The consumption of antimicrobial medicines has risen sharply in recent decades, both in humans and animals. Antibiotics in particular, but also antiviral, antifungal and antiparasitic medicines, belong to the category of antimicrobial medicines. The frequent use of antimicrobial medicines has caused microbes to become increasingly resistant to these medicines. This is known as antimicrobial resistance or AMR.
Infections with resistant organisms are very difficult to treat, which means that AMR is one of the biggest threats to public health. At the moment, about 533 deaths per year in Belgium can be attributed to infections with medicine-resistant bacteria, but by 2050, an estimated 22 500 people will die from them unless additional measures are taken to combat AMR (source: Stemming the Superbug Tide, OECD Health Policy Studies). The focus is mainly on antibiotic-resistant bacteria, which is why the terms AMR and antibiotic resistance are often used interchangeably.
Since 1999, numerous initiatives have already been taken in Belgium to promote the responsible prescribing and prudent use of antibiotics, such as policy measures, awareness campaigns, the establishment of (mandatory) antibiotic policy groups in hospitals, guidelines for human and veterinary medicine and the creation of organisations such as the Belgian Antibiotic Policy Coordination Committee (BAPCOC) and the Knowledge Centre on Antimicrobial Consumption and Resistance in Animals (AMCRA) as oversight of antibiotic use in the hospital and animal sectors.
But the current resistance problem requires new approaches, which is why the Belgian government has is now adopting a “One World, One Health” approach in developing a National Action Plan (NAP) against AMR. Human and animal health are intertwined through the environment, which is why cooperation between the various disciplines involved is necessary in the fight against AMR.
The development of this action plan is coordinated by the FPS Public Health, Food Chain Safety and Environment, in close collaboration with the Federal Agency for Medicines and Health Products (FAMHP), the Federal Agency for the Safety of the Food Chain (FASFC), the National Institute for Health and Disability Insurance (NIHDI), Sciensano (Belgian Institute for Health), the Belgian Antibiotic Policy Coordination Committee (BAPCOC) and the Knowledge Centre on Antimicrobial Consumption and Resistance in Animals (AMCRA).
Within the three pillars of humans, animals and environment, the NAP proposes several operational objectives and concrete actions to combat AMR in a global and coordinated way, with each partner responsible for actions within their domain.
For example, the Proper Use Division within the FAMHP is specifically involved in the case of actions aimed at improving the availability of antimicrobial agents to patients in Belgium and promoting their proper and rational use. It deals specifically with operational objectives 10, 11, 12 and 69 in the NAP.