Canadian AMR report urges action, federal leadership

The Canadian parliament has issued a new report that calls on the country’s public health agency to speed up development of a plan to address antimicrobial resistance (AMR) and urges more federal leadership and coordination on the issue.

The report from the House of Commons Standing Committee on Health comes after 2 years of study, during which members of the committee heard from government officials, academics, international organizations, and various stakeholders in both human and animal health. It summarizes the scope of the issue in Canada and the challenges the country faces in addressing AMR, and makes recommendations to address those challenges.

“The committee agrees that Canada has made significant efforts to tackle AMR,” committee chair Bill Casey writes. “At the same time, the committee stresses that more needs to be done, particularly with respect to federal leadership and coordination and investment in research and innovation.”

Problems with surveillance, stewardship, funding

The recommendations are geared toward the Pan-Canadian Framework for Action, a strategic plan released in 2017 that is intended to serve as a guide for coordinated efforts by the government and human and animal health and agriculture sectors to address AMR. The four main focus areas of the framework are surveillance, infection prevention and control, stewardship, and research and innovation.

Witnesses who appeared before the committee in a series of hearings in 2017 emphasized the need for more surveillance and data on AMR and antimicrobial use, improved antimicrobial stewardship in the community, and the need for more funding for research and innovation.

According to the report, committee members heard from witnesses that the Canadian Antimicrobial Resistance Surveillance System currently relies on poor-quality data and that the country lags behind others in the ability to track antimicrobial use, incidents of resistant bacteria, and the impact of drug-resistant infections. The Public Health Agency of Canada (PHAC) estimates that 18,000 hospitalized patients acquire antibiotic-resistant infections each year, but because of poor surveillance, mortality rates from AMR are unknown, Andrew Morris, MD, of the Association of Medical Microbiology and Infectious Disease Canada told the committee.

Witnesses also cited a lack of national guidelines for appropriate antimicrobial use, the need for more education for physicians, nurse practitioners, and patients on responsible antimicrobial use, and the need for more federal leadership and coordination on AMR.

In response to these challenges, the report calls for PHAC to accelerate development of the Pan-Canadian Framework for Action and include measurable goals, targets, and clear timelines for implementation. It also calls for PHAC to appoint a federal advisor to be a “national champion” for combatting AMR, to expand and improve AMR surveillance and data collection, and to work with Canada’s provinces and territories and their health professional regulatory bodies to develop national prescribing guidelines and educational materials for providers and patients.

In addition, the report recommends that the Canadian government provide “stable and adequate” funding for innovation and research and explore the possibility of funding a network of AMR research centers, and that Canadian health officials consider improving non-antibiotic alternative therapies for food-producing animals.

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