The EMA’s recommendation, now adopted by the European Commission, argues that including colistin on the list would be very complex because it would require time and money. The new Veterinary Medicines regulation was, however, adopted in 2018, and Member States have already had over three years to adapt their food systems to stricter antimicrobial use. Spain, for example, voluntarily reduced consumption of colistin to almost zero, regardless of whether this drug would be included in the list.

We should leave no stone unturned. If we do not want to lose the fight against AMR we need to rethink food production systems and preserve the most important antimicrobials, such as colistin, to protect human health. Health professionals can take part in the public consultation and give their feedback on the European Commission’s proposed list before May 17, demanding that crucial drugs for human health, such as colistin, must be preserved. Together we can still prove the vital importance for human health of colistin and make the Commission reconsider its list.

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