In 2013, Iñaki Morán spent 20 consecutive days bedridden after drug-resistant bacteria attacked his body. For the 63-year-old Spaniard, who already battles Chronic Obstructive Pulmonary Disease and has survived colon and lung cancers, this was just the beginning of a recurring nightmare. He was hospitalized again in 2016, 2017, and 2018, each time with different resistant germs. His planned double-lung transplant was nearly cancelled due to persistent infections. “My quality of life was greatly reduced,” he recalls. “In the end, I was lucky.”
Morán’s story is emblematic of a crisis that experts call a silent pandemic: antimicrobial resistance (AMR). Driven primarily by the overuse and misuse of antibiotics, antiseptics, and antifungals in humans, animals, and the environment, AMR now ranks among the top three health threats facing the European Union. Each year, it claims roughly 35,000 lives across the bloc and generates healthcare costs and productivity losses estimated at €1.5 billion.
What the EU Proposes
The European Commission has put forward a plan to reduce overall consumption of antimicrobials by 20% across member states. At the same time, it seeks to stimulate the development of new antibiotics—a field that has seen virtually no novel approvals since the 1980s. The key incentive is a transferable exclusivity voucher, granting developers an extra year of regulatory data protection for a successful new antibiotic, which can then be sold or used for another product.
Stella Kyriakides, European Commissioner for Health and Food Safety, explained the rationale: “Since the 1980s, we have not had any novel antimicrobials developed. So we needed to provide strong incentives for new, for novel antimicrobials to be developed. We are doing this by proposing the transferable exclusivity vouchers. We need to also work on advocating on the prudent use of antimicrobials and on addressing the abuse of antimicrobials. But at the same time we need to support the European pharmaceutical industry, so that they innovate, so that we have new products on the market.”
The European Federation of Pharmaceutical Industries and Associations (EFPIA) has signaled its readiness. In 2020, the industry proposed a €1 billion fund through 2030 aimed at bringing two to four new antibiotics to market. Nathalie Moll, EFPIA’s Director General, noted: “This was a sort of a bridging fund to help small biotechs that so far had been failing to be able to produce antibiotics. But it cannot replace a proper system of incentives.”
Hospital-Acquired Infections and the ICU Crisis
Dr. María Cruz Soriano Cuesta, Head of the Internal Medicine Unit at Madrid’s Ramón y Cajal Hospital, highlights the scale of the problem in intensive care. “There are extensive epidemiological studies involving more than 1,000 Intensive Care Units showing that on a given day, more than 50% of the patients admitted have an active infection. Half of those cases are hospital-acquired infections. This is a very serious issue. And unfortunately, at the ICU, the infections are often from multidrug-resistant bacteria.”
Such infections complicate treatment for already vulnerable patients, prolong hospital stays, and drive up costs. The EU’s push for better surveillance and stewardship in hospitals is part of a broader strategy that includes regular seminars bringing together patients, physicians, pharmaceutical representatives, researchers, and policymakers to share prevention and control measures.
Beyond policy and industry, patient advocacy plays a crucial role. Morán now works to raise awareness: “I think that if all patients know about their diseases, in this case Antimicrobial Resistance, if they know what the symptoms are, what the treatment is, if they are prepared, then they are going to be active patients. They are really going to put up barriers against all this. And that's what we patients are trying to spread: our knowledge based on experience.”
The EU’s approach mirrors broader public health trends. For instance, the UK’s generational tobacco ban sets a precedent for proactive health policy, while research on coffee consumption and mental health underscores the importance of lifestyle factors in disease prevention. Meanwhile, the EU’s response to crises demonstrates its capacity for coordinated action—a capacity now being tested by the silent pandemic of AMR.
