By Sascha Marschang, Policy Manager, EPHA

The latest terrorist attacks in Europe, combined with big political question marks hanging over the UK, Turkey and elsewhere, are contributing to the general malaise felt by many Europeans – uncertainty and distress as a condition rather than a passing phase. The sense of ambiguity and growing complexity of problems generates questions about the roles and responsibilities of governments, supranational bodies, communities and individuals. The big challenges of our time tend to be cross-border by nature, demanding comprehensive responses at all levels and involving change, including at the personal level.  We explore just a few of them in this month’s articles.

No surprise that we’ve chosen the theme of Resistance as the central topic of EPHA’s upcoming Annual Conference, which will discuss new ways of scaling up public health, using the urgent threat of antimicrobial resistance (AMR) as an example. Sadly, many of the challenges that prevent an effective response to other global concerns like poverty, sustainable development, migration and terrorism also apply here: action occurs at many different levels but it is not well coordinated, responsibilities are not clearly defined and commitments may not materialise if they are only voluntary.

The fact that AMR remains nebulous and intangible is precisely why we need to act urgently.  Do we really wish to see the consequences of inaction? The crisis of drug-resistant infections is an opportunity to make sweeping changes at system level that will need to occur anyway if we wish to age healthily, with effective medicines at hand when we really need them, as opposed to the status quo where antimicrobials are too often used imprudently.

This June’s Council Conclusions on AMR underline the crucial role that Europe can play in this.  Europe’s contribution must go beyond coordination to include its role as a legislator.  In the face of cross-border health threats, European action aligned with international efforts is the best card we can play; no country is able to beat drug-resistant infections on its own.

Alongside system level changes including rapid diagnostic testing to support prescribing, new innovation models for antibiotics, effective mechanisms for international cooperation and learning, and stewardship in all dimensions of the One Health approach, individuals will also need to accept responsibility. Patients must be equipped with the knowledge to think twice before requesting antibiotics; health professionals should only prescribe them when really necessary, whether in human or veterinary medicine; and policy-makers need to step up to their responsibilities to set effective rules. In the current system the protection of public health is more of an afterthought than a driver.

That is why we need to stop our resistance where it is ill-placed and work together where we can. Europe can seize AMR as a vital chance to prove its value to all Europeans by taking firm and decisive action, ensuring that everybody takes responsibility, and demonstrating to the rest of the world how it can be done.

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