Swedish Strategy to Combat Antibiotic Resistance 2020–2023.

The Swedish Strategy to Combat Antibiotic Resistance 2020–2023 is is an update of the previous Swedish Strategy 2016–2019, made in line with how circumstances for efforts to combat antibiotic resistance have changed in recent years in Sweden, in the EU and at the international level. It maintains its overarching goal of preserving the possibility of effective treatment of bacterial infections in humans and animals. It is intended to form the basis of Swedish efforts to curb the development and spread of antibiotic resistance and to prevent and manage its consequences, stressing the need for a One Health, long-term, and sustainable approach to preventive effort and management of infectious diseases and the use of antibiotics. The strategy is based on the Global Action plan on Antimicrobial Resistance adopted by the WHO Member States, the FAO Action Plan, the OIE Strategy and on other relevant plans and strategies such as the EU Action Plan against Antimicrobial Resistance, the IACG recommendations and the joint work plan of the Tripartite.
The Strategy maintains the same seven strategic objectives to achieve its overarching goal, but updates some of its content. The objectives are as follows. Objective 1: Increased knowledge through enhanced surveillance. This objective signifies that: • access to data on antibiotic resistance and the sale and use of antibiotics and other antimicrobial agents in all sectors, as well as data on healthcare-associated infections and the emission of antibiotics to the environment is improved; and • the outcome and cost-effectiveness of various measures is evaluated, using continuous data collection. Objective 2: Continuous strong preventive measures. This objective signifies that: • effective measures are taken to prevent infections and infection transmission and to minimise the spread of multi-resistant bacteria; • emissions of antibiotics and antimicrobial substances to the environment are minimised. Expected results include: • relevant actors in animal production, veterinary medicine and the food chain to have access to expertise on hygiene and infection prevention and control in order to ensure good animal health and safe food; etc. Objective 3: Responsible use of antibiotics. This objective signifies that antibiotics and other antimicrobial agents are used and managed in a responsible and environmentally friendly manner. Expected results include: • antimicrobial agents to be used in a responsible and evidence-based manner in different types of consumer products; • data to be available regarding reasons for prescribing of medicines in veterinary medicine in order to enable checking or supervision of compliance with treatment recommendations; etc.
Objective 4: Increased knowledge for preventing and managing bacterial infections and antibiotic resistance with new methods. This objective signifies that: • greater knowledge of infectious diseases contributes to new antibiotics, other treatment options, diagnostic methods and vaccines being developed; • increased knowledge about the emergence and spread of resistance contributes to the optimised use of new and existing antibiotics and to the problem of resistance being prevented and limited. Objective 5: Improved awareness and understanding in society about antibiotic resistance and countermeasures. This objective signifies that: • good knowledge and awareness exist among all relevant parties, including the general public, of measures to prevent the spread of infections and of the risks of resistance development due to the use of antibiotics; • the knowledge is implemented as behaviour that promotes containment of antibiotic resistance. Expected results include: • staff in the animal and foods sector to have good knowledge of the issue of resistance, antibiotics and antimicrobial agents, infection prevention and control practices and the One Health concept; • antibiotic resistance, infection prevention and control and healthcare hygiene to be included in relevant basic education and professional training; etc. Objective 6: Supporting structures and systems. This objective signifies that: • supporting structures and systems are in place and in use, as well as that activities regarding antibiotic resistance are followed up and the lessons learnt are acted upon; • efforts are carried out in a coherent, efficient and strategic manner on the basis of the roles of the various parties involved. Expected results include: Strama VL (Veterinary and Food) – a national working group within the Swedish national system for knowledge management in healthcare – to continue to provide knowledge-based support to various stakeholders in the veterinary and food sectors; etc. Objective 7: Leadership within the EU and in international cooperation. This objective signifies that: • Sweden continues to show international leadership in efforts to tackle antimicrobial resistance and urges responsible use of antimicrobial agents around the world. Expected results include: • Sweden to continue to support WHO, FAO, OIE and UNEP in efforts to tackle AMR, in accordance with the global action plan on AMR and equivalent documents in the agriculture and food sectors; • Sweden to contribute to a movement towards more sustainable agriculture and production systems, and to support a global phase-out of the use of antibiotics as growth promoters in animal production and of other routine use of antibiotics in groups of animals; • Sweden to urge effective cooperation on responsible use of antibiotics in animal production under EU free trade agreements to counteract antibiotic resistance.