Health care, pharmaceutical production, research, animal husbandry and food production - to solve the problem of antibiotic resistance, coordinated efforts are needed from many sectors. A big challenge is making it happen in all countries of the world.
In recent years, several important advances have been made. Antibiotic resistance has risen high on the global political agenda and the issue is driven by, among others, the EU, the World Health Organization (WHO), the World Assembly for Animal Health (WOAH), the UN Food Organization (FAO) and Environment Program (UNEP).
Sweden is in many ways a pioneering country thanks to our early intervention against antibiotic resistance. Now we, together with the countries of the world, must work to:
The more we use antibiotics, the greater the risk of bacteria becoming resistant. Therefore, it is important that antibiotics are only used when really needed. It is also important to choose the right kind of antibiotic and the right dose for the specific infection. In Sweden, antibiotics are sold on prescription, meaning that only doctors, veterinarians and certain other professional groups may prescribe antibiotics. However, in many countries, it is still possible to buy antibiotics without a prescription, which increases the risk of unnecessary use.
More people need to know when antibiotics are really needed and when they are unnecessary, in order to change the general attitude towards antibiotics.
By monitoring the resistance situation, we gain knowledge about which bacteria are becoming resistant to different kinds of antibiotics, and which kind of antibiotics can effectively treat a certain infection. Knowing how resistance develops is therefore important for prescribing the right antibiotics, and only when they are really needed. Many countries lack strong surveillance systems but Sweden supports the work of other countries to build up adequate resistance surveillance, for example through collaborations with the WHO.
Healthy people and animals do not need antibiotics. By preventing the occurrence and spread of infections, fewer individuals need to be treated with antibiotics, and the conditions that allow for resistant bacteria to develop and spread are reduced. Therefore, it is important to have preventive health care, vaccination programmes and adequate hygiene practices in health care, veterinary care, animal husbandry and food production. General health improvements, such as access to clean water, nutritious food and exercise, are fundamental to preventing infections – healthy people and animals do not get infections as often.
The more we improve the conditions within these areas, in Sweden and in the rest of the world, the more we can reduce the risk of antibiotic resistance.
When antibiotics pollute the environment, the risk of bacteria found in nature developing resistance increases. The resistance can then spread from harmless environmental bacteria to disease-causing bacteria. In order to reduce environmental pollution of antibiotics, we can, for example, ensure that the production of antibiotics does not cause emissions that could lead to bacteria developing resistance. We can also improve wastewater treatment to reduce the flow of antibiotics into the environment.
Development of antibiotics by the pharmaceutical industry has stalled over the past 30 years. They are developing some new preparations, but it will take a long time before they can be used. More research and development is needed. In particular, there is a lack of new antibiotics to treat infections caused by resistant intestinal bacteria. Sweden leads the international collaboration “Joint Programming Initiative on Antimicrobial Resistance” (JPIAMR) where a several countries together support research on the development of antibiotics, diagnostics and methods to reduce antibiotic resistance.
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