Brussels, 16/10/2001 (Agence Europe) - On Tuesday 23 October in Strasbourg, the European Parliament plenary session is to adopt the report by French Green member Didier Rod. The report suggests improving the proposal of recommendation on the cautious use of anti-microbial agents (antibacterial, fungicidal, antiviral and anti-parasitic) but also to call on the European Commission to present a framework directive aimed at effectively combating at European level the scourge of resistance developed to medicines that are essential for the treatment of infections.
By simply proposing a Council recommendation to the Member States, the Commission does not appear to have understood the overall nature of this serious public health problem, that can only be effectively countered through drastic reduction in the use of antibiotics and other anti-infection agents. In an explanatory statement, the rapporteur above all stresses the problems relating to over-consumption of antibiotics, 10 493 tonnes of which were used (52% for human use and 48% for animals, including for fattening) in the EU alone in 1997. In Paris, one ear infection out of two no longer reacts to penicillin (discovered in 1928 by Flemming and marketed in 1941). In Asia, 10% of tuberculosis strains resist the most powerful antibiotics. The plague bacillus, which used to be sensitive to all antibiotics, is also becoming resistant. In addition to antibiotics, however, this phenomenon affects nearly all micro-organisms, beginning with malaria parasites. Resistance to chloroquinine (derived from quinine, which used to be the main anti-malaria medicine) has become widely used in all areas where the endemic is found, and in Thailand the three main medicines against malaria no longer have an effect today. The appearance of such resistance is not new and the phenomenon is well known, but for a long while public health officials preferred to close their eyes to the problem, convinced that the pharmaceutical industry would come up with new remedies to replace those that have become ineffective. In the meantime, demand for medicines has not stopped growing causing the phenomenon to speed up, and laboratories today are finding it difficult to discover new molecules.
Like any living organism, bacteria, viruses and other parasites adjust to the milieu in which they find themselves and create their own defences, mainly in the form of snares that fix the anti-microbial or enzymes that are to destroy them. This is what we call resistance. Resistance can be transmitted by heredity (chromosome resistance) or as one bacteria to another (plasmid resistance) even if it does not belong to the same species. This second form of transfer of resistance acquired is more devastating than the first, in so far as it may lead to a micro-organism carrying resistance and transmitting the resistance to another, especially because it makes the appearance of resistance possible in Man through food, when the food contains the genes of resistance. Such may be the case with meat from animals which themselves have consumed - as treatment or as a growth factor - antibiotics generating resistance, but also with genetically engineered plants. Regarding the latter, the resistance gene was introduced by the industry to serve as a marker in order to follow the evolution of plants such as genetically modified soya or maize. The industry has since pledged to withdraw the gene, although it has so far done nothing to keep the pledge. This possibility of anti-microbial resistance transmission has, however, not been taken up by the European Commission, which has simply drafted a text on the use of anti-infectious agents in human medicine. Hence the intervention of the rapporteur who, with the support of a very large majority of members of the Committee on the Environment, insists that the text should be extended to the use of antimicrobial agents in veterinary medicine, in animal feed and in genetically modified crops.
Mr Rod also urges, with the support of Greek Socialist Minerva Malliori (author of several amendments adopted by the parliamentary committee), for strengthening of the recommendation provision proposed by the Commission. The modifications cover: the development of rapid diagnosis tests and tests for sensitivity to antimicrobial agents, that would allow doctors to have confirmation of the bacterial or viral nature and in order to determine the effective antimicrobial agent without having to wait for the results of analyses that require another 24 to 48 hours; - the comparative and critical assessment of antimicrobial agents used for preventive reasons (mainly with a view to reducing the prophylactic use of antibiotics, which is still too frequent); - continuous medical training independent of the pharmaceutical industry; - the control of information, promotion and advertising of medicines by the industry among medical consultants; - a ban on all antibiotic advertising for the general public (this provision, like the previous one, was strongly challenged by the Commission); - reduction of nosocomial infections (contracted in hospital), by encouraging treatment at home when it is possible, as well as clinical and laboratory practices that reduce the duration of hospitalisation.