A roadmap towards the creation of the European partnership on One Health antimicrobial resistance (OH AMR)

The increasing levels of AMR present a major threat to human health with serious consequences also to animal and environmental health. Tackling AMR in bacteria, fungi, viruses and parasites requires a strong and coordinated response to protect citizens in Europe and beyond, as indicated in the European One Health Action Plan against AMR. This action plan provides the framework within which actions should be taken against this threat. It is recognised that combatting AMR requires a One Health approach, recognizing that human and animal health and the environment are interconnected. Many diseases affected by AMR are transmitted from animals to humans and vice versa, encompassing the environment as a link between humans and animals and as a reservoir of resistant microorganisms. Tackling AMR has also become a key priority as part of the Green Deal, including through the Farm to Fork Strategy[[https://ec.europa.eu/food/farm2fork_en]]. Of importance are also the socio-economic drivers that affect the use of antimicrobials in human and animal healthcare veterinary medicine. However, the challenge in the current situation is that the AMR research and innovation landscape is still too fragmented addressing human health, animal health, feed, food safety and environment in silos, and it is also fragmented across Member States. Therefore, there is the need to move towards the integration of the various disciplines to overcome this fragmentation, thus tackling the problem of AMR with a comprehensive One Health approach bringing the diverse actors together.

Importantly, better co-ordination is essential to foster and accelerate the development and adoption of solutions to reverse the rising levels of AMR. This should allow generating the capacity and the ecosystem to improve the prevention, diagnosis and treatment of drug-resistant infections in humans.

Accordingly, proposals should cover all of the following activities:

• Development of a Strategic Research and Innovation Agenda (SRIA) for a comprehensive approach to inform the expected future European partnership on One Health antimicrobial resistance (OH AMR).
• Integration of key actors for AMR encompassing the field of human, veterinary and environmental disciplines and the broad spectrum of pathogens, including fungi and viruses.
• Robust communication and effective information exchange between diverse scientific disciplines and among multiple sectors of the society that are implicated such as patients, clinicians, veterinarians, pharmacists, food producers, pharmaceutical industry, policy makers and researchers (including those working in the social sciences and humanities).

In order to achieve the expected outcomes, international cooperation, including with low- and middle-income countries where AMR is highly prevalent and prone to spread to Europe, is strongly encouraged. Proposals should build on, be complementary to and go beyond existing initiatives such as the JPIAMR[[https://www.jpiamr.eu/]][1], the One Health EJP[[https://onehealthejp.eu/]] [2] and ICARS[[https://www.icars-global.org/]][3]. It should also implement collaborative activities with International organisations such as the World Health Organization, the World Animal Health Organisation (OIE), the Food and Agriculture Organization (FAO), and the G7 and G20 fora, with the aim to avoid duplication of efforts.

As regards integration and coordination activities, the proposal should be ambitious in its inclusiveness, encompassing the broad spectrum of pathogens, and mobilise experts from diverse disciplines, including from the social sciences and humanities, to address understanding, prevention, monitoring, epidemiology (e.g. emergence, spread, persistence), treatments and detection of AMR. It should also be a pan-European consortium with a large geographical coverage of European countries.

Proposals are expected to explore links with the following expected future European partnership of Horizon Europe: Pandemic preparedness; Innovative Health Initiative; EU-Africa Global Health; Personalised Medicine; Animals and Health; Safe and Sustainable Food Systems for People; Planet and Climate; Biodiversity, Towards more Sustainable Farming: Agro-ecology Living Labs and Research Infrastructures; Water4All – Water Security for the Planet.

The project selected for funding is expected to inform the expected future European partnership on OH AMR. To that end, the proposal selected for funding is also expected to interact with other relevant projects funded under other topics and other clusters to ensure synergies on cross-cutting challenges of common interest such as those from the health cluster’s destination 2 “Living and working in a health-promoting environment”.