SPECIAL EDITION ABOUT OUR COMMITTMENT ON
AMR- ANTIMICROBIAL RESISTANCE

Keeping AMR as a priority for the Italian G7 presidency
Antimicrobial resistance: An urgent problem, a challenge to be launched thanks to Italy
A call to action for the Italian G7 Presidency in 2024

The World Health Organisation has recognised that antimicrobial resistance (AMR) - that is the ability of microbes (especially bacteria) to modify and mutate their behaviour, making the drugs normally used against them ineffective - is one of the ten main threats to humanity, which must be tackled with the utmost urgency and with multi-sectoral interventions. We, as representatives of the associations that have signed this call to action, enthusiastically welcome the Italian Minister of Health Schillaci's commitment to make AMR "one of the central issues under the Italian G7 Presidency next year" and express our strongest support for the Italian government to choose AMR as an independent, stand-alone priority for the 2024 Health and Finance Ministerial Meetings.

The costs of AMR are immense, both in public health and economic terms. At least 1.27 million people die each year worldwide from antibiotic-resistant bacterial infection, a third more than HIV/AIDS and twice as many as malaria. And even high-income countries are increasingly affected by AMR: in the European Union alone, almost 100 people die every day from these infections. In Italy, AMR causes 10.000 deaths a year. Even the most ordinary hospitalisation or surgery can lead to dramatic consequences.

If no effective action is taken, the economic impact of AMR could be more severe by 2050 than the 2008-2009 financial crisis. A recent OECD assessment estimated that, to date, AMR costs about EUR 1.1 billion per year in European countries, and in Italy it will cost EUR 11 billion between now and 2050. Fighting AMR would save EUR 445 million per year.

Since their discovery almost 100 years ago, antibiotics have not only saved millions of lives, but have enabled medical practices that we now consider routine such as caesarean sections, chemotherapy and transplants. And yet, about one third of Staphylococcus aureus infections are already resistant to methicillin and multi-resistant to common antibiotics. Also of great concern is the increase in carbapenems resistance in Klebsiella pneumoniae and other Enterobacteria. The most vulnerable and fragile individuals, such as newborns, the elderly and the immunocompromised, rely on the efficacy of antibiotics all the time, but, just as an example, bacterial infections are the second leading cause of mortality in cancer patients.

World leaders have begun to recognise the urgency of taking concrete action to limit the progression of AMR. The last three G7 summits (UK 2021, Germany 2022 and Japan 2023) have all prioritised a discussion on the main measures to be taken. Microbiological surveillance, primary prevention with a focus on care-associated infections, promotion of the correct use of antimicrobials (stewardship), research and innovation for new drugs, vaccines and diagnostics, access to existing products and the preservation of their efficacy were highlighted as essential elements for the realisation of an effective countermeasure plan.
In Italy, we find it encouraging that the National Action Plan against AMR has been updated at the end of 2022, and that the last multiannual state budget authorised an expenditure of EUR 40 mln for each of the next three years. Given the urgency and complexity of the problem, however, more can and must certainly be done, both locally and internationally.

In September 2024, world leaders will gather for a High-Level Meeting on AMR at the United Nations General Assembly. This exceptional event will take place in conjunction with the Italian Presidency of the G7. No other opportunity seems to us better than this to make significant progress in the fight against AMR. This is why we believe it is crucial that the Italian Government makes AMR an independent and priority topic of next year's Health and Finance Ministerial meetings, demanding and promulgating concrete actions and adequate funding.

The document was signed by:

- AMCLI - Associazione Microbiologi Clinici Italiani
- CITTADINANZATTIVA
- GISA - Gruppo Italiano Stewardship Antimicrobica
- MENARINI
- SHIONOGI ITALIA
- SIAARTI - Società Italiana di Anestesia, Analgesia, Rianimazione e Terapia Intensiva
- SIFO - Società Italiana di Farmacia Ospedaliera e dei Servizi Farmaceutici
- SIM - Società Italiana di Microbiologia
- SIMIT - Società Italiana di Malattie Infettive e Tropicali
- SIMPIOS – Società Italiana Multidisciplinare per la Prevenzione delle Infezioni nelle
Organizzazioni Sanitarie
- SITA - Società Italiana di Terapia Antinfettiva, Antibatterica, Antivirale, Antifungina

The document was drafted on August 2023 by Cittadinanzattiva, Menarini and Società Italiana di Microbiologia, with international contributions from the AMR Action Fund, BEAM Alliance and CARB-X.

Cittadinanzattiva-Active Citizenship Network joins the AMR multi-stakeholder partnership platform
In line with and as a result of its long-standing commitment to the topic, Cittadinanzattiva, through its European branch Active Citizenship Network, has become a member of the AMR Multi-Stakeholder Partnership Platform, established by the Food and Agriculture Organization of the United Nations (FAO), the United Nations Environment Program (UNEP), the World Health Organization (WHO) and the World Organization for Animal Health (WOAH). 
The Platform represents an inclusive, international, multi-stakeholder entity that brings together actors working in the human-animal-plant-environment sectors to help preserve antimicrobials as life-saving medicines and ensure their responsible use within a One Health approach. The goal is to catalyze a global movement for action against antimicrobial resistance (AMR) by fostering cooperation among a diverse range of stakeholders at all levels of the One Health spectrum to ensure a healthier, sustainable, and resilient present and future in which antimicrobials are preserved as critical life-saving medicines and accessible to all. Click here for the list of members and here to know more about the platform.
A representative of Cittadinanzattiva- Active Citizenship Network participated in the first "AMR Partnership Platform information session" on 11 July, where a presentation of the operational mechanisms of the platform was given, as well as an overview of the planned activities and timetable. It also marked the launch of the call for proposals for Action Groups, offering practical information on how members can propose and engage in Action Groups. For the agenda, click here.

Creation of HERA Invest
On 12 July 2023, HERA announced the creation of HERA Invest, a €100 million addition to the InvestEU programme, to support research and development (R&D) in the most urgent cross-border health threats, funded by the EU4Health programme. Currently, European companies have difficulties in accessing sufficient public and private funding for the development and expansion of cutting-edge solutions in health and life sciences. Innovation is needed to respond to priority health threats, such as pathogens with high pandemic potential or antibiotic resistance. The HERA Invest funding instrument is aimed at small and medium-sized enterprises (SMEs) developing medical countermeasures to address one of the following health threats: (a) pathogens with pandemic or epidemic potential; (b) chemical, biological, radiological and nuclear threats from accidental or intentional releases; (c) antimicrobial resistance.
Under HERA Invest, the European Investment Bank (EIB) will provide risk loans, covering a maximum of 50 per cent of total project costs. The application process is continuous. The EIB assesses the eligibility of an operation based on defined criteria and the commercial and scientific viability of the project. For more information, click here and here. To download the Factsheet, click here.

5th Annual Global AMR Patient Summit
Also this year Cittadinanzattiva, through the director of its European branch Active Citizenship Network, participated in Pfizer's 5th Global AMR Patient Summit, held in Brussels on 25 and 26 June 2023.
The summit agenda covered a wide range of topics, including policy updates, community mobilisation for action, effective communication strategies and the latest advances in AMR research. Participants engaged in lively discussions, sharing their expertise, experiences and innovative approaches to addressing the challenges posed by AMR. Here you can find Cittadinanzattiva/Active Citizenship Network's long-term commitment to the issue at national and European level.

Italy: Antimicrobial resistance, launch of the first national monitoring on the SPiNCAR platform
In July, the Istituto Superiore di Sanità (ISS) launched SPiNCAR, an innovative platform - unique in Europe - for comprehensive monitoring of antimicrobial resistance.
SPiNCAR collects data and defines standardized and homogeneous indicators for all facilities of the National Health System, enabling Italian Regions and Local Health Authorities to compare the progress and implementation of the National Plan to Contrast Antimicrobial Resistance (PNCAR) and to define priorities for action.
The results of this survey will be valuable at all levels to understand the status of implementation of antimicrobial resistance control policies and identify the main areas of criticality. To know more Click here (Italian language).

Italy: Antimicrobial resistance, published recommendations to fight it
In Italy, Farmindustria has promoted the AMR multidisciplinary Task Force, involving representatives from the academic-scientific world, civic & patients associations, and the pharmaceutical industry, to provide recommendations on combating AMR:

- Role of vaccine prevention as a tool to fight antimicrobial resistance;
- Value, access and innovation of new antibiotics against bacterial resistance;
- Appropriateness of the use of antibiotics.

Cittadinanzattiva was among the stakeholders who joined and signed the document. To download the recommendations, click here (IT version).

Italy: Charter for quality and safety of care
Ten key points and forty-seven concrete actions to improve the quality and safety of hospital care, fighting the risk of infections and antimicrobial resistance, through commitments that mutually involve social and health companies, citizens and institutions. This is the objective of the Charter of quality and safety of care, promoted by Cittadinanzattiva together with FIASO (The Italian Federation of Public Health Trusts and Hospitals) on the occasion of World Hand Hygiene Day 2023, and realized with the contribution of representatives of institutions, health professionals, scientific societies, patient associations.
Here are some articles in EN (A - B), in addition to more than 20 articles in IT. For further information and to download the Charter, click here (IT).

Italy: Cittadinanzattiva mentioned in the National Plan for Combating Antimicrobial Resistance
In Italy, the new National Plan for Combating Antimicrobial Resistance (PNCAR) 2022-2025 was transmitted by the Presidency of the Council of Ministers to the Ministry of Health and Economy and to the Regions in September 2022. and approved in November 2022. In Italy, Cittadinanzattiva is the only civic organization involved in defining the contents of the National Plan and mentioned in the document.

The Italian repository of antimicrobial resistance-related material now online
Active Citizenship Network is glad to announce that the Italian repository of documents on the topic of Antimicrobial Resistance (AMR) is now online. The activity was realized in the framework of the European project “AMR Patient Alliance – developing educational repository for patient and caregiver awareness of drug resistant infections” promoted by the IAPO P4PS Observatory and of which Cittadinanzattiva is part, through its European branch Active Citizenship Network.
It consisted of the research and selection of ad hoc training, informational, and educational materials on the topic of antimicrobial resistance at the local, regional and national context here in Italy.
The aim was to research and select ad hoc training, information and educational materials on the topic of antimicrobial resistance in local, regional and national contexts in Italy.
Our objective was to identify and collect a range of materials available in the Italian language on the topic of antimicrobial resistance that were reliable, useful and validated from official and verified sources and, in most cases, from institutional sources.
The ultimate goal was the development of an online repository accessible to all, including patient organisations, patients and caregivers. To know more, please visit the webpages dedicated to the repository (here and here) and the webpage dedicated to our commitment to the topic of antimicrobial resistance (AMR).

On-demand course “Antimicrobial Resistance: Patient Role in Rational Use”: online the Italian version
Active Citizenship Network is glad to announce that the Italian translation of the English course “Antimicrobial Resistance: Patient Role in Rational Use” developed by the IAPO P4PS Observatory and the Patient Academy for Innovation and Research (PAIR Academy) is now available. The activity was carried out as part of the European project “AMR Patient Alliance – developing educational repository for patient and caregiver awareness of drug resistant infections” promoted by the IAPO P4PS Observatory and of which Cittadinanzattiva is a member through its European branch Active Citizenship Network.
This is the Italian translation of the European Union's online course dedicated to the topic of antimicrobial resistance (AMR) and the key role patients play in the rational and appropriate use of antibiotics. The course explains in a simple but detailed way what AMR is, how and when to use antibiotics, how and when to communicate your needs to your doctor and what we as citizens but also as civic and patient organisations can do to fight AMR. The aim was to contribute to its translation to make it open and accessible to all, both for information and awareness-raising purposes. To learn more, please visit the webpages dedicated to the course (here and here) and the webpage dedicate to our commitment to the issue of antimicrobial resistance (AMR).

Italy: Dictionary for the safety of citizen care
On the occasion of the National Day for the safety of care and of the assisted person, AGENAS, the Italian National Agency for Regional Healthcare Services (a non-economic public body funded in 1993 and under the supervision of the Ministry of Health) makes available the Dictionary for the safety of care for the citizen, with a focus on AMR, drawn up by the National Observatory of Good Practices for health safety in collaboration with Cittadinanzattiva. For further information and to download the Dictionary, click here (IT).

The EU Action Plan against Antimicrobial Resistance
Antibiotics are precious resources used every day to cure common diseases and prevent infections during surgery. Unfortunately, due to overuse, bacteria become resistant, leading to antimicrobial resistance (AMR). As a result, antibiotics become less effective and eventually useless. AMR represents a serious social and economic burden. It is estimated to be responsible for 25,000 deaths per year in the EU alone and costs EUR 1.5 billion per year. The EU is leading the way with an action plan that supports Member States and promotes collaboration between sectors and companies to fight AMR together. Watch the video realized by the European Commission.

AMR Multi-Stakeholder Partnership Platform: the Call for Action Groups proposals is open
The aim is to set priorities and targets and propose tangible actions for tackling antimicrobial resistance (AMR) thanks to the Action Groups, which are composed by at least three members of the Platform and ideally representing two or more Clusters.
The current list of current Platform’s members can be accessed in the Virtual Hub for Members and through this link.  The Hub is a virtual space where members can start and engage in discussions, share and collaborate on knowledge products, keep up to date with events, and interact with the Platform members’ community. All information regarding the submission process is available in the Hub’s Library. Find out how to apply here and submit your proposal through this form by 17 September 2023.

14 September 2023 | EU online training seminar on Adult Vaccination, join us!

Register here (registration is free but mandatory)

As part of the European project #VaccinAction2023, Active Citizenship Network is pleased to invite you on 14 September 2023, from 15:00 to 17:00 CEST, to the online event entitled "Healthy living, healthy ageing: the burden of VPDs in the European adult population - what if we do nothing?".
Vaccine preventable diseases (VPDs) are diseases caused by bacteria and viruses that can be prevented with vaccines.
The initiative will consist of a free 2-hour training seminar open to civic and patient association leaders from different countries to address - with the support of independent experts - the need to be more up-to-date and prepared to support and protect the value, in particular, of adult immunisation and its benefits for individual and public health protection.
Save your place here!
To find out more about ONLINE training, write to Daniela Quaggia. To learn more about Cittadinanzattiva-Active Citizenship Network's commitment to immunisation, click here.

15 September 2023 | AMR-Multi-Stakeholder Partnership Platform: Cluster kick-off meeting for Civil Society Organizations and Networks
Cittadinanzattiva-Active Citizenship Network, as a member of the AMR Multi-Stakeholder Partnership Platform, has been invited and will attend the meeting organised on 15 September. The initiative, which will be held virtually, aims to facilitate interaction among Civil Society Organizations and Networks that are already members of the cluster, enabling them to connect with each other, share and discuss priorities and needs, and select cluster leaders. There will also be an opportunity to propose candidates for the Steering Committee, which will be established prior to the inaugural Plenary Meeting.

19 September 2023 | AMR Stakeholder Network quarterly meeting
Cittadinanzattiva-Active Citizenship Network, as a member of the AMR Stakeholder Network, has been invited to the upcoming AMR Stakeholder Network quarterly meeting organised on 19 September, during which will be discussed important topics related to Antimicrobial Resistance (AMR) and the future actions to be taken. The AMR Stakeholder Network brings together more than 60 leading organisations and individuals committed to tackling Antimicrobial Resistance (AMR) at national, regional and European level, covering all dimensions of the ‘One Health’ approach.

20 September 2023 | Consultative workshop on a Joint Statement on AMR
Cittadinanzattiva-Active Citizenship Network was invited to a consultative workshop, organized by EPHA, on a Joint Statement on AMR ahead of the 2023 WHO Regional Committee. The workshop will take place in Brussels with a hybrid format. The primary objective of the upcoming workshop is to collaboratively formulate a joint statement, which will be presented during the WHO Regional Committee on October 24, 2023, in Astana, Kazakhstan. Specifically, the Joint Statement will respond to the unveiling of the WHO Roadmap of Action on Antimicrobial Resistance (AMR), championing the One Health perspective.

20 September 2023 | High-level summit on Health Diplomacy "Breaking Boundaries: Navigating Health Policy and Diplomacy in Clinical Trials and Bioethics"
The upcoming high-level summit on Health Diplomacy, "Breaking Boundaries: Navigating Health Policy and Diplomacy in Clinical Trials and Bioethics" will take place on 20 September at 15:00 in Brussels, at the European Parliament, in room JAN 6Q1. This summit aims at being an enlightening and engaging exploration of critical issues in clinical trials, bioethics, and healthcare diplomacy. The final objective is to emerge from this summit with a clearer understanding of how diplomacy can drive innovation in healthcare, resolve global health crises, and promote ethical practices in the medical field, fostering collaboration that transcends borders and reshapes the global health landscape. To secure a seat at the event, please register using this link. You can also tune in to the live webcast of the event.
For further information, please write to anja.kolimbatovic@europarl.europa.eu.

26 September 2023| Spain: Civil Society promoting vaccination across the life-course
The first online focus group, within the European project “Civil Society promoting vaccination across the life-course”,  will be held in Spain on 26 September 2023, organized by Asociación Española contra la Meningitis, an official partner of Active Citizenship Network. Independent experts will discuss the importance of lifecourse vaccination in their country, including lessons learned from the Covid-19 pandemic, barriers to vaccine access, options for choosing between different vaccines and possible changes to the annual vaccination calendar. To know more about the initiative, please click here.

26 September 2023| Pain Alliance Europe (PAE) General Assembly
Cittadinanzattiva-Active Citizenship Network, as a historic member, will participate in the upcoming Pain Alliance Europe (PAE) virtual General Assembly on September 26, 2023. In coherence with our long-standing commitment to fight chronic pain, the Assembly will be an opportunity to present our commitment on migraine (more details in IT – EN language here) and more generally to reaffirm the role of Patients’ Advocacy Groups in reducing headache pain in the European Union, from the Italian case history to the European Migraine Action Plan. To know more about PAE, click here.

11 October 2023 | Brussels (Belgium): EU Flu Day 2023 “Empowering healthcare professionals for everyone’s protection”
Active Citizenship Network, as a member of the Steering Group on Influenza Vaccination, invites you to join the EU Flu Day 2023 to boost your knowledge and contribute to making Europeans safer from influenza. The event will take place on Wednesday, 11 October 2023 at the European Parliament and web-streamed between 16:30 and 18:00 CEST. Please find here the registration link.
The annual EU Flu Day campaign aims to raise awareness of the need to increase influenza vaccine uptake in the EU. This fourth annual edition puts a particular focus on how to support doctors, nurses and pharmacists in their important work, as healthcare professionals are a key link in healthcare systems and play an essential role in vaccine delivery and confidence. In light of this, the Steering Group on Influenza Vaccination will present a set of actionable Policy Recommendations on the event day, outlining how European and national policymakers can empower healthcare professionals for everyone’s protection.  
Please note that room size is limited so please secure your seat by registering by 2 October 2023 if you plan to join in person. For further information, please contact the Secretariat by email: sginfluenza@acumenpa.com.

24-25 October 2023 | Brussels (Belgium): RE-energising Europe - Sharing ideas and knowledge
On October 24 and 25, 2023 seven EU-funded projects (Horizon2020) will bring together on stage speakers from the EU institutions, from the projects as well as key players from the energy market, to discuss how the work done in the past 3 years can support RE-energising Europe.
The first day will focus on understanding the future of energy demand and its policy implications through new societal trends, behavioural aspects and multiple benefits through the involvement of three different projects, including NUDGE, in which Cittadinanzattiva-Active Citizenship Network is one of the consortium partners. On October 25 the discussion will be focused on energy communities and renewable energy, accelerating Europe’s transition towards a climate neutral, inclusive future.
Key topics related to energy in Europe will be tackled: (renewable)(bio) energy communities, energy efficiency, multiple benefits, RES, RHC, women, empowering people, energy behaviour, new trends of energy consumption (digitalisation, circular economy and more). To bring content to the discussions, our initiatives will present tools and models, one stop shops, awareness raising and nudging campaigns, showcased through inspirational presentations, a poster session and a field visit (Belgian energy community).
This event will provide an opportunity for attendees to learn about the latest developments in these areas and exchange ideas and best practices. Both days complement each other and provide a comprehensive overview of the current state of research and policy recommendations in the energy field.
To know more and register, please visit this page.

15-16 November 2023 | Rome (Italy): Inaugural Plenary Assembly of the AMR Multi-Stakeholder Partnership Platform
The event will take place in person at the FAO Headquarters in Rome, Italy, on 15 and 16 November 2023.  During the Plenary Assembly, members of the platform, among which is Cittadinanzattiva-Active Citizenship Network, will have a unique opportunity to come together for the first time, engage in discussions, and collaborate on initiatives to shape the future work of the Platform. To know more about the AMR Multi-Stakeholder Partnership Platform, download the document and the brochure.