Pan European Networks: Science & Technology
antibiotics, have been found in Europe, imported from countries where they
are widespread.
Surveillance is key to detect trends and enable timely corrective action to
protect animal and human health. Countries with surveillance systems
can document the public health burden of antibiotic resistance as well as
the impact of their interventions. In countries without surveillance, the
situation can be expected to be similar, if not worse, as not documenting
the problem will not make it go away.
The situation in the European Region is quite unique as half of the region
has well-established national and international surveillance systems (i.e. EU)
whereas the other half does not (Eastern Europe and Central Asia). In two
out of three countries in this part of Europe, antibiotics are less regulated
and can be obtained over the counter, without prescription. As resistant
bacteria do not respect geographical (or biological) borders, this is of
particular concern.
On 30 October 2012, the WHO Regional Office for Europe signed
an agreement with the National Institute for Public Health and the
Environment (RIVM) of the Netherlands and the European Society of
Clinical Microbiology and Infectious Diseases (ESCMID) to survey, contain
and prevent the emergence and spread of antibiotic resistance in
countries that are in the region but outside the EU. The new network
is called the Central Asian and Eastern European Surveillance of
Antimicrobial Resistance network (CAESAR). This complements
surveillance conducted in EU countries by ECDC through the European
Antimicrobial Resistance Surveillance Network (EARS-Net).
Producers, other stakeholders and the public
should be informed about the benefits of prudent
use of antibiotics, while relevant authorities should
make guidelines on the prudent use of antibiotics
in food animals available to both veterinarians
and farmers, taking into consideration antibiotics
which are critically important for human medicine.
A list of critically important antimicrobials for
humans has been defined and published by
the WHO in consultation with the WHO Advisory
Group on Integrated Surveillance of Antimicrobial
Resistance (AGISAR).
Europe and the wider world
In the European Region, resistance of some
pathogens now reaches over 50% in some
countries, and new resistant mechanisms are
emerging and spreading rapidly. In the European
Union (EU), Norway and Iceland, for example,
400,000 resistant infections are estimated to
occur every year, leading to about 25,000 deaths,
according to the ECDC. Antibiotic resistance is not
just a local or even regional problem, as deadly
bacteria are crossing borders everywhere. In the
last two years, virulent strains of
Escherichia coli
bacteria, resistant to almost all available
From the left: Andre
van de Sande (National
Institute for Public
Health and the
Environment (RIVM) of
the Netherlands),
Zsuzsanna Jakab
(WHO Regional Director
for Europe) and Gunnar
Kahlmeter (European
Society of Clinical
Microbiology and
Infectious Diseases
(ESCMID)). The signing
of the Central Asian
and Eastern European
Surveillance of
Resistance Network
(CAESAR) agreement
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