KNOW WHAT AMR IS AND HOW POLICY CHANGES AFFECT THE USE OF ANTIMICROBIALS FOR LIVESTOCK
Courtesy of Phil Boute, DVM.
Health Canada changes around the use of antimicrobials is to address, in part, the threat of the ongoing development of antimicrobial resistance (AMR).
AMR is the ability of an infectious organism to adapt and survive the effects of a drug(s) that is normally used to treat the infection. All use of antimicrobials potentially contributes to the development of resistance.
AMR can be minimized by eliminating excessive or inappropriate use of antimicrobials. Slowing the development of resistance is important to preserve the effectiveness of and access to antimicrobials for use in humans and animals.
The World Health Organization has identified AMR as an increasingly serious threat to global public health, which requires action across all government sectors and in society.
The 2016 O'Neill Commission Report1 on AMR suggests that without significant policy to address AMR, the current 700,000 deaths globally per year due to resistant infections could rise to 10,000,000 per year, and the cost in terms of lost global production could reach 100 trillion USD.
A recent report, Interagency Coordination Group on Antimicrobial Resistance report to the Secretary General of the United Nations2, included the following key messages:
- Antimicrobial resistance is a global crisis that threatens a century of progress in health and achievement of the sustainable development goals.
- There is no time to wait. Unless the world acts urgently, antimicrobial resistance will have disastrous impact within a generation.
- Because the drivers of antimicrobial resistance lie in humans, animals, plants, food and the environment, a sustained One Health response is essential to engage and unite all stakeholders around a shared vision and goals."
The One Health approach to address the threat of AMR calls on all stakeholders to use antimicrobials responsibly. The goal is to maintain access to effective antimicrobials, an essential resource necessary for protection of public health, and animal health and welfare.
Given the importance of protecting human health, veterinary medicine and animal agriculture must be proactive in demonstrating responsible use. If antimicrobials are not used responsibly in animal agriculture, access may be lost. This could result from continued development of resistance or from further regulatory controls and restrictions to preserve antimicrobials for human health only.
Animal owners, livestock producers and veterinarians must work together to ensure responsible antimicrobial use.
Veterinary oversight is a key element of antimicrobial stewardship and preserving access to effective antimicrobials.
Veterinary oversight includes the professional involvement of a licensed veterinarian providing guidance or direction for appropriate use of antimicrobials in animals with the objective of ensuring prudent use and minimizing the emergence or spread of antimicrobial resistance.
Veterinarians, through their education, experience and accountability, are equipped to provide this guidance and direction. This includes prescribing treatment for an animal or group of animals. The direction is specific and may be summarized as the right drug for the right reason, to the right animal(s), at the right dose, by the right route, at the right time, for the right duration, and with the right records.
For animal owners and producers who regularly work with a veterinarian, there has been very little change in day-to-day operations and access to antimicrobials. It is important to note that most MIAs have been available only by prescription for decades. Animal owners or producers who administer antimicrobials through feed will now require a veterinarian's prescription.
The veterinary profession and industry groups have been communicating to their members about the importance of developing a veterinarian-client-patient relationship (VCPR). For animal owners and producers who do not have a veterinarian, establishing a valid VCPR is required prior to issuing a prescription. The process of establishing a VCPR will normally include discussions about animal health and disease prevention. The veterinarian may also work with the producer to develop farm-specific animal health protocols.
In this sense, the value of the partnership established through a VCPR is not limited to a requirement for a veterinarian issuing a prescription. This partnership between the veterinarian and the animal owner provides an excellent opportunity to engage in a discussion about animal health management strategies that could reduce or even eliminate certain use of antimicrobials.
Examples of these health management strategies include:
- Reviewing and discussing animal housing.
- Handling facilities.
- Animal nutrition.
- Parasite control.
- Vaccination strategies to optimize health and reduce incidence of disease that might otherwise require antimicrobial treatment.
- Increased veterinary oversight of use of antimicrobials as well as health management strategies to reduce or avoid antimicrobial use are important elements of "antimicrobial stewardship".
Talk to your herd veterinarian about antimicrobial stewardship or visit www.abvma.ca to search for veterinary care in your area.