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A tribute to the foot soldiers: European health agencies in the fight against antimicrobial resistance

Published online by Cambridge University Press:  30 July 2020

Thibaud Deruelle Open the ORCID record for Thibaud Deruelle [Opens in a new window]
Thibaud Deruelle*
Affiliation:
University of Exeter, Exeter, UK
*
*Corresponding author. Email: td327@exeter.ac.uk
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Abstract

The prevention of antimicrobial resistance (AMR) has been a flagship of the EU's health policy since the early 2000s, leading the European Commission to mandate three European agencies to cooperate in the fight against AMR: EMA (the European Medicines Agency), ECDC (European Centre for Disease Prevention and Control) and EFSA (the European Food Safety Agency). This article is at the intersection of EU health policy and the burgeoning scholarship on bureaucratic reputation. Little is known on the role played by reputational incentives on inter-agency cooperation. This empirical work supports the claim that cooperation creates incentives for agencies to protect their reputational uniqueness vis-à-vis each other. However, rather than threatening their cooperation, it amounts to a process of sense-making of their respective roles in the integrated fight against AMR. Evidence is generated through the agencies' textual sources, as well as in-depth interviews and analysed through a narrative analysis. From the early days of inter-agency cooperation, to recent legislative work, this paper offers in-depth insights on the EU's governance against AMR.

Keywords

Antimicrobial resistanceEuropean agenciesEuropean UnionFuture of health policyReputation
Type
Article
Information
Health Economics, Policy and Law , Volume 16 , Special Issue 1: SPECIAL ISSUE: The future of EU health law and policy , January 2021 , pp. 23 - 37
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Adolph, C, Greer, SL and Massard da Fonseca, E (2012) Allocation of authority in European Health Policy. Social Science & Medicine 75, 1595–1603.Google ScholarPubMed
Anderson, M, Clift, C, Schulze, K, Sagan, S, Ouakrim, D and Mossialos, E (2019) Averting the AMR crisis. What are the avenues for policy action for countries in Europe policy. Health Systems and Policy Analysis Brief 32, 1–38. doi: http://www.euro.who.int/en/about-us/partners/observatory/publications/policy-briefs-and-summaries/averting-the-amr-crisisGoogle Scholar
Bedsworth, LW, Lowenthal, MD and Kastenberg, WE (2004) Uncertainty and regulation: the rhetoric of risk in the California low-level radioactive waste debate. Science, Technology, & Human Values 29, 406–427.Google Scholar
Bold, C (2011) Using Narrative in Research, 1st Edn. London: SAGE Publications Ltd.Google Scholar
Busuioc, M (2013) European Agencies: Law and Practices of Accountability. Oxford Studies in European Law. Oxford: Oxford University Press.Google Scholar
Busuioc, M (2016) Friend of foe? Inter-agency cooperation, organizational reputation and turf. Public Administration 94, 40–56.Google Scholar
Busuioc, M and Lodge, M (2015) The reputational basis of public accountability. Governance 29, 247–263.Google Scholar
Busuioc, M, Curtin, D and Groenleer, M (2011) Agency growth between autonomy and accountability: the European police office as a “living institution”. Journal of European Public Policy 18, 848–867.Google Scholar
Carpenter, DP (2000) State building through reputation building: coalitions of esteem and program innovation in the national postal system, 1883–1913. Studies in American Political Development 14, 121–155.Google Scholar
Carpenter, DP (2001) The Forging of Bureaucratic Autonomy: Reputations, Networks and Policy Innovation in Executive Agencies, 1862–1928. Princeton: Princeton University Press.Google Scholar
Carpenter, D (2010) Reputation and Power: Organizational Image and Pharmaceutical Regulation at the FDA. Princeton, NJ, United States: Princeton University Press.Google Scholar
Carpenter, DP and Krause, GA (2011) Reputation and public administration. Public Administration Review 72, 26–32.Google Scholar
Cassidy, A (2017) Humans, Other Animals and ‘One Health’ in the Early Twenty-First Century. London: Palgrave Macmillan.Google Scholar
Castro-Sánchez, E, Iwami, M, Ahmad, R, Atun, R and Holmes, AH (2018) Articulating citizen participation in national anti-microbial resistance plans: a comparison of European countries. European Journal of Public Health 28, 928–934.Google ScholarPubMed
CDC (2014) First TATFAR Progress Report Available at https://www.cdc.gov/drugresistance/pdf/TATFAR-Progress_report_(2014)pdf.Google Scholar
Clemens, T, Sørensen, K, Rosenkötter, N, Michelsen, K and Brand, H (2017) The directorate-general for health and consumers 1999–2014: an assessment of Its functional capacities. Health Policy 121, 594–603.Google ScholarPubMed
ECDC (2005a) 3rd Management Board meeting minutes (26 May 2005) Available at http://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/mb/MB%20%20Meeting%20Minutes/0505_MB_Minutes.pdfGoogle Scholar
ECDC (2005b) 4th Advisory Forum meeting minutes (28–29 November 2005) Available at https://ecdc.europa.eu/en/publications-data/4th-advisory-forum-meeting-minutes-28-29-november-2005Google Scholar
ECDC (2006) 7th Management Board meeting minutes (20–21 June 2006) Available at http://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/mb/MB%20%20Meeting%20Minutes/0606_MB_Minutes.pdfGoogle Scholar
ECDC (2008a) 14th Advisory Forum meeting minutes (6–7 May 2008) Available at http://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/af/AdvisoryForum%20%20Meeting%20Minutes/0806_Advisory Forum_Minutes.pdfGoogle Scholar
ECDC (2008b) 16th Advisory Forum meeting minutes (9–10 December 2008) Available at http://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/af/Advisory Forum%20%20Meeting%20Minutes/0812_Advisory Forum_Minutes.pdfGoogle Scholar
ECDC (2009a) 18th Advisory Forum meeting minutes (12–13 May 2009) Available at https://ecdc.europa.eu/en/publications-data/18th-advisory-forum-meeting-minutes-12-13-may-2009Google Scholar
ECDC (2009b) 19th Advisory Forum meeting minutes (22–23 September 2009) Available at https://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/af/Advisory Forum%20%20Meeting%20Minutes/0912_Advisory Forum_Minutes.pdfGoogle Scholar
ECDC (2010a) 22nd Advisory Forum meeting minutes (5–6 May 2010) Available at http://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/af/Advisory Forum%20%20Meeting%20Minutes/1010_Advisory Forum_minutes_22nd_meeting.pdfGoogle Scholar
ECDC (2010b) 23rd Advisory Forum meeting minutes (29–30 September 2010) Available at https://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/af/Advisory Forum%20%20Meeting%20Minutes/1012_Advisory Forum_minutes_23rd_meeting.pdfGoogle Scholar
ECDC (2010c) 20th Management Board meeting minutes (9–10 November 2010) Available at https://ecdc.europa.eu/en/publications-data/20th-management-board-meeting-minutes-9-10-november-2010Google Scholar
ECDC (2012) 25th Advisory Forum meeting minutes (3–4 May 2012) Available at http://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/mb/MB%20%20Meeting%20Minutes/management-board-25-meeting-minutes.pdfGoogle Scholar
ECDC (2016) 46th Advisory Forum meeting minutes (13–14 September 2016) Available at http://ecdc.europa.eu/sites/portal/files/media/en/aboutus/governance/mb/MB%20%20Meeting%20Minutes/MB38%20Thirty-eighth%20Meeting%20of%20the%20ECDC%20Managment%20Board.pdfGoogle Scholar
ECDC (2018) Country Visits Reports (2018) 15 November 2018 Available at https://www.ecdc.europa.eu/en/all-topics-z/antimicrobial-resistance/preparedness/country-visits-reports.Google Scholar
ECDC/EFSA/EMA (2015) First Joint Report on the Integrated Analysis of the Consumption of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Humans and Food-Producing Animals (JIACRA I) Available at https://www.ema.europa.eu/documents/report/ecdc/efsa/ema-first-joint-report-integrated-analysis-consumption-antimicrobial-agents-occurrence-antimicrobial_en.pdf.Google Scholar
ECDC/EFSA/EMA (2017) Second Joint Report on the Integrated Analysis of the Consumption of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Humans and Food-Producing Animals (JIACRA II) Available at https://www.ema.europa.eu/documents/report/ecdc/efsa/ema-second-joint-report-integrated-analysis-consumption-antimicrobial-agents-occurrence_en.pdf.Google Scholar
ECDC, EMA (2009) The Bacterial Challenge: Time to React Joint Technical Report. Available at http://ecdc.europa.eu/en/publications-data/ecdcemea-joint-technical-report-bacterial-challenge-time-react.Google Scholar
EFSA (2007) Minutes of the 30th Management Board meeting (27 March 2007) Available at https://www.efsa.europa.eu/sites/default/files/assets/mb070327-m.pdfGoogle Scholar
EFSA (2012) Minutes of the 53rd Management Board meeting (14 June 2012) Available at https://www.efsa.europa.eu/sites/default/files/assets/120614-m.pdfGoogle Scholar
EFSA (2013) Minutes of the 56th Management Board meeting (14 March 2013) Available at http://www.efsa.europa.eu/sites/default/files/assets/mb130314-m.pdfGoogle Scholar
EFSA (2014) Minutes of the 60th Management Board meeting (20 March 2014) Available at https://www.efsa.europa.eu/sites/default/files/assets/mb140320-m.pdfGoogle Scholar
EFSA (2015) Minutes of the 67th Management Board meeting (3 December 2015) Available at http://www.efsa.europa.eu/sites/default/files/mb151203-m.pdfGoogle Scholar
EFSA, ECDC (2008) Memorandum of Understanding between the European Food Safety Authority and the European Centre for Disease Prevention and Control, 3rd April 2008 Available at https://www.efsa.europa.eu/sites/default/files/assets/mouecdc.pdfGoogle Scholar
EFSA, EMA (2012) Memorandum of understanding on working arrangements between the European Medicines Agency and the European Food Safety Authority, 26 January 2012 Available at https://www.ema.europa.eu/documents/other/memorandum-understanding-working-arrangements-between-european-medicines-agency-european-food-safety_en.pdfGoogle Scholar
EMA (2010) Minutes of the 68th Management Board meeting (7 October 2010) Available at https://www.ema.europa.eu/documents/minutes/minutes-68th-meeting-management-board-7-october-2010_en.pdfGoogle Scholar
EMA (2011a) Minutes of the 70th Management Board meeting (16–17 March 2011) Available at https://www.ema.europa.eu/documents/minutes/minutes-70th-meeting-management-board-16-17-march-2011_en.pdfGoogle Scholar
EMA (2011b) Minutes of the 74th Management Board meeting (15 December 2011) Available at https://www.ema.europa.eu/documents/minutes/minutes-74th-meeting-management-board-15-december-2011_en.pdfGoogle Scholar
EMA (2012) Minutes of the 76th Management Board meeting (7 June 2012) Available at https://www.ema.europa.eu/documents/minutes/minutes-76th-meeting-management-board-7-june-2012_en.pdfGoogle Scholar
EMA (2015) Minutes of the 87th Management Board meeting (19 March 2015) Available at https://www.ema.europa.eu/documents/minutes/minutes-87th-meeting-management-board-19-march-2015_en.pdfGoogle Scholar
EMA Committee for Medicinal Products for Veterinary Use (CVMP) and EFSA Panel on Biological Hazards (BIOHAZ), Murphy, D, Ricci, A, Auce, Z, Beechinor, JG, Bergendahl, H, Breathnach, R et al. (2017) EMA and EFSA joint scientific opinion on measures to reduce the need to use antimicrobial agents in animal husbandry in the European Union and the resulting impacts on food safety (RONAFA). EFSA Journal 15, no. 1 (January 2017). https://doi.org/10.2903/j.efsa.2017.4666Google Scholar
EMA, ECDC (2010) Working Arrangements between the European Medicines Agency (EMA) and the European Centre for Disease Prevention and Control (ECDC), 10 December 2010 Available at https://www.ema.europa.eu/documents/other/working-arrangement-between-european-medicines-agency-ema-european-centre-disease-prevention-control_en.pdfGoogle Scholar
EMA, EFSA, ECDC (2009) Scientific opinion on the substantiation of health claims related to boron and maintenance of bone (ID 218, 219) and maintenance of joints (ID 219, 220) pursuant to article 13(1) of regulation (EC) No 1924/2006. EFSA Journal 7, 1261.Google Scholar
European Commission (2011) Communication from the Commission to the European Parliament and the Council. Action Plan against the rising threats from Antimicrobial Resistance Available at https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52011DC0748Google Scholar
European Commission (2013a) 2013/652/EU: Commission Implementing Decision of 12 November 2013 on the Monitoring and Reporting of Antimicrobial Resistance in Zoonotic and Commensal Bacteria (Notified under Document C(2013) 7145) OJ L. Vol. 303. Available at http://data.europa.eu/eli/dec_impl/2013/652/oj/eng.Google Scholar
European Commission (2013b) 2013/653/EU: Commission Implementing Decision of 12 November 2013 as Regards a Union Financial Aid towards a Coordinated Control Plan for Antimicrobial Resistance Monitoring in Zoonotic Agents in 2014 (Notified under Document C(2013) 7289) (2013) OJ L. Vol. 303. Available at http://data.europa.eu/eli/dec_impl/2013/653/oj/eng.Google Scholar
European Commission (2017) A European One Health Action Plan against Antimicrobial Resistance (AMR) Available at https://ec.europa.eu/health/amr/sites/amr/files/amr_action_plan_2017_en.pdfGoogle Scholar
European Commission (2018) Progress Report New AMR Action Plan Text. European Commission. Available at http://ec.europa.eu/health/amr/sites/amr/files/amr_2018-2022_actionplan_progressreport_en.pdf.Google Scholar
European Union (2003a) Regulation (EC) No 1831/2003 of the European Parliament and of the Council of 22 September 2003 on Additives for Use in Animal Nutrition (Text with EEA Relevance) (2003) OJ L. Vol. 268. Available at http://data.europa.eu/eli/reg/2003/1831/oj/eng.Google Scholar
European Union (2003b) Directive 2003/99/EC of the European Parliament and of the Council of 17 November 2003 on the Monitoring of Zoonoses and Zoonotic Agents, Amending Council Decision 90/424/EEC and Repealing Council Directive 92/117/EEC (2003) 325. Vol. OJ L. Available at http://data.europa.eu/eli/dir/2003/99/oj/eng.Google Scholar
European Union (2019) Regulation (EU) 2019/6 of the European Parliament and of the Council of 11 December 2018 on veterinary medicinal products and repealing Directive 2001/82/EC (Text with EEA relevance), Pub. L. No. 32019R0006, 004 OJ L (2019) Available at http://data.europa.eu/eli/reg/2019/6/oj/eng.Google Scholar
Feldman, MS (2004) Making sense of stories: a rhetorical approach to narrative analysis. Journal of Public Administration Research 14, 147–170.Google Scholar
Ferreira, JP and Staerk, K (2017) Antimicrobial resistance and antimicrobial use animal monitoring policies in Europe: where are we? Journal of Public Health Policy 38, 185–202.Google Scholar
Interview 2. Staff member, DG SANTÉ, European Commission. 6 February 2019 Interview by Thibaud Deruelle.Google Scholar
Interview 3. Philippe Roux, DG SANTÉ, European Commission. 6 February 2019.Google Scholar
Interview 5. Paolo Guglielmetti, DG SANTÉ, European Commission. 7 February 2019 Interview by Thibaud Deruelle.Google Scholar
Interview 8. Anonymized interview. 14 February 2019 Interview by Thibaud Deruelle. Skype Business.Google Scholar
Interview 9. Anonymized interview. 14 February 2019.Google Scholar
Interview 10. Anonymized interview. 04 March 2019 Interview by Thibaud Deruelle. Skype Business.Google Scholar
Interview 13. Anonymized interview. 25 March 2019 Interview by Thibaud Deruelle. Skype Business.Google Scholar
Interview 15. Anders Tegnell, State Epidemiologist, Public Health Agency. 11 March 2019 Interview by Thibaud Deruelle.Google Scholar
Interview 17. Anonymized interview. 26 July 2019.Google Scholar
Interview 20. Zoltan Kunsagi, Scientific Administrator. 2 August 2019 Interview by Thibaud Deruelle.Google Scholar
Interview 21. Lieven De Raedt, Belgian Representative to the Management Board of the ECDC. 4 August 2019 Interview by Thibaud Deruelle.Google Scholar
Lodge, M (2008) Regulation, the regulatory state and European politics. West European Politics 31, 280–301.Google Scholar
Majone, G (1997) The new European agencies: regulation by information. Journal of European Public Policy 4, 262–275.Google Scholar
Majone, G (2002) Delegation of regulatory powers in a mixed polity. European Law Journal 8, 319–339.Google Scholar
Maor, M (2010) Organizational reputation and jurisdictional claims: the case of the U.S. food and drug administration. Governance 23, 133–159.Google Scholar
Maor, M and Sulitzeanu-Kenan, R (2016) Responsive change: agency output response to reputational threats. Journal of Public Administration Research and Theory 26, 31–44.Google Scholar
Maor, M, Hebrew, S and Ben-Nun, P (2013) Organizational reputation, regulatory talk and strategic silence. Journal of Public Administration Research and Theory 23, 581–608.Google Scholar
Monnet, DL and Kristinsson, KG (2008) Turning the tide of antimicrobial resistance: Europe shows the way. Eurosurveillance 13, 19039.Google ScholarPubMed
Polkinghorne, DE (1995) Narrative configuration in qualitative analysis international. Journal of Qualitative Studies in Education 8, 5–23.Google Scholar
Riessman, CK (1993) Narrative Analysis, 1st Edn, Newbury Park, CA: Sage Publications, Inc.Google Scholar
Roe, EM (1989) Narrative analysis for the policy analyst: a case study of the 1980–1982 medfly controversy in California. Journal of Policy Analysis and Management 8, 251–273.Google Scholar
Roe, EM (1994) Narrative Policy Analysis: Theory and Practice. Duhram: Duke University Press.Google Scholar
Soss, J (2006) Talking our way to meaningful explanations. A practice-centered view of interviewing for interpretive research. In Yanow, D and Schwartz-Shea, P (eds), Interpretation and Method: Empirical Research Methods and the Interpretive Turn, 1st Edn. Armonk, NY: Routledge, pp. 161–182.Google Scholar
Watier, L, Cavalié, P, Coignard, B and Brun-Buisson, C (2017) Comparing antibiotic consumption between two European countries: are packages an adequate surrogate for prescriptions? Eurosurveillance 22, 17–00352.Google ScholarPubMed
Wilson, JQ (1989) Bureaucracy: What Government Agencies Do and Why They Do It. New York: Basic Books.Google Scholar