Nordic Collaboration for Sustainable Access to Antibiotics

The outline was created as a foundation leading up to the Swedish presidency of the Nordic Council of Ministers in 2024. A guiding vision for the Swedish presidency is that the Nordic region should be the world's most integrated and sustainable region by 2030.

Access needs to improve – especially for children

The Nordic market for antibiotics is small compared to many other EU countries. Additionally, several narrow-spectrum antibiotics that are widely used within the Nordic region are not as common in other countries. Insufficient access to these antibiotics and repeated shortages are significant issues in the Nordic countries. Ensuring sustainable access to antibiotic formulations for children is particularly urgent. There are currently several international initiatives aimed at improving access to essential medicines, including antibiotics.

Proposals for priority measures

The Public Health Agency of Sweden has, as part of a government assignment, presented measures, identified in a literature review, together with researchers at Uppsala University and Nordic experts. We propose that eight measures should be prioritised in a Nordic collaboration and that measures that can impact each other should be implemented together or in a correct sequence. Examples of prioritised measures include mutual recognition of approvals for older antibiotics and new reimbursement models with income guarantees.

The Council of ministers aims to strengthen cooperation on resistance and access
At the meeting of the Nordic Council of Ministers in April 2024, access to antibiotics and the various measures identified in the literature review were discussed. All participants agreed on the importance of continuing to strengthen the Nordic cooperation on antimicrobial resistance (AMR). A Nordic initiative to enhance access to new, advanced antibiotics, as well as older antibiotics, including narrow-spectrum antibiotics, was welcomed. The ministers decided to continue the work, prioritising measures in Step 1 and the new reimbursment model with income guarantees. The prioritised measures need to be further developed based on feasibility at the Nordic level before a potential implementation can be tested in a pilot study.

Potential for harmonisation etween countries

In parallel with this work, the Public Health Agency of Sweden, btogether with the collaboration platform Platinea, has mapped the antibiotic markets in Denmark, Finland, Norway and Sweden, focusing on clinically prioritised antibiotics with a risk ofnsufficient availability. The lack of access to antibiotic formulations for children was shown to be particularly concerning. The results indicate noticeable differences in product offerings between the Nordic countries despite similar medical needs, highlighting the potential for harmonisation.

Nordic experiences need to be shared

The Nordic countries are in a very favorable position globally regarding work on AMR and access to antibiotics. It is important to continue sharing our experiences and further improve innovative working methods and incentives.