natgillin/translations-raw huggingface dataset:
The Joint Action on antimicrobial resistance, to support national One Health policies, facilitated cooperation between Member States but faced challenges to the sustainable implementation of its results. 
Den gemensamma tgrden om antimikrobiell resistens till std fr nationella One Health-strategier frmjade samarbetet mellan medlemsstaterna, men det visade sig svrt att genomfra resultaten p ett hllbart stt.
A recent Commission funded study led by the OECD was a compass for cost effective options for Member States to reduce antimicrobial resistance in hospitals and other healthcare settings. 
En frsk studie, som finansierades av kommissionen och leddes av OECD, satte fokus p kostnadseffektiva stt fr medlemsstaterna att minska den antimikrobiella resistensen p sjukhus och i andra hlso-och sjukvrdsmiljer.
Outcome indicators were not consistently used by the Member States we visited, or by the Commission, to monitor progress; data on health care associated infections, which are the primary source of AMR infections, was incomplete; and, at the time of our audit, there was insufficient knowledge about AMR in the environment. 
Varken de medlemsstater vi beskte eller kommissionen anvnde utfallsindikatorer p ett konsekvent stt fr att vervaka framstegen. Uppgifterna om vrdrelaterade infektioner, som r den frmsta kllan till infektioner med resistenta bakterier, var ofullstndiga, och vid tidpunkten fr vr granskning fanns det inte tillrckligt med kunskaper om antimikrobiell resistens i miljn.
VII The prudent use of veterinary antimicrobials is generally improving in the Member States. 
VII Anvndningen av antimikrobiella veterinrmedicinska lkemedel blir generellt sett mer terhllsam i medlemsstaterna.
Between 2011 and 2016, sales of veterinary antimicrobials reduced by 20 %. 
Mellan 2011 och 2016 sjnk frsljningen av antimikrobiella veterinrmedicinska lkemedel med 20 %.
However, there are big differences between the Member States, and consumption of some antimicrobials is still too high. 
Det finns dock stora skillnader mellan medlemsstaterna, och frbrukningen av vissa antimikrobiella medel ligger fortfarande p en fr hg niv.
Recent EU legislation on medicinal products and feed addressed some known weaknesses. 
I den senaste EU-lagstiftningen om lkemedelsprodukter och foder som innehller lkemedel tgrdades vissa knda brister.
The future Common Agricultural Policy provides an opportunity to further strengthen the EU framework for dealing with AMR. 
Den framtida gemensamma jordbrukspolitiken utgr en mjlighet att ytterligare strka EU:s ram fr att hantera antimikrobiell resistens.
VIII The antimicrobials market lacks commercial incentives to develop new treatments. 
VIII Marknaden fr antimikrobiella medel saknar kommersiella incitament att utveckla nya behandlingar.
Funding from the EU budget is a major source of investment for research, and has created structures to speed up the development of new antimicrobials. 
Finansieringen frn EU:s budget r en betydande klla till investeringar i forskning och har skapat strukturer fr att pskynda utvecklingen av nya antimikrobiella medel.
But EU funded public Đ private research initiatives experienced delays, and there have been no breakthroughs yet. 
EU-finansierade offentlig-privata forskningsinitiativ har dock drabbats av frseningar och det har nnu inte skett ngra genombrott.
The Commission has not comprehensively evaluated its approach to antimicrobial research, and its action plan does not address some of the specific challenges facing AMR research. 
Kommissionen har inte gjort ngon grundlig utvrdering av sin strategiska modell fr antimikrobiell forskning och tar i sin handlingsplan inte upp vissa av de specifika utmaningarna fr forskningen om antimikrobiell resistens.
Concrete initiatives to address market failures affecting provision of new antimicrobials are largely absent. 
Det finns i stort sett inga konkreta initiativ fr att tgrda marknadsmisslyckanden nr det gller tillhandahllandet av nya antimikrobiella medel.
IX Based on our conclusions, we make recommendations aimed at strengthening the CommissionŐs response to antimicrobial resistance through better support to Member States; promoting the prudent use of antimicrobials and better monitoring of antimicrobial resistance; and strengthening strategies for research. 5 
IX Utifrn vra slutsatser lmnar vi rekommendationer som syftar till att strka kommissionens tgrder mot antimikrobiell resistens genom att stdja medlemsstaterna p ett bttre stt, frmja terhllsam anvndning av antimikrobiella medel och bttre vervaka antimikrobiell resistens samt strka forskningsstrategierna. 5
Introduction What is Antimicrobial Resistance 01 Antimicrobials are used to treat people, animals and plants. 
Inledning Vad r antimikrobiell resistens? 01 Antimikrobiella medel anvnds fr att behandla mnniskor, djur och vxter.
Antimicrobial resistance (AMR) happens when microbes (bacteria, viruses, parasites, and fungi) develop resistance against medicines that were previously able to fight them, making the treatment less efficient or completely ineffective. 
Antimikrobiell resistens uppstr nr mikrober (bakterier, virus, parasiter och svampar) utvecklar resistens mot lkemedel som tidigare kunde bekmpa dem, vilket gr behandlingen mindre effektiv eller helt overksam.
AMR develops naturally over time, usually through genetic changes1, but it accelerates when antimicrobials are overused or misused i.e. are not used prudently Đ meaning the right drug is used when needed, at the right dose, frequency, and duration (Figure 1 shows how AMR develops). 
Antimikrobiell resistens utvecklas naturligt ver tid, vanligen genom genetiska frndringar1, men det gr snabbare om antimikrobiella medel veranvnds eller missbrukas, det vill sga om de inte anvnds terhllsamt. terhllsam anvndning innebr att rtt lkemedel anvnds nr det behvs, med rtt dos, frekvens och varaktighet (figur 1 visar hur antimikrobiell resistens utvecklas).
Figure 1 Đ How antimicrobial resistance develops High number of bacteria including good bacteria (protecting body from illness), bacteria causing illness and few resistant bacteria. 
Figur 1 Đ S utvecklas antimikrobiell resistens Stort antal bakterier, inbegripet bra bakterier (som skyddar kroppen mot sjukdomar), bakterier som orsakar sjukdomar och f resistenta bakterier.
Antibiotics kills off all bacteria (the good ones and ones causing the illness) except the antibiotic resistant bacteria. 
Antibiotika ddar alla bakterier (de bra och de som orsakar sjukdomen) frutom de antibiotikaresistenta bakterierna.
Drug resistant bacteria has now conditions to grow and take over. 
Lkemedelsresistenta bakterier har nu frutsttningar att vxa och ta ver.
Drug resistant bacteria can transfer its mutation to other bacteria. 
Lkemedelsresistenta bakterier kan verfra mutationen till andra bakterier.
Source: ECA based on United States Centers for Disease Control and Prevention (CDC). 
Klla: Revisionsrtten, p grundval av United States Centers for Disease Control and Prevention (CDC).
02 The World Health Organisation (WHO) identified AMR as a serious threat to global health, development and food security2. 
02 Vrldshlsoorganisationen (WHO) har faststllt att antimikrobiell resistens r ett allvarligt hot mot den globala hlsan, utvecklingen och livsmedelstryggheten2.
The European Centre for Disease Prevention and Control (ECDC) reported3 that 33 000 people die each year, based on Antimicrobial resistance Đ Key facts, WHO, February 2018. 
Europeiska centrumet fr frebyggande och kontroll av sjukdomar (ECDC) har, utifrn Antimicrobial resistance Đ Key facts (antimikrobiell resistens Đ grundlggande fakta), WHO, februari 2018.
WHO (2017), Antibiotic Resistance Fact Sheet, World Health Organization. 
WHO (2017), Antibiotic Resistance Fact Sheet (faktablad om antibiotikaresistens), Vrldshlsoorganisationen.
6 1 2 3 
6 1 2
2015 data, in the EU / European Economic Area (EEA) from infections caused by drug resistant bacteria. 
uppgifter frn 2015, rapporterat3 att 33 000 personer dr varje r i EU och Europeiska ekonomiska samarbetsomrdet (EES) p grund av infektioner som orsakas av lkemedelsresistenta bakterier.
AMR generates additional yearly costs of Ű1.5 billion4 due to extra healthcare costs and productivity losses. 
Antimikrobiell resistens fr med sig rliga kostnader p 1,5 miljarder euro4 p grund av extra hlso-och sjukvrdskostnader och produktivitetsfrluster.
Infections caused by organisms that have developed resistance, usually acquired in hospitals and other healthcare settings, may require lengthier and costlier treatments, some with serious side effects (e.g. renal failure), and carry a higher risk of death for patients. 
Infektioner som orsakas av organismer som har utvecklat resistens, och vanligen drabbar mnniskor p sjukhus och i andra hlso-och sjukvrdsmiljer, kan krva mer utdragna och kostsamma behandlingar. Vissa fr med sig allvarliga biverkningar (t.ex. njursvikt) och strre risk fr att patienterna dr.
03 Nearly 40 % of the health burden of AMR is caused by bacteria resistant to last-line antibiotics (such as carbapenems and colistin). 
03 Nstan 40 % av den hlsobrda som antimikrobiell resistens fr med sig orsakas av bakterier som r resistenta mot sista linjens antibiotika (t.ex. karbapenemer och kolistin).
When last-line antibiotics are no longer effective, it is difficult and may be impossible to treat infected patients5. 
Nr sista linjens antibiotika inte lngre r effektiv r det svrt och ibland till och med omjligt att behandla smittade patienter5.
04 In the EU / EEA, about two thirds of total antimicrobial use is for food producing animals6. 
04 I EU/EES str livsmedelsproducerande djur fr omkring tv tredjedelar den totala anvndningen av antimikrobiella medel6.
Some of these then end up in the environment7. 
Vissa av dessa hamnar i miljn7.
There is evidence that reductions in the use of antimicrobials in food-producing animals lead to reductions in the presence of antimicrobial-resistant microorganisms in these animals8. 
Det finns belgg fr att minskad anvndning av antimikrobiella medel hos livsmedelsproducerande djur leder till minskad frekomst av resistenta mikroorganismer hos djuren8.
EU Action on Antimicrobial Resistance, European Commission, 2017. 
EU Action on Antimicrobial Resistance (EU:s tgrder i frga om antimikrobiell resistens), Europeiska kommissionen, 2017.
ECDC infographic on AMR, November 2018. 
ECDC infographic on AMR (ECDC:s informationsgrafik om antimikrobiell resistens), november 2018.
See Table 5 of the most recent JIACRA report (from 2017) on the consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food producing animals. 
Se tabell 5 i den senaste JIACRA-rapporten (frn 2017) om frbrukningen av antimikrobiella medel och frekomsten av antimikrobiell resistens hos bakterier frn mnniskor och livsmedelsproducerande djur.
See, for example WHO guidelines on use of medically important antimicrobials in food-producing animals and How do we reduce antibiotic resistance from livestock?, Hannah Ritchie, Our World in Data, November 2017. 
WHO guidelines on use of medically important antimicrobials in food-producing animals (WHO:s riktlinjer om anvndning av medicinskt viktiga antimikrobiella medel hos livsmedelsproducerande djur) och How do we reduce antibiotic resistance from livestock? (hur ska vi minska antibiotikaresistensen hos djur?), Hannah Ritchie, Our World in Data, november 2017.
See, for example, ŇRestricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysisÓ, The Lancet, November 2017; or ŇWHO calls on food industry to stop routinely using antibiotics in healthy animalsÓ, The Pharmaceutical Journal, November 2017. 
Se t.ex. Restricting the use of antibiotics in food-producing animals and its associations with antibiotic resistance in food-producing animals and human beings: a systematic review and meta-analysis (begrnsa anvndningen av antibiotika hos livsmedelsproducerande djur och 7 3 4 5 6 7 8
Why fighting AMR is complicated 06 The continued overuse or misuse of antimicrobials in the human and animal health sectors accelerates the development of antimicrobial resistance. 
06 Fortsatt veranvndning och missbruk av antimikrobiella medel i hlso-och sjukvrdssektorn nr det gller bde mnniskor och djur snabbar p utvecklingen av antimikrobiell resistens.
The ECDC has reported some reductions in the consumption of antimicrobials for human health, with significant variations between Member States9. 
ECDC har rapporterat vissa minskningar nr det gller frbrukningen av antimikrobiella medel inom humanmedicin, men det varierar stort mellan medlemsstaterna9.
The prevention and control of cross-transmission of antimicrobial-resistant microorganisms in healthcare settings, in particular hospitals and long-term care facilities, is important. 
Det r viktigt att frebygga och bekmpa korsverfring av resistenta mikroorganismer i hlso-och sjukvrdsmiljer, i synnerhet sjukhus och inrttningar fr lngvarig vrd och omsorg.
However, it is a challenge to ensure good infection prevention and control measures (such as hand hygiene, contact precautions, patient isolation, and cleaning) in practice. 
I praktiken r det dock en utmaning att skerstlla bra tgrder fr att frebygga och bekmpa infektioner (t.ex. handhygien, frsiktighetstgrder nr det gller kontakt, isolering av patienter och stdning).
These measures require training, resources, and supervision across healthcare facilities; and need to be applied rigorously by the hundreds of thousands of healthcare personnel in the EU. 
Sdana tgrder krver utbildning, resurser och vervakning vid hlso-och sjukvrdsinrttningarna och mste tillmpas strikt av alla hundratusentals anstllda inom hlso-och sjukvrdssektorn i EU.
In addition, ECDC data indicates that basic diagnostic tests in hospitals, required to target medical treatments, are not being carried out across the EU as often as necessary. 
Vidare visar ECDC:s uppgifter att sdana grundlggande diagnostiska tester som krvs fr riktade lkemedelsbehandlingar inte utfrs tillrckligt ofta vid sjukhus i EU.
Figure 2 illustrates how AMR can spread. 
Figur 2 visar hur antimikrobiell resistens kan spridas.
8 9 ŇAntimicrobial consumption Đ Annual epidemiological Report for 2017Ó, ECDC, 2018. 
Antimicrobial consumption Đ Annual epidemiological Report for 2017 (frbrukning av antimikrobiella medel Đ rlig epidemiologisk rapport 2017), ECDC, 2018.
Figure 2 Đ How resistance to antibiotics spreads Antibiotics provide a cure for bacterial infections, but bacteria develop resistance against the antibiotics. Overuse or misuse of antibiotics accelerates the development of resistance. 
Figur 2 Đ S sprids antibiotikaresistens 9 Antibiotika r ett botemedel mot bakteriella infektioner, men bakterier utvecklar resistens mot antibiotika. veranvndning och missbruk av antibiotika leder till att resistens utvecklas snabbare.
9 Doctors should only prescribe the appropriate antibiotic when needed , at the correct doses when treating humans. Even if not every carrier of a superbug gets sick, the microbe spreads and becomes more prevalent. 
Lkare br enbart frskriva lmplig antibiotika nr s krvs och i rtt dos nr mnniskor behandlas. ven om inte alla som br p en superbakterie blir sjuka sprids mikroben och blir mer utbredd.
Source: ECA based on ECDC, CDC. 
Klla: Revisionsrtten p grundval av ECDC och CDC.
Bacteria in the environment (e.g. on plants) may be exposed to antibiotics (e.g. from waste water). 
Bakterier i miljn (t.ex. p vxter) kan exponeras fr antibiotika (t.ex. via spillvatten).
This may accelerate the development of resistance in these microbes which may later spread to humans or animals. 
Det kan pskynda utvecklingen av resistens hos dessa mikrober, som senare kan spridas till mnniskor eller djur.
No new classes of antibiotics were found since the 1980s: antimicrobial stewardship and infection prevention and control in humans and animals are thus critically important to ensure that existing antibiotics remain effective 
Inga nya antibiotikaklasser har upptckts sedan 1980-talet: Strategier fr antimikrobiell lkemedelsbehandling och frebyggande och bekmpning av infektioner hos mnniskor och djur r drfr av strsta vikt fr att skerstlla att befintliga antibiotika fortsatt r effektiva.
07 No new class of antibiotics has become available since the 1980s (see Figure 3). 
07 Inga nya antibiotikaklasser har blivit tillgngliga sedan 1980-talet (se figur 3).
This absence of new drugs is complicated by the fact that some existing antibiotics, which continue to work, are no longer widely marketed by drug manufacturers. 
Bristen p nya lkemedel kompliceras n mer av det faktum att vissa befintliga antibiotika, som fortfarande fungerar, inte lngre salufrs i ngon strre utstrckning av lkemedelstillverkarna.
Several large corporations announced in recent years their withdrawal from antibiotics research and development10. 
Flera stora fretag har under de senaste ren meddelat att de inte lngre kommer att forska om eller utveckla antibiotika10.
Such research is a lengthy, uncertain and expensive process, and by definition any new drugs discovered will need to be used prudently to maintain their effectiveness. 
Sdan forskning r en lng, osker och dyr process, och per definition kommer eventuella nya lkemedel som upptcks att behva anvndas terhllsamt fr att de fortsatt ska vara effektiva.
A recent project funded by the Joint Undertaking Innovative Medicines Initiative (JU IMI)11 estimated that it could cost Ű1 billion to bring a new drug to the market. 
Inom ramen fr ett aktuellt projekt, som finansierades av det gemensamma fretaget fr initiativet fr innovativa lkemedel (gemensamma fretaget IMI)11, gjordes uppskattningen att det kan kosta en miljard euro att f ut ett nytt lkemedel p marknaden.
Figure 3 Đ Discovery of new antibiotics More than 30-Year Void in Discovery of New Types of Antibiotics (Number of antibiotic classes discovered or patented) 7 111 9 2 55 10 1900s 1910s 1920s 1930s 1940s 1950s 1960s 1970s 1980s 1990s 2000s 2010s 2020s Source: ECA based on ŇA sustained and robust pipeline of new antibacterial drugs and therapies is critical to preserve public healthÓ, Pew Charitable Trusts, May 2016. 
Figur 3 Đ Upptckt av ny antibiotika ver 30 r sedan nya antibiotikatyper upptcktes (Antal antibiotikaklasser som har upptckts eller patenterats) 7 111 9 55 2 Vad hnder nu? 10 1900-talet1910-talet1920-talet1930-talet1940-talet1950-talet 1960-talet1970-talet1980-talet1990-talet2000-talet2010-talet2020-talet Klla: Revisionsrtten p grundval av A sustained and robust pipeline of new antibacterial drugs and therapies is critical to preserve public health (hllbar och robust utveckling av nya antibakteriella lkemedel och behandlingar r absolut ndvndig fr att bevara folkhlsan), Pew Charitable Trusts, maj 2016.
08 Ultimately the fight against AMR consists of two main challenges: o ensuring a more prudent and efficient use of existing antimicrobials (including by increasing awareness, better hygiene practices, training, surveillance and monitoring, and enhanced diagnostics) in humans, plants and animals; o and discovering and making available new antimicrobials (through research and development). 
08 Till syvende och sist bestr kampen mot antimikrobiell resistens av fljande tv huvudsakliga utmaningar: o 10 11 Skerstlla mer terhllsam och effektiv anvndning av befintliga antimikrobiella medel (bland annat genom att ka medvetenheten, bttre hygienstrategier, utbildning, tillsyn och vervakning samt bttre diagnostik) hos mnniskor, vxter och djur.
10 See, for example, article in ŇChemistry WorldÓ from July 2018 and the 2018 OECD report ŇStemming the superbug tide Đ Just a few dollars moreÓ. 
Se t.ex. artikeln i Chemistry World frn juli 2018 och OECD:s rapport frn 2018: Stemming the superbug tide Đ Just a few dollars more (hejda superbakterierna Đ bara ngra dollar till).
11 DRIVE AB report ŇRevitalising the antibiotic pipelineÓ, 2018, from the New Drugs for Bad Bugs programme, 2018. 
DRIVE AB-rapport: Revitalising the antibiotic pipeline (vitalisera antibiotikautvecklingen), 2018, frn programmet New Drugs for Bad Bugs.
No registered classes of antibiotics discovered after 1984 WhatŐs next? 
Inga registrerade antibiotikaklasser har upptckts efter 1984
Global actions to fight antimicrobial resistance 09 The WHO Global Action Plan12, adopted in 2015, required WHO member countries to develop and start implementing their National One Health Action Plan (NAP) by mid-2017. 
Globala tgrder fr att bekmpa antimikrobiell resistens 09 Enligt WHO:s globala handlingsplan12, som antogs 2015, var medlemslnderna skyldiga att utveckla och brja genomfra sina nationella One Health-handlingsplaner senast i mitten av 2017.
The WHOŐs ŇOne HealthÓ principle recognises that an integrated approach to antimicrobials is needed, which considers human health, animal health and the environment (see Figure 2). 
Enligt WHO:s ÓOne HealthÓ-princip krvs en integrerad strategi fr antimikrobiella medel som tar hnsyn till mnniskors hlsa, djurhlsa och miljn (se figur 2).
10 The WHOŐs Global Database for AMR shows that Member States were at different stages in terms of developing and implementing NAPs13. 
10 Av WHO:s globala databas ver antimikrobiell resistens framgr att medlemsstaterna hade kommit olika lngt med att utarbeta och genomfra sina nationella handlingsplaner13.
According to a survey we conducted for our audit, out of 24 EU Member States that replied, 16 indicated having a NAP, five indicated having elements of one, and three indicated they did not have one. 
I en enkt som vi genomfrde fr vr revision angav 16 EU-medlemsstater, av de 24 som svarade, att de hade en nationell handlingsplan, fem att de hade delar av en sdan plan och tre att de inte hade ngon.
11 The WHO Global Action Plan is mirrored by international efforts to cooperate on research for AMR. 
11 WHO:s globala handlingsplan avspeglas i internationella insatser fr att samarbeta inom forskningen om antimikrobiell resistens.
Since 2009, the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) collaborates and shares best practices between North America and Europe. And in 2018, the G20 launched its Global Antimicrobial Resistance Research and Development Hub. 
Transatlantic Taskforce on Antimicrobial Resistance (Taftar) samarbetar och delar bsta praxis mellan Nordamerika och Europa sedan 2009. r 2018 lanserade G20 sin Global Antimicrobial Resistance Research and Development Hub (den globala forsknings-och utvecklingshubben fr antimikrobiell resistens).
EU actions to fight antimicrobial resistance 12 Human health is a national competence. 
EU:s tgrder fr att bekmpa antimikrobiell resistens 12 Mnniskors hlsa r en nationell befogenhet.
Articles 6 and 168 of the Treaty on the Functioning of the European Union (TFEU) give the Union competence to carry out actions to support, coordinate, supplement and encourage cooperation between Member States, for the protection and improvement of human health. 
Artiklarna 6 och 168 i frdraget om Europeiska unionens funktionsstt (EUF-frdraget) ger unionen befogenhet att vidta tgrder fr att stdja, samordna, komplettera och frmja samarbetet mellan medlemsstaterna, fr att skydda och frbttra mnniskors hlsa.
The Decision requires Member States to perform 12 Global action plan on antimicrobial resistance, WHO, May 2015. 
12 Global action plan on antimicrobial resistance (global handlingsplan mot antimikrobiell resistens), WHO, maj 2015.