News and Opinions  –  2023

Malin Grape – Sweden’s AMR Ambassador on her role and the Swedish EU Presidency

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Early 2022, Malin Grape was appointed by the Swedish Government as Sweden’s, and the world’s, first AMR Ambassador - to further strengthen global efforts against antimicrobial resistance. ReAct had the opportunity to talk to her about her role one year after her appointment and about antimicrobial resistance and the current Swedish EU Presidency.

Malin Grape, AMR Ambassador Sweden. Photo: Ninni Andersson/Government offices of Sweden.

Ms Grape leads the Swedish Ministry of Health and Social Affairs’ international work on antimicrobial resistance. She represents Sweden and contributes expertise in EU work and in international forums such as the WHO.

It has now been 1 year since you took up your role as AMR Ambassador for Sweden. How has the response been?

– It has raised quite some interest and a lot of positive response  – which is of course great!

– I think it is natural for Sweden to take this initiative – based on the Swedish early and consistent efforts to address antibiotic resistance nationally – we have a good reputation.

– I also like to mention that – in addition to me – Dame Sally Davies who is the Special Envoy for the UK is the only person with a similar role. We would like to have more “colleagues” around the world! I hope we can inspire other countries to appoint ambassadors on antimicrobial resistance and build up a more formalized network, a bit like countries that have Global Health Ambassadors.

In 2014, Sweden and the United Kingdom co-drafted an AMR resolution in the WHO. Together with the UK, Sweden co-founded the Ministerial Alliance of Champions against Antimicrobial Resistance. Other members include the United States, France, Australia, Brazil, Canada, China and South Africa.

What have you focused your work on during the past year?

Malin Grape at the European Health Forum Gastein. Photo: European Health Forum Gastein.

– The role is to represent Sweden on the AMR issue in the EU and internationally – based on the Swedish experience.

– I have had many exchanges with individual countries but also in various international fora. Of course, the Swedish EU Presidency has been hovering in the background already from the start – as it was stated very early on that antimicrobial resistance would be a priority issue in the health field during the presidency. I have worked a lot with that.

On the first of January 2023, Sweden took over the Presidency of the Council of the European Union. The Presidency strives to find ways forward in addressing fundamental challenges of our time – one of them being the silent pandemic of antimicrobial resistance.

Sweden now holds the Presidency of the EU until June – what are the plans to raise the issue of antibiotic resistance during the Presidency?

Photo: Sweden EU Presidency website.

6-7 March, Sweden will organize a high-level meeting on antimicrobial resistance in Stockholm. It will be for EU member states, representatives from EU-institutions and a few international organizations. We are spending a lot of time on preparations for the meeting now.

– In this meeting the idea is to stimulate reflection and dialogue and together explore how the European Union, through its member states and institutions, can leverage progress in addressing antimicrobial resistance.

– Against a One Health-background, the meeting will center around the human health perspective and have a twofold focus: 1, sustainable access to existing antibiotics and stimulation of development of new antibiotics and 2, how the EU can contribute to reinforced global response to antimicrobial resistance.

– I think there is a strong potential to advance the response to AMR, through enhanced political priority and coordination of joint efforts promoting synergies.

– At EU level there is a lot going on that is relevant to the AMR issue.  The EU Commission present work shortly that coincides with the Swedish EU Presidency.

– For example, the review of the EU pharmaceutical legislation – a huge piece of work that has been ongoing for many years – is due to be presented in mid-March. The EU Commission has stated early on that the legislation will include concrete proposals linked to the control of antimicrobial resistance.

– Linked to the pharmaceutical legislation, the European Commission will also present a policy package including a Council Recommendation on antimicrobial resistance. During the Swedish EU Presidency, we will lead the negotiations between the EU Member States and our hope is that the Council Recommendations will be adopted by the end of the Swedish Presidency in June.

– All in all, there will be a lot of focus on the issue the coming six months for the Swedish EU Presidency.

What role do you think Sweden can play in the EU – and the global work?

– Right now, by engaging the EU. Sweden is a small country but member states are listening to us based on the homework Sweden has done for the past 20 years.

– During the Swedish EU Presidency there is an opportunity to strengthen EU’s engagement- to have a continued strong role on the global arena.

How do you see the role of civil society – and actors like ReAct?

– Civil society is super important. We need civil society organizations for a broader community engagement, to raise the issue throughout society.

– Antimicrobial resistance is a difficult topic to communicate. Just by using an abbreviation – AMR – we speak usually only to those most engaged – and this makes the issue more difficult to grasp, making it challenging to be personally touched.

– Here I think ReAct has a good approach as you at time speaks about non-treatable infections and add the human perspective – this makes the issue more understandable and relatable – it is a better way of describing the global health challenge we are facing as individuals.

– I would wish for more patient organizations to get involved – it would be another way to increase engagement and attention around antimicrobial resistance – both towards policy makers and the general public. Civil society can really help to nuance the narrative on antibiotic resistance.

– We are all affected by the issue. We all know someone who needs an operation, who have cancer, who has given birth prematurely or similar. Effective antibiotics are vital in such acute situations. But it is not something the we often reflect upon.

–  I must say, I do appreciate ReAct’s work enormously. You have a well-deserved respect internationally. You are small – but well-known and highly respected.

What do you see as key priorities for the future?

Global leaders negotiating and collaborating around a table in front of a world map.
Stronger globally coordinated governance is needed for stronger actions on antimicrobial resistance. Illustration: Shutterstock.

– This is a global health issue where it is difficult to say one thing to prioritize as we need to move forward in many areas simultaneously. Still, one area that would be key for other crosscutting aspects is global governance and global engagement.

– We are looking forward to the AMR High Level Meeting at UN General Assembly in 2024. It is time for more ambitious commitments from countries, to find a better structures for global governance, accountability and follow-up.

– Implementation must happen from two directions – from the highest global level and governments – but also simultaneously on the ground, in communities.

– I also want to emphasize the importance of strengthening preventive efforts. It will not be enough with new antibiotics or using less antibiotics for animals or other efforts – we need to work more on infection prevention and control to reduce the spread of resistant bacteria. We have learned a lot from the Covid-19 pandemic and should make use of some of those outstanding experiences.

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