ARCHIVED - Summary of the Final Report of the Advisory Committee on Animal Uses of Antimicrobials and Impact on Resistance and Human Health
Resistance to antimicrobial drugs is a serious problem in Canada and around the world. The problem, often referred to as antimicrobial resistance or AMR, costs lives and money and threatens our ability to treat infections in both humans and animals. The medical community in Canada recognizes that the most serious resistance problems in people can be attributed to over-use in human medicine and drugs used in animal food production.
In 1999, Health Canada established the Advisory Committee on Animal Uses of Antimicrobials and Impact on Resistance and Human Health. Its role was to provide advice and assistance to Health Canada in the development of policy options related to animal uses of antimicrobial agents
Consisting of twenty members, the Committee had broad representation from animal industries (dairy, meat, poultry, fish), animal welfare organizations, Canadian Agri-Food Research Council, the Canadian Veterinary Medical Association, drug manufacturers, physicians, public health officials, academia, provincial governments and consumers. During its deliberations, the Advisory Committee reviewed and discussed relevant scientific literature and consulted with international experts.
Although mindful of the many detailed reviews and recommendations available in the public domain and reluctant to "reinvent the wheel," the Committee decided it was important to present:
- the Canadian perspective in their recommendations;
- detailed discussion of the scientific evidence of human and animal health impacts;
- the international response to the problem;
- stakeholder perspectives on the benefits of antimicrobials in animals; and
- the options for managing resistance risks.
The Report of this Committee was submitted to the Director General of Health Canada's Veterinary Drugs Directorate on June 28, 2002. The Committee has suggested that in the interest of openness and the need for a broad consultation on the issue of antimicrobial resistance, Health Canada should make this Report public and seek comments from Canadians.
The Advisory Committee on Animal Uses of Antimicrobials and Impact on Resistance and Human Health believes that antimicrobial resistance is approaching crisis proportions in human medicine - where efforts are being made to curtail unnecessary antimicrobial use in people, and to control infections in hospitals and in the community.
In veterinary medicine, resistance in animals occurs whenever antimicrobials are used, whether for therapy, disease, or growth promotion. This reduces the effectiveness of available antimicrobials in treating infections and leads not only to increased use of more expensive drugs that are important to human health, but also to the spread of resistant bacteria from animals to humans. While the magnitude of the public health impact is unknown, it has been determined that resistance is a serious problem in bacterial infections of humans originating from animals.
Furthermore, the Committee believes that these problems warrant changes to the ways that antimicrobials are regulated, distributed and used in animals. There are 38 recommendations in the Report. The six key recommendations are contained in the executive summary and are attached to this fact sheet in Appendix A.
Key Recommendations in the Executive Summary of the Report of the Advisory Committee on Animal Uses of Antimicrobials and Impact on Resistance and Human Health
- Make all antimicrobials used for disease treatment and control available by prescription only.
- Develop an extra-label use policy which ensures that this practice does not endanger human health. Such a policy should include the ability to prohibit the extra-label use of specific drugs of critical importance to human health.
- Evaluate, register and assign a DIN to all antimicrobials used in food animals, whether manufactured domestically or imported. This include antimicrobials imported in bulk Active Pharmaceutical Ingredients (APIs), which should be allowed into Canada only under permit. The intent of this recommendation is to stop the direct use of APIs in food animals.
- Stop the importation, sale and use of antimicrobials not evaluated and registered by Health Canada. The intent of this recommendation is to stop the "own use" loophole.
- Evaluate antimicrobials for growth promotion or feed efficiency using sound risk analysis principles and rapidly phase out antimicrobial claims not fulfilling the following criteria: demonstrably effective; involving products rarely, if ever used in human therapy; and not likely to impair the efficacy of any other prescribed antimicrobial for human infections through the development of resistant strains.
- In consultation with the provinces, other federal agencies and industry groups, design and implement an ongoing, permanent, national surveillance system for antimicrobial resistance arising from food-animal production. Surveillance should include indicator and pathogenic bacteria isolated from animals, foods and imported animal products.
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