The federal government is not doing enough to contain the spread of drug-resistant organisms, putting the health of Canadians at risk, auditor general Michael Ferguson said in a report released Tuesday.


By: Bruce Campion-Smith Ottawa Bureau, Jennifer Yang Global health reporter

Published on Tue Apr 28 2015

OTTAWA—A federal watchdog’s warning that Ottawa is not doing enough to contain the spread of drug-resistant organisms is “long overdue,” say experts who have been urging action for years.

In a report released Tuesday, the auditor general states that Health Canada has dragged its feet in developing a national strategy to address antimicrobial resistance — a growing crisis that many infectious disease experts consider the “biggest public health challenge of the 21st century.”

“This is long overdue and I think it’s a very important report,” says John Prescott with the University of Guelph’s veterinary college, an antibiotic resistance expert who has been studying the issue for three decades.

“I think it’s a report that embarrasses the Public Health Agency of Canada and Health Canada. And I think deservedly so, because they’ve let Canadians down.”

Experts like Prescott have been pushing for a national plan since 1997, when Ottawa first convened a conference to develop a strategy against antibiotic resistance.

But 18 years later, there is still no national consensus on how Ottawa and the provinces should best work together to tackle a threat that undermines the effectiveness of drugs used to treat infections.

And because of poor surveillance, the Public Health Agency of Canada is likely in the dark about the true impact of drug-resistant organisms on the health of Canadians.

Health Minister Rona Ambrose said her department has taken action on several fronts, including better monitoring and reporting and $4 million for research in areas such as treating drug-resistant infections and preserving the effectiveness of existing antibiotics.

She said a “major contributor” to the rising rate of drug resistance organisms is the “inappropriate use of antimicrobial medicines.”

Still, the report’s findings paint a sobering picture of Ottawa’s failure to act on what the World Health Organization and even the Public Health Agency of Canada itself has flagged as a serious health worry.

The effectiveness of antimicrobials — used to treat infections — has been declining as organisms develop a resistance to the drugs.

“I think this is the biggest public health challenge that the entire globe faces in the 21st century,” says microbiologist Gerry Wright, who studies antibiotic resistance at McMaster University.

“Antibiotics underpin all of modern medicine. Not just direct treatments of infections but all the things we take for granted, from open heart surgery to cancer chemotherapy to taking care of pre-term infants. We are in a serious jam.”

The auditor general’s report focused on antibiotic resistance, which is considered the area of greatest concern.

Already, it’s estimated that some 18,000 Canadians contract resistant infections in Canadian hospitals each year, the report says.

Auditor General Michael Ferguson said it’s up to federal health officials to take the lead to protect the effectiveness of antimicrobials used for treating serious infections.

“A lot of that stronger, national leadership has to come from the Public Health Agency itself. They have to get those provinces on board. They have to be able to establish this as a priority,” he told reporters Tuesday.

But even though discussions with the provinces and territories have been ongoing since 2011, there remains no national strategy in Canada to address antimicrobial resistance.

Ambrose said her department is working on a “national response” but Ferguson was holding out little hope.

“It’s hard to see how we’ll ever have a comprehensive, pan-Canadian strategy for many years to come,” he said.

Ferguson also flagged problems with how the agency tracks the scope of drug-resistant organisms in Canada, saying it had only “limited” information on drug-resistant infections and the use of antimicrobials in both humans and animals.

“People who work in this area have really been astonished by the lack of progress,” Prescott says.

The report says that Health Canada is also aware of gaps in regulations that allow farmers to import unlicensed antimicrobial drugs and other pharmaceuticals for use in their own animals.

“The imprudent use of antimicrobials in food animals can lead to the spread of drug-resistant organisms through the food chain,” the report says.

The report bluntly concludes that Health Canada and the Public Health Agency “have not fulfilled key responsibilities to mitigate the public health risks posed by the emergency and spread of antimicrobial resistance in Canada.”

The report calls for creation of Canadian strategy to address antimicrobial resistance, better surveillance and tightened controls over the use of antimicrobials for animal use.

For Wright, it has been frustrating to watch Canada lag behind other developed countries in tackling antibiotic resistance. Germany developed a national strategy in 2008 and the United Kingdom and United States both announced their strategies in 2013 and 2014, respectively.

Other countries’ strategies

According to the World Health Organization, several countries have developed their own national strategies to address antimicrobial resistance, including:

Germany (in 2008)

France (in 2011)

United Kingdom (in 2013)

United States (in 2014).

These strategies focus on reducing antibiotic use and preventing the emergence and spread of antibiotic resistance.