TOPIC :

COUNTRY : FRANCE

Antibiotics are medicines used to prevent and treat bacterial infections. Antibiotic resistance occurs
when bacteria change in response to the use of these medicines.

Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and
animals, and the infections they cause are harder to treat than those caused by non-resistant
bacteria.

When microbes become resistant to medicines, the options for treating the diseases they cause are
reduced. This resistance to antimicrobial medicines is happening in all parts of the world for a broad
range of microorganisms with an increasing prevalence that threatens human and animal health.

The direct consequences of infection with resistant microorganisms can be severe, including longer
illnesses, increased mortality, prolonged stays in hospital, loss of protection for patients undergoing
operations and other medical procedures, and increased costs. Antimicrobial resistance affects all
areas of health, involves many sectors and has an impact on the whole of society.

Resistance develops more rapidly through the misuse and overuse of antimicrobial medicines.
Antibiotic use for human health is reported to be increasing substantially. Surveys in a wide range of
countries show that many patients believe that antibiotics will cure viral infections that cause
coughs, colds and fever. Antibiotics are needed to treat sick animals but are also widely used in
healthy animals to prevent disease and, in many countries, to promote growth through mass
administration to herds

The indirect impact of antimicrobial resistance, however, extends beyond increased health risks and
has many public health consequences with wide implications, for instance on development.

The World Economic Forum has identified antibiotic resistance as a global risk beyond the capacity
of any organization or nation to manage or mitigate alone,5 but in general there is little awareness
of the potential social, economic and financial impacts of drug resistance. In developed economies,
these include higher health care costs and decreases in labour supply, productivity, household
incomes, and national income and tax revenues.

Today, microbial resistance to antibiotics (antimicrobial resistance) is a serious public health

problem that is reaching rapidly. Despite action taken by the World Health Organisation (WHO), the
number of victims (mortality, morbidity) is steadily rising, and the outlook is increasingly bleak.

With the pressing need for new therapies to be found, the efficacy of existing antibiotics to be
maintained and the spread of resistance in the environment to be limited, many countries have
recently launched ambitious plans, particularly the United States (US) and United Kingdom (UK).

In France, every year more than 150,000 patients develop a multidrug-resistant bacterial infection,
from which more than 12,500 of whom never recover. Due to to the human cost, there is a
considerable economic cost, mainly resulting from the overuse of antibiotics in France. A poor
European example,France spends between EUR71 million(compared with the European average)
and EUR441 million(compared with the average of the most virtuous countries.

And this antibiotic resistance globally caused by the overuse antibiotic , persistent misuse of
antibiotics, . Few standards govern household waste, hospital activity, livestock holdings or manure
spreading near waterways, and yet they expose the whole environment to antibiotics.

For example: In 2010, France was also the largest consumer of antibiotics in agriculture, tied with
the Netherlands. Recent data (2014) shows that both of these countries have considerably cut down
on their use of antibiotics in the animal sectors.

Emerged by this phenomonon , Now, they consume less than Belgium, Germany, Spain, Italy,
Hungary, Portugal and Cyprus.9The tonnage of antibiotic treatments in animals in France, which
remained constant between 1999 and 2007, fell between 2008 and 2013. Antibiotic misused is
decreasing as what France did to tackle higher rate of antibiotic resistance for example :

a) Working a project on Comission’s Action Plan

The Commission's 2011 Action Plan against the rising threats from AMRcontains 12 actions
for implementation with EU Member States and identifies 7 areas where measures are most
needed:

 making sure antimicrobials are used appropriately in both humans and animals
 preventing microbial infections and their spread
 developing new effective antimicrobials or alternatives for treatment
 cooperating with international partners to contain the risks of AMR
 improving monitoring and surveillance in human and animal medicine

b) Raising a program in

In France, this programme, mainly based on a public national awareness campaign, was
widely adopted. Subsequently, antibiotic use in the community decreased by 26%.
Surveillance was also strengthened through the development of national reference centres
and surveillance networks for antimicrobial use and resistance coordinated by the National
Institute of Public Health.
These are now major contributors to the European Centre for Disease Prevention and
Control's European Antimicrobial Resistance Surveillance Network (EARS-Net) and European
Surveillance of Antimicrobial Consumption Network (ESAC-Net).

c) Working on Project with new EU One Health Action Plan against Antimicrobial Resistance

The key objectives of this new plan are built on three main pillars:
1. Making the EU a best practice region
2. Boosting research, development and innovation
3. Shaping the global agenda

d) Working on a Project with WHO

Tackling antibiotic resistance is a high priority for WHO. A global action plan on antimicrobial
resistance, including antibiotic resistance, was endorsed at the World Health Assembly in May
 2015. The global action plan aims to ensure prevention and treatment of infectious diseases
with safe and effective medicines.

The “Global action plan on antimicrobial resistance” has 5 strategic objectives:

 To improve awareness and understanding of antimicrobial resistance.

 To strengthen surveillance and research.
 To reduce the incidence of infection.
 To optimize the use of antimicrobial medicines.
 To ensure sustainable investment in countering antimicrobial resistance.

Alarmed by the importance of these, France would :

1.Joining forces with international partners ( WHO , International Health Institutions)

to contain the risks of spreading antibiotic resistance from international trade and travel and via the
environment

2. Raise public awareness of antimicrobial resistance through targeted local and national initiatives
that have a long-term outlook

( By setting up campaigns , or media to encourage citizens to take individual action to help keep
antibiotics effective)

France is a partner in the European e-bug programme. Coordinated in the UK, this educational
project is being carried out across the EU Member States. It comprises a set of digital and
documentary teaching aids on the topic of infectious diseases.

In France, information in paper format is sent to primary and secondary schools, and just recently
sixth-form colleges as well, by the INPES

References :

ECDC. Antimicrobial resistance surveillance in Europe 2013. ECDC, 2014, report, 211 p. Available at
http://ecdc.europa.eu/en/activities/surveillance/EARS-Net/ 23

Centers for Disease Control and Prevention (CDC). Antibiotic resistance threats in the United States,
2013. CDC, 2013, report, 114 p. Available at http://www.cdc.gov/drugresistance/threat-report-
2013/ 24 Alliance for the Prudent Use of Antibiotics (APUA).

The cost of antibiotic resistance to U.S. families and the health care system. Available at
http://www.tufts.edu/med/apua/consumers/personal_home_5_1451036133.pdf

25 Smith R, Coast J. The economic burden of antimicrobial resistance. Why it is more serious than
current studies suggest. 2013. Available at
http://lshtm.ac.uk/php/economics/assets/dh_amr_report.pdf
Smith R, Coast J. The true cost of antimicrobial resistance. BMJ 2013;346:f1493