National Strategy against Antibiotic Resistance 2015–2020.

This National Strategy against Antibiotic Resistance 2015–2020 is a multi-sectoral policy document adopting a One Health approach. Overarching goals of the National Strategy for the period 2015–2020 are: 1. Reduce the total use of antibiotics. 2. More appropriate use of antibiotics. 3. Improved knowledge of what drives the development and spread of antibiotic resistance. 4. Be a driver in international and normative work to improve access, responsible use, and development of new antibiotics, vaccines and better diagnostic tools.
To achieve the overarching goals, the goals for each of the sector-specific areas have been developed to be measurable and verifiable. For food producing animals and household pets, the goals are: 1. Mapping of resevoirs of antibiotic resistant bacteria will be carried out in the most relevant animal populations and plants important to food safety. 2. LA-MRSA will not be established in the Norwegian pig population. 3. ESBL in the Norwegian poultry-production will be reduced to a minimum. 4. The use of antibiotics in terrestrial animals used for food production will be reduced by at least 10 percent compared with 2013. 5. The use of antibiotics in household pets will be reduced by at least 30 percent compared with 2013. 6. Narasin and other coccidiostats with antibacterial properties will be phased out of chicken production, as long as this does not adversely affect animal health and well-being, and does not result in increased use of antibiotics for treatment of infections. For fish, the goal is: Total antibiotic use in fish farming in 2020 will be at the same or lower levels than for the period 2004-2014, measured in total kilograms of antibiotics. For climate and environment, the goals are set as follows: 1. Mapping of antibiotic resistant bacteria will be carried out in representative environments and selected organisms in animals, water and soil with varying degrees of exposure to antibiotics. 2. Studies will be initiated to explore the effect in nature of other drivers of resistance, including disinfectants, biocides and heavy metals. For the sector of health, the goals include: 1. Antibiotic use in the total inhabitants will be reduced by 30 percent, measured in DDD6 /1000 inhabitants/day, as compared with 2012. 2. Norway will be one of the three European countries that uses the least antibiotics in humans, measured in DDD/1000 inhabitants/day. 3. Prescription of antibiotics will be reduced from an average today of 450 prescriptions per 1000 inhabitants per year to 250 prescriptions per 1000 inhabitants per year. 4. Prescription of antibiotics for respiratory infections will be reduced by 20 percent, measured in DDD/1000 inhabitants/day, compared to 2012. 5. Studies will be carried out on the burden of disease as a consequence of antibiotic resistance, as a consequence of possibly too little antibiotic use, and the effect of infection control measures. In addition, the Norwegian National Strategy Against Antibiotic Resistance 2015-2020 lays out 8 focus areas, including: . Strengthen scientific understanding; . Improve the level of understanding and competence regarding the use of antibiotics, among the general population as well as among prescribers; Improve prescribing practices in all sectors; etc.