COUNCIL RESOLUTION

of 8 June 1999

on antibiotic resistance

"A strategy against the microbial threat"

(1999/C 195/01)

THE COUNCIL OF THE EUROPEAN UNION,

1. CONSIDERING that antibiotic resistance is a major European and global health problem;

2. RECALLING that a high level of human health protection is to be ensured in the definition and implementation of all Community policies and activities;

3. CONSIDERING that an effective reduction and prevention of micro-organisms becoming resistant to antibiotics used in human and veterinary medicine and in animal feeding stuffs and preservation of the effectiveness of antibiotics for the treatment of infection cannot be achieved by national initiatives alone, but require a common strategy and coordinated action at Community and international level;

4. RECALLING that the growing awareness of this problem has triggered various initiatives and actions in different areas at national, Community and international levels;

5. RECALLING the World Health Organisation (WHO) Conference held in Berlin in October 1997 and the report on the medical impact of the use of antimicrobials in food animals resulting from that Conference as well as the WHO Conference held in Verona in December 1997;

6. RECALLING the Resolution of the European Parliament of 15 May 1998 on the use of antibiotics in animal feed(1);

7. RECALLING the EU Conference on the Microbial Threat held in Copenhagen on 9 and 10 September 1998 and the Recommendations resulting from this conference which identified possible initiatives and actions that could be taken at Community level;

8. WELCOMING the own-initiative opinion of the Economic and Social Committee of 9 September 1998(2) on the resistance to antibiotics as a threat to public health;

9. RECALLING the Council Regulation (EC) No 2821/98 of 17 December 1998 amending, as regards withdrawal of authorisation of certain antibiotics, Directive 70/524/EEC concerning additives in feedingstuffs(3);

10. RECALLING that the Council invited the Commission on the occasion of the adoption of the abovementioned Regulation to submit a report before 30 June 1999 on all the public health, economic and legal implications of the antibiotic resistance issue with regard to the external dimension;

11. RECALLING the Decision No 2119/98/EC of the European Parliament and of the Council of 24 September 1998 setting up a network for the epidemiological surveillance and control of communicable diseases in the Community(4) which constitutes a framework for the surveillance of communicable diseases;

12. RECALLING that under Directive 95/69/EC(5) establishments manufacturing antibiotics used as additives in feeding stuffs are required to hold a register to ensure the traceability of the quantities of antibiotics used, specifying among other things the nature and the quantity of the additive;

13. TAKING NOTE of the opinion of the Scientific Steering Committee of 28 May 1999;

14. WELCOMING the projects initiated at European level and supported by the Commission in this area and the actions by the European Agency for the Evaluation of Medicinal Products (EMEA) in the area of control of the use of antibiotics;

15. STRESSES that antibiotic resistance increases morbidity and mortality due to communicable diseases;

16. UNDERLINES that this leads not only to a diminution of quality of life but also to additional health and medical care cost;

17. EMPHASISES that antibiotics are indispensable to combat infectious diseases and that it is therefore imperative to preserve the effectiveness of those medicinal products which are still effective;

18. CONSIDERS that antibiotic resistance and its various causes need a multidisciplinary and cross-sectorial approach;

19. CONSIDERS it necessary in view of the global dimension of this problem that the Member States and the Commission in close cooperation with the Member States promote actively the aims of this Resolution in international organisations, in particular in the WHO, Food and Agriculture Organisation (FAO) and International Office of Epizootics (OIE);

20. REITERATES its commitment to defining an overall strategy to guard against the development of antibiotic resistance;

21. CONSIDERS that this overall strategy should be based on risk assessment using known scientific findings, keeping in mind a precautionary approach, and comprise coordinated control and preventive action and research in particular in the following areas:

- control and preventive action relating to

- surveillance of antibiotic resistance in humans, animals and foodstuffs and its effects

- monitoring and control of usage of antibiotics (in human and veterinary medicine, animal feedingstuffs, horticulture and other agricultural productions, and foodstuffs)

- infection control in health care (hospital and non-hospital care)

- infection control in animal production

- development of new therapeutic and preventive pharmaceuticals

- promotion of prudent use of antibiotics and education in pharmacotherapy,

- research relating to

- effects of preventive measures

- development of new antibiotics and alternatives

- best use of antibiotics

- determinants which enlarge the risk of emergence of antibiotic resistance

- mechanisms of the spread and development of antibiotic resistance

- best farming practice so to improve animal health;

22. CALLS UPON THE MEMBER STATES

- to establish multi-disciplinary and cross-sectorial policies in order to facilitate the containment of the spread of antibiotic resistance,

- to cooperate in order to enable an effective comparable monitoring of the supply and use of antibiotics and an effective comparable surveillance of antibiotic resistance,

- to maintain the principle of antibiotics authorised as human and veterinary medicine being "prescription-only-medicines" and to ensure vigilance on the implementation of this principle,

- to promote adherence to the principles of infection control both in hospitals and non-hospital care as well as in animal production,

- to promote optimal prescribing and use of antibiotics (through professional education, guidelines, etc.) and to prevent their unnecessary and inappropriate use in human and veterinary medicine,

- to promote actions aimed at raising the awareness of health professionals, farmers and the general public of the problem of antibiotic resistance,

- to promote health orientated animal production systems, thus reducing the need for antibiotics,

- to promote research in this area,

- to cooperate closely with the Commission, in particular in the aforementioned areas;

23. INVITES THE COMMISSION

- to include as a priority the surveillance of antibiotic resistance in human medicine and in the field of zoonosis control and to promote through the Community network for the epidemiological surveillance and control of communicable diseases complementarity of this surveillance;

- to ensure, on the basis of comparable data provided by Member States, the reporting, including conclusions, on the supply and use of antibiotics in particular in human and veterinary medicine as well as in animal feeding, horticulture and other agricultural productions and foodstuffs;

- to support the exchange of experience and information concerning the rational usage of antibiotics by appropriate Community activities;

- to promote research work in the implementation of the Fifth Research Framework Programme with regard to

- the evolution of antibiotic resistance within bacterial populations and the understanding of the transmissibility of resistant bacteria in humans, animal populations and the environment,

- possible transmission of antibiotic resistance potentially linked to the use of antibiotic resistance markers in the production of transgenic foodstuffs or feedingstuffs,

- the development of new rapid diagnostic and susceptibility testing systems for focused treatment,

- effective alternatives to antibiotics to prevent and control communicable diseases;

- to consider the opportunity of preparing a proposal for a Recommendation in accordance with the Treaty;

- to examine the necessity of reviewing current Community legislation in the areas of human and veterinary medicine, including medicated feedingstuffs, animal feedingstuffs, horticulture and other agricultural productions and foodstuffs, including the Community authorisation system of medicinal products with a view to reaching the objectives of this Resolution;

- to pay particular attention to the problem of antibiotic resistance in specific health actions related to applicant countries, in particular in the framework of the PHARE 2000 programme;

- to cooperate in this area, in close coordination with the Member States, with the relevant international organisations.

(1) OJ C 167, 1.6.1998, p. 306.

(2) OJ C 407, 28.12.1998, p. 7.

(3) OJ L 351, 29.12.1998, p. 4.

(4) OJ L 268, 3.10.1998, p. 1.

(5) Council Directive 95/69/EC of 22 December 1995 laying down the conditions and arrangements for approving and registering certain establishments and intermediaries operating in the animal feed sector and amending Directives 70/524/EEC, 74/63/EEC, 79/373/EEC and 82/471/EEC (OJ L 332, 30.12.1995, p. 15). Directive as last amended by Directive 1999/29/EC (OJ L 115, 4.5.1999, p. 32).