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Editorial

In 2024, the UN General Assembly called for joining forces and increasing efforts in combatting antimicrobial resistance (AMR) worldwide. World leaders understood that AMR is not only one of the biggest threats to public health and economy, it is also a problem that needs to be addressed and tackled in a cross-sectional approach - between human health, animal health and the environmental sector. In particular, it was understood that it was time to move from knowledge-gathering to implementation.
 
In Denmark, the Danish Veterinary and Food Administration unveiled its third National Action Plan Against AMR in Animals and Food in September 2024. The plan aligns with international frameworks such as the WHO’s Global Action Plan and the EU’s One Health Strategy, while also responding to Denmark’s own political agreements, including the 2024 Food and Veterinary Agreement. 

The action plan builds on continuing efforts from former action plans from 2017 and 2021. It is structured around four strategic pillars and describes 22 concrete actions. First, it aims at strengthening surveillance of AMR in food production systems by continued integration of whole genome sequencing (WGS), supporting evidence-based decision-making in the veterinary sector. Second, it continues promoting responsible antibiotic use in livestock through regulatory refinement, enhanced veterinary supervision, and incentives for reduced consumption. Third, it advances targeted communication strategies to support informed choices among veterinarians and producers, including updated treatment guidelines and public information campaigns. Finally, it prioritizes national and international collaboration, among these Denmark’s participation in Nordic and EU joint actions and research activities, and the fostering of cross-sectoral coordination and science implementation, on a global scale. 

In June 2025, the Danish Ministry of the Interior and Health published its second national action plan for the fight of antimicrobial resistance in humans. The action plan provides a broad framework for the Danish efforts to promote rational use of antimicrobials and to prevent antimicrobial resistance within four focus areas: (1) fighting and reducing AMR, (2) better access to antimicrobials, (3) infection prevention and control and (4) international engagement. For each area, overarching political objectives and monitoring indicators are set to track progress towards the objectives. In total, 21 initiatives are suggested as concrete steps to work with the action in practice. The new action plan shifts to focus on positive progress measured by specific indicators rather than reaching predefined goals. The ambition is to promote sustainable change that ultimately will strengthen rational use of antimicrobials and combat antimicrobial resistance in the long term. 
Both action plans address the need for joint actions and call for the development of a new national One Health AMR strategy. From the technical level, a wish for a cross-spanning committee to cover and follow One Health actions has been uttered but not yet fulfilled.
 
Denmark is fortunate in many ways. The political system is built on mutual trust and close collaboration between politicians, policy makers, and executors. The health care system is characterized by short distance to high quality treatment. The surveillance is based on long-standing registers and robust data infrastructure. Despite this and close to 30 years of surveillance, DANMAP 2024 detects and presents areas that need increased focus and awareness such as the recent development and changes in antibiotic usage in pig production and the continued high usage of combination penicillin's in humans with a simultaneous rise in resistance towards piperacillin-tazobactam in the monitored invasive bacterial species.
 
The DANMAP monitoring programme plays a pivotal role in operationalizing the strategic pillars from both action plans. By expanding the reporting of WGS results in recent years, DANMAP has enhanced its surveillance infrastructure and supports evidence-based risk assessment. The broadened scope to expand surveillance on AMR in animal pathogens and report antimicrobial use at the active compound level and in specific subgroups provides granular insights essential for regulatory refinement and targeted interventions. DANMAP also tracks antibiotic use trends in relation to specific reduction targets and evaluates the impact of implemented control measures, thereby informing policy and practice. Furthermore, its data and expertise contribute to awareness campaigns and the development of updated treatment guidelines, reinforcing informed decision-making among prescribers and producers. Internationally, DANMAP’s participation in EU, Nordic, DANIDA and Strategic Sector Collaboration (SSC) AMR-related projects, along with its integration into national intersectoral coordination mechanisms, ensures that Denmark’s efforts are both globally aligned and domestically coherent, advancing the One Health agenda through collaborative, data-driven action.
 
Despite the efforts DANMAP has not been able to monitor antibiotic usage at production site or patient level, a necessity if the impact and results from antimicrobial stewardship-programmes are to be followed and evaluated. It should also be questioned if DANMAP properly detects and describes AMR levels in healthy individuals or in certain population groups such as inhabitants of nursing homes. On the food production side there is a wish for following development of AMR in diseased animals more closely than today. 

Next year DANMAP will celebrate its 30th birthday. There is much to be proud of, but also plenty to do. Let´s keep it this way! 

The DANMAP team