AMR or antimicrobial resistance; the term certainly isn’t new, but it’s likely you will be hearing more about it now that Ottawa has released its Federal Action Plan on Antimicrobial Resistance and Use.
Canada is also working toward endorsing a Global Action Plan by the World Health Assembly.
In essence the federal government has started the clock running on a pan-Canadian plan to come to grips with AMR.
As with all such plans action translates into lists of things to be done and deadlines for completing each task.
There will be more surveillance, more stewardship in the form of education or communication with the public, more research and quite possibly more regulation.
This is welcome news in one respect: it’s time nations started getting serious about this topic.
Everyone agrees antimicrobial resistance is a clear danger to people, and animals. Antibiotics are vital to controlling disease in both so no one in agriculture or the human side objects to doing what is necessary to halt it or at least slowing the spread. Deciding what is necessary is a more complex question.
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The danger, of course, is that once you have deadlines people start looking for quick fixes to meet their targets, and that can do more harm than good.
There are no quick fixes to AMR.
As of now we know that the Public Health Agency of Canada will establish a new robust surveillance system to monitor and track AMR in animals and humans. It’s been testing for AMR in samples from abattoirs and retail beef since 2002. So far its surveillance indicates resistance to antimicrobials of the most importance to human medicine is very low, and not increasing. The same is true for multi-drug antimicrobial resistance.
This backs up the findings on two sizable feedlot studies in 1998-99 and 2007-10.
Very low levels of resistance to various bacteria were found in the cattle and best of all there was no evidence of transmission of resistant bacteria to the people working the feedlots who volunteered to be tested.
A third study funded partly by checkoff dollars is underway and scheduled to wrap up in 2018. Researchers hope to determine if the use of important human antimicrobials in beef cattle contributes to antimicrobial resistance. They will also test for the prevalence of indicator bacteria (E. coli and enterococci) in drainage basins, surface water and retail beef downstream from the feedlots and compare the results to isolates obtained from human clinical samples.
Canadian research has shown that less than 10 per cent of treatments in feedlots involve drugs used in human medicine. This includes the very important fluoroquinolones such as Baytril A 100 and cephalosporins like Excenel and Exceed. These classes of drugs are used as a last resort to treat very serious infections in humans and animals. The so-called high-category macrolides like Micotil and Draxxin are again used sparingly to treat sick animals. The medium-category tetracyclines like Liquamycin and Aureomycin that are less crucial in human medicine make up a larger share of the 10 per cent.
The other 90 per cent consist of ionophores like Rumensin that are not used in human medicine. Resistance to them would be problematic for cattle producers but not for medical doctors.
Thankfully the Canadian Cattlemen’s Association (CCA) and other livestock organizations have been at the table as this action plan was being concocted. Their role will be to keep insisting on science-based solutions. Nothing new there. The CCA has been preaching prudent drug use since the mid-1990s first through its Quality Starts Here program and more recently with its Verified Beef Production modules. A new one on biosecurity will offer best management practices to minimize the risk of introducing and spreading a disease within the herd.
Even the best biosecurity measures including vaccinations cannot avoid all bacterial infections so there will always be a need for antibiotics to preserve the health of today’s cattle.
This is where we are bound to see more regulation as this action plan moves ahead. It’s already happening. Health Canada last month served notice that it intends to tighten the oversight on own-use permits for imported active pharmaceutical ingredients. The changes would exclude drugs sold by prescription, medically important drugs, medicated premixes for livestock feed and drugs for which Canada has not established a a maximum residue limit.
Meanwhile the Veterinary Drug Directorate of Health Canada has asked the industry to remove growth promotion claims. Food firms like McDonald’s and Costco are getting into the game and even the auditor general of Canada has issued a report on antimicrobial resistance.
This topic is starting to have the smell of powder keg about it. Let’s hope the Health Canada action plan can keep the discussion focused on reality determined by science.