Photo: Centers for Disease Control and Prevention

Danish effort to combat antimicrobial resistance mapped out

Wednesday 26 Mar 14
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Frank Møller Aarestrup
Professor, Head of Research Group
National Food Institute
+45 35 88 62 81
Denmark's systematic and scientific strategy for combatting antimicrobial resistance in food has been internationally recognised, and Denmark is now considered a world leader in this area. A scientific paper from the National Food Institute, Technical University of Denmark, which is published in the international journal Food Control, describes how the strategy was developed and how others can use the Danish methods to combat antimicrobial resistance.

Antimicrobial resistance in food production is a complex global problem. Danish food producers, regulators, veterinarians, scientists and the pharmaceutical industry have good experience in working together to reduce this problem. In a scientific article the National Food Institute has mapped out both the factors that gave the problem of antimicrobial resistance good growing conditions, and the successful way the problem has been dealt with.

"The Danish experience shows how valuable it is to apply a systematic approach when solving a problem like antimicrobial resistance in food."

The article is based on a report which the National Food Institute has produced for the International Risk Governance Council (IRGC), an independent think tank. IRGC has used the report as a case study in how to successfully assess and manage a risk of potentially global proportions.

Uncertainty about the problem in the 1960s

WHO has declared antimicrobial resistance to be one of the main threats to human health. Concerns about the use of antimicrobial growth promoters in the rearing of food-producing animals and the negative impact it could have in relation to human health started emerging in the 1960s.

"In the 1960s science couldn’t clearly explain the impact that farmers’ routine use of growth promoters was having on human health. Without clear evidence that this practice posed a real threat, it was difficult to create common ground among the various actors who were part of the problem, but who could also be part of the solution," professor Frank Møller Aarestrup from the National Food Institute says.

DANMAP – the key to success

In the 1990s – after many years of intensive research – a high prevalence of antimicrobial resistant bacteria was documented in animals that had been given growth promoters as opposed to animals that had not. Studies also showed that the type of antimicrobial resistant bacteria that were found in animals could also be found among meat-eaters, but not among vegetarians.

To generate more accurate data, Denmark introduced the monitoring programme DANMAP in 1995, which describes the annual consumption of antimicrobials and the prevalence of antimicrobial resistant bacteria in animals, foods and humans in Denmark.

"DANMAP generates transparent and independent data, which regulators have been able to use as the basis for science-based decision-making," Jørgen Schlundt, director of the National Food Institute, explains.

One of these decisions was that Denmark, in 2000, introduced a ban on the use of antimicrobials as growth promoters. In 2006 the ban was introduced across the EU.

Danish model inspires internationally

"The Danish experience shows how valuable it is to apply a systematic approach when solving a problem like antimicrobial resistance in food. It also shows how vital it is that all relevant stakeholders are included in the discussions and that they act on scientific data rather than assumptions," Jørgen Schlundt says.

There has been considerable interest internationally, including from the U.S. Congress, in learning from the Danish experience.

"This is why it is important that Denmark continues to lead the way and sets a good example in the fight against antimicrobial resistance," Jørgen Schlundt adds.

Inspired by the Danish model, several other countries have launched surveillance programmes for antimicrobial use and antimicrobial resistance. A European network of national surveillance programmes (EARS-Net) has also been established. EARS-Net collects data on antimicrobial resistance within the EU.

Read more

The scientific article, which has been published in Food Control, is available here: Evidence-based policy for controlling antimicrobial resistance in the food chain in Denmark.

Also read the National Food Institute’s press releases: Denmark is at the forefront in the fight against resistance and Danish food successes as a result of cross-disciplinary collaboration.

There is also a description of the Danish approach in this brochure: Data for action. The Danish approach to surveillance of the use of antimicrobial agents and the occurrence of antimicrobial resistance in bacteria from food animals, food and humans in Denmark (pdf).