A One Health Event to mark European Antibiotics Awareness Day 2018
The Minister for Agriculture, Michael Creed T.D., and the Minister for Health, Simon Harris T.D., today jointly welcomed the ‘One Health 2018: A Joint Approach for Healthcare and Veterinary Professionals’ Conference in the Convention Centre Dublin. This event is co-hosted by the Department of Agriculture, Food and the Marine, the Department of Health and the Health Service Executive and is supported by the Environmental Protection Agency. This conference underlines Ireland's continuing commitment to European Antibiotic Awareness Day and World Antibiotic Awareness Week. Minister Creed highlighted that Antimicrobial Resistance (AMR) is firstly a serious public health concern, but is also an animal health and welfare and environmental concern.
Minister Creed stated, “The key objectives of this One Health event are to again heighten awareness of AMR and to facilitate the knowledge transfer and exchange of best practice amongst healthcare and veterinary professionals in relation to use, prescribing and management of antibiotics in human and animal health. The vital role that doctors and veterinary practitioners play in fighting AMR is critical in terms of their frontline role in addressing healthcare associated infection in both humans and animals and disease prevention in animal stock and in their prudent use of antibiotics.
Minister Harris added: “The fact that this event is a first for Ireland - a One Health conference bringing together all those with a prescribing remit under the One Health umbrella is testament to the commitment of all these professionals; this committed engagement to work together across the One Health family is crucial to our task. It is important to acknowledge the collaborative effort over the past year in ensuring there are safeguards against inappropriate prescribing, dispensing and consumption of medicines. This conference seeks to address and advance those aims."
Both Ministers also acknowledged the collaborative effort of stakeholders in the development last year of Ireland's National Action Plan on Antimicrobial Resistance 2017-2020, known as iNAP, to address the challenge of AMR. iNAP aims to ensure the development and implementation of multifaceted interventions which will safeguard against inappropriate prescribing, dispensing and consumption of medicines, while simultaneously promoting rational use in patients and animals that are expected to benefit from treatment. This conference addresses those aims.
In addition Minister Creed stated:
“I am delighted today to see progress made by stakeholders on some of the key objectives on iNAP, and I welcome the elements which will be launched at this event, such as the ‘Prudent use of antibiotics guidelines for farmers ‘and a new policy document on Highest Priority Critically Important Antimicrobials (HP-CIAs) for use in animals.
Finally, both Ministers agreed that a commitment to a whole of Government approach to tackling AMR is the only way forward.
Notes for Editors
‘One Health 2018’will mark European Antibiotic Awareness Day 2018 and coincides with World Antibiotic Awareness Week 2018. This ensures Ireland’s campaigns on antibiotics are part of the wider global approach on raising awareness and educating the public and professionals on appropriate actions.
What is AMR?
Antimicrobial resistance (AMR) is resistance of a microorganism to a drug that was originally effective for treatment of infections caused by that microorganism. Resistant microorganisms (including bacteria, fungi, viruses and parasites) are able to withstand attack by antimicrobial drugs, such as antibacterial drugs (e.g., antibiotics), antifungals, antivirals, and antimalarials, so that standard treatments become ineffective and infections persist, increasing the risk of spread to others.
The evolution of resistant strains is a natural phenomenon that occurs when microorganisms replicate themselves erroneously or when resistant traits are exchanged between them. The use and misuse of antimicrobial drugs accelerates the emergence of drug-resistant strains. Poor infection control practices, inadequate sanitary conditions and inappropriate food handling encourage the further spread of AMR.
What is the effect of AMR?
A European Centre for Disease Control/European Medicines Agency (ECDC/EMEA) 2009 Report estimated that in 2007 drug-resistant bacteria were responsible for about 25,000 human deaths per annum in the EU alone, with associated healthcare costs and productivity losses of €1.5bn. The Report also stated that approx. 4 million patients are estimated to acquire a healthcare associated infection in the EU every year. (ECDC JOINT TECHNICAL REPORT 'The Bacterial Challenge: time to react' (2009)).
What does ‘One Health’ mean?
The 'One Health' concept is a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment. Recognising that human health, animal health and ecosystem health are inextricably linked, ‘One Health’ seeks to promote, improve and defend the health and well-being of all species by enhancing cooperation and collaboration between physicians, veterinarians, other scientific health and environmental professionals and by promoting strengths in leadership and management to achieve these goals.
There is international consensus through the ‘One Health’ Initiative to which the WHO (World Health Organisation), FAO (Food and Agriculture Organisation) and the OIE (World Health Organisation for Animal Health) are signatories, that tackling the global public health threat of AMR requires action across human and animal health sectors, agriculture and the wider environment.
The multi-sector harmonisation of strategies and measures to address the challenge of AMR are necessary at a global, regional, and national level. There has been global intersectoral collaboration since 2010, with the World Organisation for Animal Health (OIE), the World Health Organisation (WHO) and the Food and Agriculture Organisation of the United Nations (FAO) establishing tripartite actions to coordinate strategies to ensure antimicrobials maintain their efficacy, and are used responsibly. These agencies are signatories to a ‘One Health’ worldwide initiative.
The European Commission has also promoted a holistic and multi-sectoral approach involving many groups such as the public health, food safety, animal health and welfare, research and innovation, bio-safety and environment sectors. The EU at both Council and Parliament levels has developed its Community Strategy against AMR having regard to the ‘One Health’ concept.
At a national level the Chief Medical Officer (CMO) and the Chief Veterinary Officer (CVO) of the Department of Health and the Department of Agriculture, Food and the Marine, respectively, established the National Interdepartmental Antimicrobial Resistance Consultative Committee in 2014 as part of the ‘One Health’ initiative, and to advance a holistic national approach in working together to ensure that effective antibiotics remain available into the future.
The Committee is co-chaired by the CMO and CVO and has a clear role and mandate across the human and animal health sectors. Committee membership consists of representatives of both Departments, relevant HSE agencies, EPA, HPRA, FSAI and other key stakeholder groupings in the human and animal health sectors.
What is the World Health Organisation (WHO) Global Action Plan 2015?
In May 2015, delegates at the World Health Assembly endorsed a global action plan to tackle antimicrobial resistance - including antibiotic resistance, the most urgent drug resistance trend.
The plan sets out 5 Strategic Objectives:
1. Improve awareness and understanding of antimicrobial resistance;
2. Strengthen surveillance and research;
3. Reduce the incidence of infection;
4. Optimize the use of antimicrobial medicines;
5. Ensure sustainable investment in countering antimicrobial resistance.
The WHO called on member countries to develop their own national action plans on antimicrobial resistance in line with the Global Action Plan.
What are the other developments at the international level in relation to AMR?
In June 2016, the European Council adopted a set of conclusions in relation to AMR entitled ‘The next steps under a ‘One Health’ approach to combat antimicrobial resistance’. The Council called on Member States to develop national action plans in line with the WHO Action Plan.
In September 2016, the UN General Assembly adopted a Political Declaration on Antimicrobial Resistance which reaffirmed that the blueprint for tackling AMR is the WHO Global Action Plan on AMR and its five overarching strategic objectives. The General Assembly reaffirmed countries commitments to produce national action plans based on the five strategic objectives in the WHO Action Plan.
In June 2017 the European Commission published its second AMR action plan entitled 'A European One Health Action Plan against Antimicrobial Resistance (AMR)'. This second action plan builds on the political commitment and actions achieved by the first EU action plan (2011-2016). The overarching goal of the new plan is to preserve the efficacy of antimicrobials so that they remain effective disease treatment options for humans and animals into the future. The plan outlines a range of activities under three strategic headings as follows:
(1) Making the EU a best practice region
(2) Boosting research, development and innovation in order to better control the spread of AMR
(3) Strengthening the role of the EU on the global stage to drive actions to address AMR in the context of the ‘One Health’ approach
(4) The Plan provides a 'framework for continued, coherent and more extensive action to tackle AMR'.
iNAP is Ireland's response to international calls to produce a multisectoral action plan to tackle AMR. Ireland is fully committed to and engaged in addressing resolution of the problem of AMR. We will continue to collaborate at international, EU and national levels to this end.
The Final Programme will be available on the Departments websites.
Ireland’s National Action Plan on Antimicrobial Resistance 2017 – 2020 is available at:
https://www.agriculture.gov.ie/media/migration/animalhealthwelfare/amr/iNAP251017.pdf
Department of Agriculture, Food and the Marine AMR webpage available at
https://www.agriculture.gov.ie/amr/
Department of Health webpage available at https://www.health.gov.ie/national-patient -safety-office/patient-safety-surveillance/antimicrobial-resistance-amr-2/
Health Service Executive webpage at https://www.hse.ie/eng/about/who/healthwellbeing/our-priority-programmes/hcai/