Norway's battle against Antimicrobial Resistance in the agricultural sector

AMR knows no boundaries, neither geographical nor sectoral. Combatting AMR therefore requires a global and multi-sectorial approach. Knowledge and international research cooperation are essential to solve this challenge.

It is of the outmost importance to raise awareness about AMR among relevant stakeholders. Therefore, it is most appreciated that the UN General Assembly, WHO, FAO and OIE are addressing this critical topic. As Minister of Agriculture and Food, I have raised this subject both in meetings with the EU Commissioner for Health and Food Safety, and at the G20 meeting in Berlin, Germany earlier this year. In June 2017, I host the Nordic Council of Ministers meeting in Ålesund, Norway, where AMR will be the main topic. The resolutions from these organisations are important first steps, but they need to be accompanied by national, regional and global action. It requires initiatives from all relevant sectors, especially in the fields of health, agriculture and aquaculture to work closely together using synergistic and complementary approaches. Norway funds significant research in AMR, national as well as international. 

Important global initiatives to battle AMR are to increase awareness and knowledge on appropriate antibiotic use, to end all use of antibiotics as growth promoters and to ensure that prescribing of antibiotics is not influenced by economic incentives, as is the case in many countries. Furthermore, it is important to reserve some categories of antibiotics for human treatment only. In addition, we should improve preventive measures and infection control and support research and development for new vaccines, diagnostic tests and antimicrobials. 

In contrast to the situation in many countries in the southern and eastern Europe, the use of antibiotics in Norway is low. The prescribing patterns are favourable, and antibiotics can't be bought unless prescribed by doctors, veterinarians or fish health graduates. Antimicrobial resistance is therefore a limited problem in Norway. But still, we will take action. The Norwegian Government has adopted a national strategy against AMR for the period 2015–2020. Important principles and initiatives in this strategy are:

• The use of antibiotics as growth promoters has been banned in Norway since 1995.
• Veterinarians and doctors don't have economic incentives when prescribing antibiotics.
• As a routine, antibiotics are not used prophylactic.
• We aim to reserve certain categories of antibiotics for human treatment only.
• We will strengthen the supervision of veterinarians prescribing antibiotics for production animals and pets to ensure correct use.
• To extend and harmonize the global monitoring of antibiotic use and AMR.
• To improve infection control and support research and development for new vaccines, diagnostic tests and antibiotics.
• Alternative methods that have been proven equally efficient and safe should be given precedence over antimicrobial treatment.
• Guidelines for prudent use of antibiotics in veterinary and human medicine are adopted.
• We increase research and knowledge of what drives development and the spread of AMR.

Norway, as the only country in Europe, has a very ambitious strategy to prevent that resistant bacteria get a foothold in swine husbandry. The first cases of LA-MRSA (livestock associated methicillin-resistant Staphylococcus aureus) in Norway were identified in 2013. Until 2016, the bacteria was found in 65 herds. In an attempt to prevent the bacteria from establishing in Norway, the affected herds were slaughtered, and the farms cleaned and disinfected. Since then, there has been very few new cases. The vision of a MRSA-free pig production still stands. It seems that the primary source of the outbreaks have been farm workers infected with LA-MRSA. The infection has then spread through trade with live animals. Norway will enforce regulations demanding that farm workers must wear infection control equipment when having contact with pigs, unless they have tested negative for resistant bacteria. 

The consumption of antibiotics and the incidence of resistance in farmed animals in Norway is among the very lowest in the world. The favourable situation is because of good health in animals. This leads to reduced need for antibiotic and restrictive practices by veterinarians as regards to use. In addition, we have responsible and competent farmers and livestock industry, and good cooperation between animal health and public health authorities. 

There is a clear connection between the amount of antibiotic used and the incidence of resistance in humans and animals, as well as in the environment and in our food. Low use of antibiotics in food production is a huge advantage for public health.