Merci de patienter pendant le chargement de votre Bulletin

Newsletter INFORMATION EN CONTINUHow disease control and animal health services can impact antimicrobial resistance. A retrospective country case study of Sweden

INFORMATION EN CONTINU Posté sur 2021-04-28 14:35:07

How disease control and animal health services can impact antimicrobial resistance. A retrospective country case study of Sweden


Taille de la police - A A A +


Martin Wierup (1), Helene Wahlström (2) & Björn Bengtsson (2)

(1) Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Uppsala, Sweden.
(2) National Veterinary Institute, Uppsala, Sweden.

The designations and denominations employed and the presentation of the material in this article do not imply the expression of any opinion whatsoever on the part of the OIE concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers and boundaries.
The views expressed in this article are solely the responsibility of the author(s). The mention of specific companies or products of manufacturers, whether or not these have been patented, does not imply that these have been endorsed or recommended by the OIE in preference to others of a similar nature that are not mentioned.


Data and experiences in Sweden show that it is possible to combine high productivity in animal production with the restricted use of antibiotics. The major key factors that explain Sweden’s success in preventing AMR are:

  • Swedish veterinary practitioners were aware of the risk of AMR as early as the 1950s, and the need for prudent use of antibiotics was already being discussed in the 1960s.
  • Early establishment of health services and health controls to prevent, control and, when possible, eradicate endemic diseases reduced the need for antibiotics.
  • Access to data on antibiotic sales and AMR made it possible to focus on areas of concern.
  • State veterinary leadership provided legal structures and strategies for cooperation between stakeholders and facilitated the establishment of coordinated animal health services that are industry-led, but supported by the State.

In Sweden, disease control and efforts to mitigate antimicrobial resistance (AMR) have resulted in the lowest use of antibiotics in the European Union (EU) and a low occurrence of AMR [1, 2]. The OIE and its Tripartite partners, World Health Organization (WHO) and Food and Agriculture Organization of the United Nations (FAO), have emphasised the importance of taking action to combat AMR [3], and in order to support efforts to tackle this problem we carried out a country case study [4] to identify the key factors behind Sweden’s success in this area. As highlighted by the EU [5], lessons learnt from successful strategies in individual countries can be valuable for other countries, and it is hoped that the factors outlined here will prove useful to OIE Members across the globe.

State leadership of veterinary activities and epizootic disease control

In Sweden, the State took the lead role in disease control early in the 20th century when a series of outbreaks of major epizootic diseases occurred (Table I). Substantial efforts were made to eradicate these diseases, and the laboratory and veterinary infrastructure that the State developed at the time subsequently became a valuable tool in the prevention of endemic disease.

Early focus on endemic diseases – major target for antibiotic use

In 1945, industry-led animal health advisory organisations began providing health advice services to help animal producers control endemic diseases, which are the major burden of disease and the major target for antibiotic use (Fig. 1). Today, close to 100% of all commercial producers use these organised health services. In 1969, regulations were introduced enabling industry organisations to obtain State funding to implement disease control programmes for specific diseases of national importance. These programmes, known as ‘organised health controls’ follow government guidelines and are supervised by the State. This collaboration between industry and the State has enabled important endemic diseases to be controlled or eradicated (Table II).

Fig. 1
Fig. 1. Estimated global burden of animal infectious diseases indicating the relative magnitude of the burden (losses of production and labour and costs of control and medical care). Source: International Assessment of Agricultural Knowledge, Science and Technology for Development (IAASTD) 2009

Veterinary expertise on farms

Producers who use organised health services or participate in organised health control programmes receive regular visits from veterinarians. This enables them to benefit from veterinary expertise and obtain advice on farm-specific issues and on complying with policies and recommendations on biosecurity, the use of antibiotics and good agricultural practice.

Antibiotic use and resistance

Since the mid-1950s, veterinary practitioners and researchers in Sweden have frequently highlighted the risks of AMR and the need for prudent use of antibiotics. The ban (1986) on antibiotics for growth promotion (AGP) put the focus on disease prevention by other means, including management, feeding, and housing. Data on the occurrence of AMR has been available since the late 1950s and data on antibiotic sales has been accessible since 1980, and these data have been used to formulate policies, guidelines and legislation on the use of antibiotics, and to evaluate the effects of actions taken. The data transformed a general awareness of AMR into a concrete understanding of the problem and enabled action to be taken to mitigate the emergence of AMR.

Several actions have also been taken to counteract the spread of resistant bacteria of specific importance. A policy on the treatment of mastitis in dairy cows in 1995 reduced the occurrence of penicillin-resistant Staphylococcus aureus from 10% to 1% by recommending that cows infected with resistant S. aureus should be culled rather than treated. In addition, cooperation between national authorities in the human and animal sectors has enabled Sweden to take a One Health approach to the problem of antibiotic resistance.

Cooperation in problem solving

The Veterinary Competent Authority has facilitated control of infectious diseases and AMR by using its regulatory and financial tools. Cooperation between relevant stakeholders has enabled mutual understanding of the need for, and benefits of, implementing measures to prevent and control infectious diseases and to counteract AMR. Controls on the import of, and domestic trade in, animals, genes and feed ingredients have prevented the introduction and spread of several infectious diseases. The use of antibiotics has also become an important issue on the political agenda and for consumers.

Early actions

In areas of major importance for counteracting AMR, Sweden took action long before other countries; for example, it implemented national disease eradication programmes early on, and as a result was able to eradicate bovine tuberculosis and bovine brucellosis (Table I). Also, the country introduced measures to control Salmonella more than 60 years ago, which has resulted in virtually salmonella-free animal and feed production. Sweden was the first country to regularly publish data on national sales of antibiotics and to ban the use of AGPs, and it initiated national monitoring of AMR in animals as early as 2000.


  1. European Medicines Agency (EMA) (2020). – European surveillance of veterinary antimicrobial consumption, 2020. ‘Sales of veterinary antimicrobial agents in 31 European countries in 2018’. (EMA/24309/2020). EMA, Amsterdam.
  2. European Food Safety Authority (EFSA) & European Centre for Disease Prevention and Control (ECDC) (2020). – The European Union summary report on antimicrobial resistance in zoonotic and indicator bacteria from humans, animals and food in 2017/2018. EFSA J., 18 (3), e06007.
  3. World Health Organization (WHO) (2015). – Global Action Plan on Antimicrobial Resistance. WHO, Geneva.
  4. Wierup M., Wahlstrom H. & Bengtsson B. (2021). – Successful prevention of antimicrobial resistance in animals – A retrospective country case study of Sweden. Antibiotics, 10 (2), 129.
  5. European Commission (2017). – The new EU One Health Action Plan against Antimicrobial Resistance.

n OIE News – April 2021

Informations relatives à l'article

  • 20min

    A Multi-Agency Simulation Exercise - Building Biological Threat Reduction Capacities

  • 14min

    Tracking Antimicrobial Resistance Control on a Global Scale Through Country Self-Assessment Surveys—TrACSS

  • 10min

    New access point to previous editions of the Terrestrial Animal Health Code

  • 23min

    Nature for Health Trust Fund Seeks Country Partners

  • 13min

    Multidisciplinary Project Examines Australia’s One Health Pandemic Governance

  • 23min

    Mieux comprendre et définir le rôle des auxiliaires villageois d’élevage (AVE) dans le cadre du renforcement des services vétérinaires de première ligne

  • 31min

    What is the Observatory?

  • 47min

    Destination 2040 - there and back through the OIE Futures Literacy Laboratory

  • 17min

    The OIE holds its 16th annual World Fund Advisory Committee Meeting

  • 11min

    The World Organisation for Animal Health launches a database on public—private partnerships in the veterinary domain

  • 20min

    Competent and well-equipped Veterinary Services in support of national health systems: the OIE contribution

  • 24min

    Exploring how futures are imagined and used: unleashing the potential of Foresight and Futures Literacy

  • 10min

    OIE Tool for the Evaluation of Performance of Aquatic Animal Health Services (PVS Tool - Aquatic), 2nd edition

  • 6min

    New suppliers selected for the OIE Rabies Vaccine Bank

  • 9min

    New suppliers selected for the OIE PPR Vaccine Bank

  • 13min

    Lessons learnt series on veterinary paraprofessionals

  • 14min

    Keeping our institutional meetings despite the virtual environment

  • 13min

    Electronic sanitary certificates for safe international trade in animals and animal products

  • 6min

    Discover the new OIE Documentary Portal

  • 12min

    Moving forward on the Global Burden of Animal Diseases (GBADs) Programme

  • 28min

    Virtual interviews as an alternative to field missions? Lessons learnt from a pilot experience

  • 29min

    Enhancing veterinary laboratory capacity in COVID-19’s wake through the first-ever virtual OIE PVS mission

  • 14min

    The third OIE Animal Welfare Global Forum

  • 26min

    Current state and future of small companion animal practice in Africa

  • 24min

    The OIE World Fund: 2020 financial performance

  • 15min

    A Standard Operating Procedure to improve notification of emerging diseases of terrestrial animals

  • 15min

    The OIE Aquatic Animals Commission furthers aquatic animal health globally and delivers substantial achievements during its last term

  • 23min

    The digital archive of the OIE Bulletin from 1927 to 1982 is now available on the Documentary Portal

  • 23min

    Global report indicates decreasing trend in antimicrobials intended for use in the animal sector

  • 35min

    How disease control and animal health services can impact antimicrobial resistance. A retrospective country case study of Sweden

  • 34min

    Reflections on the Foot-and-Mouth Disease Epidemic of 2001: a United Kingdom Perspective

  • 46min

    Reflections on the Foot-and-Mouth Disease Epidemic of 2001: an Irish Perspective

  • 7min

    Safe Trade and FMD Control Training Course

  • 15min

    STAR-IDAZ International Research Consortium on Animal Health Releases a State-of-the-Art Report on Priority Animal Diseases

  • 17min

    OIE PVS Pathway missions go virtual!

  • 31min

    100-year anniversary of the origin of the OIE at the 1921 Paris International Conference

  • 23min

    First workshop of the OIE Twinning Network on Viral Haemorrhagic Fevers in West and Central Africa

  • 14min

    Taking a closer look at the 15th OIE World Fund Advisory Committee Meeting

  • 13min

    The OIE and the University of Liverpool host the launch of the Global Burden of Animal Diseases (GBADs) Programme

  • 13min

    Global leaders meet to elevate sustainable political support for antimicrobial resistance issue

  • 24min

    News from the OIE Laboratory Twinning Programme

  • 49min

    Veterinary workforce development: the relevance of skill qualification, education and occupational frameworks

  • 12min

    Assessing the risks of zoonotic diseases under the One Health approach: a new tripartite operational tool

  • 4min

    G20 statement

  • 112min

    Overcoming the impact of COVID-19 on animal welfare:
    COVID-19 Thematic Platform on Animal Welfare

  • 34min

    Twinning is winning

  • 42min

    Global Burden of Animal Diseases – building a community of practice for animal health economics

  • 7min

    Identifying and testing suitable and safe aircraft disinfectants for use on cargo planes that transport animals

  • 8min

    Le Directeur général de la FAO et la Directrice générale de l'OIE ont échangé leurs points de vue au sujet de la coopération entre leurs deux organisations

  • 15min

    Applying Big Data solutions to One Health challenges in the Mediterranean region

  • 8min

    Namibia’s demonstration of freedom from bovine tuberculosis

  • 10min

    Triage in the trenches, for the love of animals

  • 21min

    Global Strategic Plan to end human deaths from dog-mediated rabies by 2030

  • 22min

    OIE rabies international standards: towards ‘Zero by 30’

  • 8min

    Epidemiological survey of bovine viral diarrhoea in dairy cattle in Nepal

  • 3min

    LSD: a new challenge to the Veterinary Services of Central Asian countries

  • 15min

    Improving sustainability to avoid laboratory disasters

  • 2min

    On the frontlines of rabies eradication