The Comparative History of Antimicrobial Resistance in Norway 1945-1998

Anti microbial resistance (AMR) has been a challenge for clinical medicine, pharmacology and public health since World War II. It has gone through a career from a rare clinical problem in the 1950s to being a major public health threat. Initially being di scussed in expert circles it gradually became an issue for the wider public from the 1980s. We tend to focus on AMR as a medical problem today, yet it was also environmental concerns that initiated public concern. Norway has enjoyed low rates of AMR over decades and has thus fared well in relation to this challenge. The question this research project wants to raise is why this is so. This will be done through an investigation of the period 1945 to 1998, from the arrival of modern anti-infective therapy do wn to the design of an explicit strategy to combat AMR in 1998. Our research will have a comparative approach, carried out in cooperation with an established European Science Foundation network on the history of drug therapies. Once base data are collecte d, two studies will be carried out: One on the relation of clinical research and medical science, taking its departure from pioneering work done at Haukeland hospital (Bergen) in the 1950s; and one on the relation of medical science and public health in t he following decades, in this case departing from work done at Wilhelmsens Institute in Oslo. Methodologically, we frame AMR as a historical object: While reflecting biological processes its meaning also evolved from discourses such as the ones that we st udy. We study the peculiarities of the Norwegian management of AMR for two purposes: To document this history in a way suited to inform lay and expert audiences; to serve as one of a set of examples to be studied in collaboration with colleagues in severa l European countries.