Twenty-five of the 30 European Union (EU)/European Economic Area (EEA) countries have a national action plan (NAP) on antimicrobial resistance (AMR). However, in 2021 only eight countries were implementing these plans and tracking performance using monitoring and evaluation frameworks.1 When it comes to AMR in the EU, differences in countries’ NAPs exist with regards to their One Health approach, content, and level of detail, especially with regards to resources, operationality, monitoring and evaluation.2

This paper details a case study of a review of the NAPs in Italy, the Netherlands and Spain. Its goal is to better understand the epidemiology related to AMR in the three countries. Then their NAPs are evaluated and compared. Finally, this paper formulates recommendations to improve the NAPs and their implementation. More effective NAPs will help tackle AMR in the EU.

The rates of antimicrobial usage show substantial disparities among Italy, Spain, and the Netherlands, with certain regions struggling with alarmingly high levels of consumption. As this study underscores, the intricate relationship between antimicrobial use and the emergence of resistance remains a pressing concern. The data collected in this study corroborates this connection. Moreover, it is worth emphasising that the southern countries within our analysis have witnessed a disproportionately significant surge in resistance. This emphasises the pressing need to intensify the fight against AMR in these regions.

Download the paper (PDF)

  1. OECD. Antimicrobial Resistance in the EU/EEA A One Health Response. 2022
  2. DG Health and Food Safety. Member States’ One Health National Action Plans against Antimicrobial Resistance. Available from: