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This development, combined with the limited development of new antibiotics in
recent decades, makes the situation in Sweden alarming.
Regarding the occurrence of immunity, the overall vaccination coverage against
measles, mumps and rubella has increased since Public Health Policy Report 2005.
The vaccination coverage for these diseases lies above the critical threshold for herd
immunity with a margin. At the same time, studies show reduced protection against
rubella in pregnant women. Sexually transmitted diseases like HIV and chlamydia
are increasing, but there is no clear trend for acute hepatitis B. The majority of
newly reported HIV infections still involve immigrants, who have been infected
before arrival to Sweden. The endemic increase in HIV infections is primarily occurring
among homosexual men, but the number of infections among heterosexuals is
also increasing. Several larger outbreaks of HIV have also occurred among injecting
drug users since Public Health Policy Report 2005. This, together with outbreaks of
hepatitis B among injecting drug users in recent years, shows the risk of infection in
this group, despite recommendations for vaccination. The statistics on HIV infection
are uncertain.
The goal of the Swedish National Public Health Policy is to create societal conditions
to ensure good health on equal terms for the entire population. But the
national statistics on the infectious diseases continuously surveyed through statutory
notifications under the Communicable Diseases Act do not provide access data
on education, income and country of birth. Consequently, we lack national data to
analyse socioeconomic differences in this objective domain. Literature reviews about
infectious diseases in Europe show that infectious diseases such as HIV are distributed
differently among different socioeconomic groups, just like chronic diseases.
Furthermore, studies show that preventive strategies that are specifically adapted to
the targeted socioeconomic group are more effective. Accordingly, it would be reasonable
to find out how antibiotic resistance, vaccinations, and infectious agents are
distributed nationally in different socioeconomic groups and depending on country
of birth.
Today, it is scientifically well recognised that the use of antibiotics affects the
development of antibiotic resistance. It is therefore important that future measures
for the prevention of antibiotic resistance focus on interventions that will lead to the
rational use of antibiotics. In the work to counteract the development of antibiotic
resistance, there is a need for continued vigorous measures to strengthen prevention
and the hygienic work in healthcare. There is also an urgent need to develop alternative
treatment therapies and new antibiotics.
With regard to the occurrence of immunity, the overview of the measures implemented
shows that the monitoring and evaluation systems for vaccination are not
sufficient for today’s demands. The current manual system involves a significant
amount of administrative work and new types of vaccine require other forms of
continuous evaluation. Accordingly, there is a need to strengthen the monitoring
systems for vaccines. Measures that will strengthen and improve the early detection
10 M å l o M r å d e 7 – S K Y d d M o T S M I T T S P r I d n I n G