As antibiotics become less effective against infection, Minister of Health, Jane Philpott, outlines the response to antimicrobial resistance in Canada
Antimicrobial resistance (AMR) is one of the most serious global health threats today. Existing antimicrobials, such as antibiotics, are becoming less effective as AMR is outpacing the development of new drugs to treat infections. AMR happens naturally when bacteria that cause illness become resistant to the antimicrobials used to treat infections. However, inappropriate use of antimicrobials in health care, agriculture and veterinary settings can increase AMR. Resistant infections that are more difficult to treat can lead to long-term illness, increased health care costs and death. It is estimated that, with no action, annual worldwide human deaths attributable to AMR could reach 10 million by 20501.
Tackling AMR in Canada
Canada must be prepared to detect and respond to the threat of AMR to lessen the health risks to Canadians in the face of rising rates of drug-resistant infections around the world.
The Government of Canada created a Federal Framework and Action Plan, which has laid out the concrete actions we have been taking in recent years to address AMR and antimicrobial use (AMU). We are using a “One Health” lens with coordinated effort across human health, animal health and agri-food sectors, among others, to help prevent and control AMR.
We are strengthening surveillance systems to help identify new threats or changing patterns of AMR and AMU in humans and animals. For example, the Public Health Agency of Canada’s Canadian Antimicrobial Resistance Surveillance System integrates information about AMR and AMU in humans and animals to inform public health action. It draws on relevant data from both the human health and animal health domains through partnerships with specialised surveillance systems and laboratories.
Our government is strengthening the responsible use of antimicrobials in human and veterinary medicine, through the development of regulatory and non-regulatory initiatives, including public health guidelines, best practices and widespread communication to health professionals and the public. In May, Health Canada announced changes to the Food and Drug Regulations that strengthen rules to control access to veterinary antimicrobial drugs to better promote their prudent use in food-producing animals. Complementary measures are being developed to ensure that a veterinarian’s prescription will be required to obtain antimicrobial drugs for animal use. The Canadian Food Inspection Agency is also working with the animal feed industry to ensure prudent AMU through changes in the Compendium of Medicating Ingredient Brochures. The government is also collaborating with national and international partners to advance policy, research and innovation in Canada and abroad. For example, the Canadian Institutes of Health Research (CIHR) invests in the Joint Programming Initiative on AMR, a global research network made up of 23 member countries.
CIHR is also investing in Canadian research teams that are developing innovative diagnostic tools to help clinicians quickly identify whether prescribing antibiotics will be effective.
Our government plays a role in developing and disseminating information and guidance, and encouraging prudent AMU by public health and healthcare professionals, food producers, veterinarians and the Canadian public. Public awareness activities help Canadians to understand the benefits and risks of antimicrobials and why their use is not always warranted for treatment of infectious diseases.
Working with our partners
Addressing antimicrobial resistance in Canada requires sustained efforts across multiple sectors and organisations. Provinces and territories, academia, animal and human health professionals, food production stakeholders and pharmaceutical and livestock industries each hold essential levers for reducing AMR.
A Pan-Canadian Framework for Action is being developed jointly with the provinces and territories and other key partners to guide our collective action in tackling AMR in Canada. This high-level Framework will identify strategic objectives, opportunities for action and desired outcomes under 4 pillars: surveillance, stewardship, infection prevention and control, and research and innovation.
Some key opportunities identified for future action include:
- Establishing coordinated ways to link AMR and AMU data from human health, animal health and agriculture sectors;
- Engaging all levels of government and stakeholders to deliver communication, education and training programs and tools on evidence-based infection prevention and control practices and strategies;
- Building knowledge about antimicrobial stewardship through enhanced and coordinated education for prescribers, dispensers and end-users of antimicrobials; and,
- Establishing a fast-tracked, cost-effective process for licensing antimicrobial drugs, alternatives to antimicrobials and new diagnostic tools in Canada to incentivise pharmaceutical investment without compromising safety, efficacy and quality.
Once the Framework has been completed, we will focus on developing an action plan that lays out concrete actions and timelines to meet the Framework’s objectives.
Looking to the future
Significant work remains to be done to protect Canadians from the threat of AMR and to minimise the impact on human and animal health. Everyone has a role to play and it is through collective actions that we will make real progress in tackling AMR in Canada and around the world.
1 “Tackling Drug-Resistant Infections Globally: Final Report and Recommendations” The review on antimicrobial resistance chaired by Jim O’Neill, May 2016 https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf
Canada’s Minister of Health