Antimicrobial resistance in France

Antimicrobial resistance

Antimicrobial resistance is a global problem – as the French Minister of Social Affairs and Health clearly understands. She outlined her country’s coordinated regional, national, and international approaches in a recent Lancet article

It’s lots shorter and, perhaps, punchier than the UK version.

The posting here condenses the French article further, to help with your reading.

In 2002 data from the European surveillance network showed France had high rates of antibiotic consumption and resistance. The first antimicrobial resistance programme in France was a public awareness campaign. There was strengthened surveillance. Community antibiotic use decreased by an impressive 26%.

Part of this success must surely have been because starting levels were so high.

The second French plan, in 2006-10, included media campaigns aimed at the public, and a school educational programme. These campaigns were less successful than the first one.

Now there’s a third plan. A new focus on hospitals includes incentives, antibiotic stewardship teams, a list of “critical antibiotics for human use” with specific recommendations for restricted use, and for mandatory enhanced surveillance and follow-up of prescriptions.

A new law empowers the health regional agencies (ARS) to organise, monitor, and coordinate actions to reduce antimicrobial resistance.

The parallel national plan tackling antibiotic use in animals reduced antibiotic volume in the agricultural sector by nearly 40%.

There’s a dedicated task force which in early 2015 proposed four major objectives. These were aligned with the WHO Global Action Plan on Antimicrobial Resistance and included strengthened research, improved surveillance and antibiotic stewardship, and increased awareness of antimicrobial resistance among the public and health professionals.

France is also pushing to have antimicrobial resistance high on the global agenda. For example, they are suggesting harmonisation of resistance-surveillance programmes across Europe.

Other concrete actions include:

  • Development of a list of existing antibiotics that have been progressively abandoned in the past – so that some of these could be reintroduced.
  • A new business model for drug development, intellectual property, and reimbursement. The current model is inappropriate because new molecules must be developed – but their use must be highly restricted. New rules and incentives are needed so that new health products that qualify for “antimicrobial resistance prevention” can benefit from fast-track evaluation and approval, extended patents, tax refund mechanisms, or volume/pricing decoupling.

 

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