Antimicrobial Resistance: A One Health Approach
From Department of Health; Department of Agriculture, Food and the Marine
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From Department of Health; Department of Agriculture, Food and the Marine
Published on
Last updated on
Antimicrobials are medicines such as antibiotics used to prevent and treat infections in humans, animals, plants, and crops. These medicines are very useful drugs and save lives. Antimicrobial medicines help people to live longer. They also help to protect people from infections when having surgery, giving birth and when receiving treatment for diseases including cancer.
Microorganisms are tiny living things that are found all around us. They are too small to be seen by the naked eye. Some microorganisms can make us sick. The most common types of microorganisms are bacteria, viruses, and fungi. Antimicrobial medicines work by killing harmful microorganisms or stopping the growth of microorganisms that cause infections.
Antimicrobials include medicines such as antibiotics, antifungals, antivirals and antiprotozoals.
When an antimicrobial medicine that previously worked to treat an infection or disease caused by a microorganism stops working or does not work as well as it did before, this is called antimicrobial resistance. Antimicrobial resistance means that there are less treatment options available. This makes the most common infections more difficult to treat. If infections cannot be treated the risk of diseases spreading, severe illness and death increases.
Antimicrobial resistance happens naturally over time. However, the rate of antimicrobial resistance is increasing because a huge amount of antimicrobials are being used across the world in humans, animals, and the environment. Antimicrobial resistance is being made worse by overusing antimicrobial medicines and by not using antimicrobial medicines correctly. The result of this is that common infections are becoming more difficult to treat and so called ‘superbugs’ are developing. This is a problem because many antimicrobial medicines do not work to treat ‘superbugs’. Antimicrobial medicines should only be used when they are needed to fight serious infections.
To help reduce antimicrobial resistance it is important to:
The ‘One Health’ concept recognises that the health of people is connected to the health of animals and the environment. One Health is a collaborative, multisectoral, and trans-disciplinary approach. One Health works at local, regional, national, and global levels to achieve the best health and well-being outcomes.
Ireland is fully committed to and engaged in addressing the issue of AMR and continues to collaborate at national, EU and international levels to progress this agenda. Ireland contributes to the European Antimicrobial Resistance Surveillance System and is a member of the EU AMR One Health Network.
Ireland’s One Health activities at national level led to the publication of the first One Health Report on Antimicrobial Use and Antimicrobial Resistance (2019) which brings together usage and resistance surveillance data in both the human and animal health sectors for the first time.
In recognition of the serious and increasing threat of antimicrobial resistance, the Department of Health’s Chief Medical Officer (CMO) and the Department of Agriculture, Food, and the Marine’s Chief Veterinary Officer (CVO) established the National Interdepartmental AMR Consultative Committee in November 2014. This committee meets Ireland’s requirements to have an intersectoral co-ordinating system for addressing AMR at European Level.
Committee membership consists of representatives from both departments and across the human health, animal health and the environmental sectors. The Committee meets at least twice a year, or more if needed.
Ireland’s first National Action Plan on Antimicrobial Resistance 2017 – 2020, known as iNAP1, was published jointly by the Departments of Health (DOH) and Agriculture, Food, and the Marine (DAFM) in October 2017. This was Ireland’s first roadmap for tackling Antimicrobial Resistance on a national level. The ways to deal with AMR are broadly covered under antimicrobial stewardship, infection prevention and control, research, surveillance, and communications. The 3-year plan was developed and implemented in line with the One Health approach.
More information on AMR
Ireland’s second One Health National Action Plan on Antimicrobial Resistance 2021-2025 (iNAP2) was published jointly by the Departments of Health (DOH) and Agriculture, Food, and the Marine (DAFM) in November 2021. iNAP2 is the successor plan to Ireland’s first National Action Plan on Antimicrobial Resistance 2017-2020 (iNAP1) and outlines over 150 actions to tackle the threat of AMR.
The development of iNAP2 was informed by a number of external stakeholder engagements; the learning from two public health emergencies, COVID-19 and CPE ; recommendations received as a result of the joint monitoring visit from the European Commission and European Centre for Disease Control ; and learning and experience from the implementation of iNAP1. iNAP2 also adopts a One Health approach and aligns with the Resilience and Recovery 2020-2021: Plan for Living with COVID-19 (September 2020 ), the Department of Health Statement of Strategy 2021-2023 , the Programme for Government: Our Shared Future .
Both iNAPs follow the five strategic objectives outlined in the WHO Global Action Plan 2015:
Ireland’s National Action Plans on Antimicrobial Resistance will ensure a sustained focus on responding to AMR.
Ireland’s Second One Health National Action Plan on Antimicrobial Resistance 2021-2025 (iNAP2)
Ireland’s Second One Health National Action Plan on Antimicrobial Resistance 2021-2025 (iNAP2) – Midterm Review Report
As it was developed in a time of change and challenge for the health and social care services, iNAP2 contained a commitment to a mid-term review of the human health actions. This allowed provision of refinement of the actions for the remaining lifetime of the plan. This is now complete and was published on 11th May 2023.
A joint Departmental event was held on Thursday 23rd June 2022 at Farmleigh House to acknowledge the work done under Ireland’s National Action Plan on Antimicrobial Resistance 2017-2020 (iNAP1) in tackling AMR and promote even greater ambition under Ireland’s second One Health Action Plan on Antimicrobial Resistance 2021-2025 (iNAP2).
There were speakers from across the One Health sector and our keynote address was given by Ms Emer Cooke, Executive Director, European Medicines Agency.
Ellen Martin – HSE AMRIC Senior Antimicrobial Pharmacist
Dr Patricia Harrington & Dr Kieran Walsh – HIQA Health Technology Assessment
Dr Simon Doherty – Animal Health & Welfare School of Biological Sciences, Queen’s University Belfast
Professor Dearbháile Morris – Head of Bacteriology, National University of Ireland Galway
Dr Jean O’Dwyer – Deputy Head of Environmental Science, University College Cork
Keynote Speaker - Dr Emer Cooke, Executive Director, European Medicines Agency.