Annual report on antimicrobial consumption and antimicrobial resistance in humans and animals in Iceland 2023

The report is published in collaboration with the Icelandic Food and Veterinary Authority which provides sections on AMC in animals and AMR associated with animals and food. Landspitali Hospital, the Icelandic Medicines Agency, the University of Iceland Experimental Center for Pathology at Keldum, and the Environment Agency of Iceland also contributed data to the report.

One Health: AMR is a global and multidisciplinary challenge

Antimicrobial resistance (AMR) is a growing global problem and one of the biggest health threats facing the world. The danger is real that in the future it will not be possible to treat simple and serious infections with antibiotics, leading to serious health and economic consequences worldwide.

The World Health Organization (WHO) has declared that AMR is one of the main health threats facing humanity today. "One health" is a holistic vision that encompasses the health of people, animals, and the environment. The term is particularly relevant in the fight against AMR as resistant pathogens are readily transmitted between humans, animals, and the environment, and also between countries.

The Icelandic government's national action plan against AMR

The Icelandic government has decided to further strengthen interdisciplinary collaboration in the fight against AMR. To this end, a working group was established two years ago to draft a one health (OH) national plan (NAP) to prevent the spread of AMR. The working group submitted a proposal for an OH AMR NAP at the beginning of 2024, and last August the Minister of Health Willum Thor Thorsson, the Minister of Food, Agriculture and Fisheries Bjarkey Olsen Gunnarsdottir and the Minister of the Environment, Energy and Climate Gudlaugur Thor Thordarson signed an AMR NAP for Iceland. The NAP is for five years, 2025–2029, specifies six main actions, and includes cost estimates of the implementation of the 24 goals and 75 projects that have been prioritized.

Antimicrobial consumption and antimicrobial resistance in Iceland

The total sales of antimicrobials for humans in Iceland in 2023 were similar to sales in 2019 and 2022 but were considerably lower compared to the years 2020 and 2021 at the peak of the COVID-19 epidemic (when the prevalence of other infections decreased). AMC is still higher in Iceland than in other Nordic countries but is close to the average for EU/EEA countries.

Iceland still has a low rate of AMR in humans compared to many European countries. In 2023, however, the number of notifiable cases of AMR in Iceland increased compared to previous years. A total of 500 cases of ESBL/AmpC-producing bacteria were reported, representing the most common type of broad-spectrum beta-lactamase-producing organisms. The number of MRSA (Methicillin-resistant Staphylococcus aureus) and VRE (Vancomycin-resistant Enterococcus) notifications also increased in 2023 when 156 MRSA cases and 17 VRE cases were reported.

The future

Although the situation in Iceland is currently largely favorable in terms of antimicrobial use and antimicrobial resistance much work remains to be done. Although the newly approved OH AMR NAP for Iceland is an important milestone, the continued support of the government and key institutions remains critical in the fight against AMR.

See more:

• Annual report on antibiotic use and antibiotic susceptibility in humans and animals in Iceland 2023 (Icelandic, Summary in English)

The Chief Epidemiologist