Surveillance provides a basis for taking action to control antimicrobial resistance (AMR). It is a core pillar in both the global action plan on AMR and the European strategic action plan on antibiotic resistance.

Consistent and high-quality data on the incidence, prevalence, range across pathogens and geographical patterns related to AMR are needed to guide the treatment of patients; to inform local, national and regional actions; and to monitor the effectiveness of interventions.

To strengthen the evidence base through enhanced and standardized global surveillance and research (strategic objective 2 of the global action plan), in 2015 WHO developed the Global Antimicrobial Resistance Surveillance System (GLASS). GLASS currently collects and reports data on AMR rates aggregated at the national level. The system enables comparable and validated data on AMR to be collected, analysed and shared with countries and partners to inform decision-making; to drive local, national and regional action; and to provide the evidence for interventions and advocacy. GLASS also collects data on the implementation status of national surveillance systems.

In the WHO European Region, the main surveillance mechanisms gathering and presenting combined data from countries are the European Antimicrobial Resistance Surveillance Network (EARS-Net) and the Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR) network. EARS-Net collects data from 30 countries, mainly within the European Union, while CAESAR collects data from 19 countries, primarily in eastern Europe and central Asia. In combination, these two networks provide surveillance data for almost all the 53 Member States in the WHO European Region.

The demand for technical support and specialized expertise to strengthen AMR surveillance is increasing rapidly. As a result, the WHO Regional Office for Europe is working closely with collaborating centres (WHO CCs) across the Region. These provide crucial support to Member States to strengthen their AMR surveillance and develop new training modules, coordinated by the Regional Office.

In parts of the WHO European Region, implementation of a national AMR surveillance system based on routine antibiotic susceptibility testing is limited by the underutilization of microbiological diagnostics in routine clinical practice. To improve this, a proof-of-principle study, set up as a joint collaboration between WHO Europe and the National Institute for Public Health and the Environment (RIVM) in the Netherlands, was carried out in several countries in the Region.