Strengthening antimicrobial resistance governance in Europe: a coordinated one health approach.

Antimicrobial resistance (AMR) causes over 35,000 deaths annually in the EU/EEA and is projected to result in 1.91 million global deaths each year by 2050. The second Joint Action on Antimicrobial Resistance and Healthcare-Associated Infections (EU-JAMRAI-2), uniting 128 partners from 30 countries, represents a coordinated EU/EEA effort to curb AMR through a One Health approach. Although nearly all EU/EEA countries have an AMR National Action Plan, our initial assessment revealed that implementation remains constrained by limited resources, weak intersectoral coordination and fragmented leadership. EU-JAMRAI-2 addresses these challenges by promoting harmonized surveillance, strengthening infection prevention and control, applying behaviorally tailored stewardship interventions, ensuring sustainable access to essential antibiotics, and raising awareness among priority target audiences. By analyzing policy gaps and operational barriers, this paper underscores the need for stronger accountability and political commitment to translate strategies into sustainable action. Strengthening AMR governance through a unified European approach is essential to achieve effective, lasting progress against this silent pandemic.