Roadmap for integrated One Health AMR surveillance in Nordic countries

Objectives 
Outline the basis for integrated One Health AMR surveillance in the Nordic region by mapping existing surveillance systems and research assets, identifying key challenges to cross-border alignment, and proposing practical steps toward coordinated cross-sector, cross-country surveillance. 

Study design
Mapping and review of Nordic AMR infrastructure. 

Methods
We mapped AMR data sources and surveillance infrastructure across the Nordic countries and compiled the findings into an online resource (www.nomoreamr.org). We also assessed requirements for linking national systems, including ethical, legal, and data-sharing considerations relevant to establishing an integrated regional framework. 

Results
The Nordic countries have well-established AMR surveillance systems supported by digital infrastructure, longstanding public health collaboration, and similar socio-economic organization. However, surveillance is currently conducted independently, with limited cross-border data sharing and coordination. Synchronizing national systems would strengthen regional preparedness by enabling earlier detection of emerging threats and supporting more consistent, evidence-based policies and coordinated antimicrobial stewardship. A shared Nordic surveillance network could also serve as an adaptable model for other regions. 

Conclusions
Establishing an integrated Nordic One Health AMR surveillance is feasible but requires structured linkage of existing national systems and clear ethical and legal frameworks for data access and sharing. The compiled mapping resource can support the technical and governance steps needed to advance regional integration.