Assessing European Union member states' progress toward antimicrobial sales reduction targets under the European Green Deal: A comparative policy and performance analysis.

Background and Aim: Antimicrobial resistance (AMR) is a growing One Health threat driven by the excessive use of antimicrobials (AMs) in human and veterinary medicine. Recognizing this, the European Green Deal's Farm to Fork (F2F) strategy set a target to reduce veterinary AM sales by 50% by 2030 compared to 2018 levels. Understanding the performance of European Union (EU) Member States (MS) is critical to evaluate progress and identify gaps. This study assesses the performance of EU-27 MS in reducing veterinary AM sales during the progress period (2018-2022) and estimates their likelihood of achieving the 2030 reduction target. Materials and Methods: Data from the European Medicines Agency (European Surveillance of Veterinary Antimicrobial Consumption) and Common Agricultural Policy (CAP) Strategic Plans were analyzed. Indicators included AM sales (mg/population correction units [PCUs]), trends from 2018-2022, and national targets for CAP Strategic Plans result indicator R.43 ("Limiting antimicrobial use"). MS were grouped by performance level, strong, average, limited, or insufficient, using the zero unitarization method, and results were visualized with color-coded classifications. Results: Between 2018 and 2022, AM sales for food-producing animals declined by 31% across the EU, with notable reductions in Portugal (-57%), Malta (-48%), France (-44%), and Latvia (-43%). However, sales increased in Poland (+7%) and Lithuania (+36%), and the largest absolute sales remained concentrated in Spain, Poland, Italy, and Germany (over 70% of total EU sales). PCU analyses revealed uneven intensity of AM use, with Spain and Poland showing high usage rates, while Germany and France demonstrated more efficient use. During the progress period, 20 MS were rated as strong contributors, while three MS showed limited contributions. For the target period (2023-2030), only six MS (e.g., Italy, Romania, Latvia, and Malta) are projected to maintain strong contributions, whereas seven MS, including Poland, Lithuania, and Denmark, are unlikely to achieve the target. Conclusion: The EU-27 achieved substantial reductions in AM sales during 2018-2022, yet performance remains uneven across MS. While some countries have already met or are close to the 2030 target, others require accelerated policy interventions, veterinary stewardship, and stronger CAP alignment. Achieving the EU-wide 50% reduction by 2030 will depend heavily on high-consumption MS adopting best practices from leading countries.