Canada’s federal government wants the public to know that it is promoting the “prudent use” of medically important antimicrobial drugs in food-producing animals.
But it doesn’t want the public to know what that means — and it certainly doesn’t want the public to hear what its scientists and veterinarians have to say about what many are calling a “crisis” in modern agriculture and public health.
“They muzzled people,” said Dr. James Hutchinson, medical director of the Vancouver Island Antimicrobial Stewardship Program.
Previously, Hutchinson chaired the Canadian Committee on Antibiotic Resistance. He has also contributed to the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) and currently co-chairs the Antimicrobial Stewardship Working Group for the International Society of Chemotherapy.
He believes the Canadian government has failed to take the threat of antibiotic resistance seriously.
“I think the feds have done an extraordinarily bad job on this file, so they’re just now getting to the point of enough embarrassment to do some acting,” Hutchinson said, following a presentation at the National Institute for Animal Agriculture’s symposium on antibiotic use and resistance in Atlanta, Georgia.
In 2013, the U.S. Food and Drug Administration announced that medically important antimicrobials used as growth promotants would be phased out by 2016 — on a voluntary basis. In April of this year, Health Canada quietly made a step in the same direction, issuing a vague notice to stakeholders indicating growth promotions and production claims may be removed from labels for antimicrobial drugs used in livestock production that are also used in human medicine.
The notice does not say if this measure — should it be taken — will be voluntary or mandatory, or what type of oversight might be required. Nor does Health Canada indicate how the removal of these claims will actually reduce antibiotic use, or what stakeholder consultations might look like.
The Manitoba Co-operator attempted to clarify Health Canada’s position, requesting an interview with someone in the department in early July, but for the next 10 weeks we were told that no one was available to speak to us.
Health Canada responded to a list of six emailed questions by returning three answers. Those three answers made use of the phrase “prudent use” four times, while providing no new information.
Hutchison said there is a lack of both public knowledge and media coverage when it comes to antibiotic use and resistance in Canada, and it’s not by accident.
It’s the product of limited media access — the result of tight controls put in place by the Prime Minister’s Office (PMO), he said.
“The actual questions are vetted through the PMO, the questions are vetted, then the answers are vetted throughout the PMO… people don’t get that it’s really bad, it’s the worst it’s ever been, and we’ve got to step up and say we need information,” he said.
Some information on the Canadian situation can be gleaned from a report issued by the National Farmed Animal Health and Welfare Council in September, titled Antibiotic Use and Antimicrobial Resistance: strategies for animal agriculture.
The report contains several recommendations, including that industry stakeholders follow the lead of the poultry sector and end the extra-label use of Category 1 drugs, which are considered essential to human health, as preventive measures in animal agriculture.
The council also recommended that CIPARS make its data available to the public.
Dr. David Leger, a veterinary epidemiologist with the Public Health Agency of Canada was one of the report’s authors and a speaker at the National Institute of Animal Agriculture’s symposium.
But as a federal employee, Leger said he was not permitted to speak to the media unless approval was received from media relations.
Patrick Girard, senior media relations officer, for Agriculture and Agri-Food Canada, denied that approval. “Dr. Leger is there to participate in the symposium,” Girard said, but not to speak to the media.
Many American doctors, epidemiologists and veterinarians taking part in the wide-reaching symposium spoke highly of the work being done on antibiotic resistance in Canada, particularly around the issue of resistant salmonella Heidelberg found in Quebec poultry operations.
“I know we’ve worked with Canada and its CIPARS program for years; there are some stellar people up there,” said Dr. Tom Chiller, a medical doctor with the American Center for Disease Control and Prevention and former chief of the National Antimicrobial Resistance Monitoring System for enteric bacteria.
“I think you guys have some of the best data out there to show that antibiotic use can directly affect human health… they’re able to look at this and generate really good data, so I think it’s a matter of communicating that data to policy-makers and others to say here’s the issue.”
But without access to information, how much data is reaching policy-makers and whether it’s being acted upon remains unknown.
Further complicating the issue of antibiotic resistance is that while the federal government does monitor antimicrobial resistance, it does not control production, distribution or use of veterinary drugs in Canada. That role belongs to the provinces.
And currently, Manitoba Agriculture, Food and Rural Development does not track antimicrobial resistance in the province, nor does Manitoba Health, although some human pathogens are reportable if found to be drug resistant, including methicillin-resistant staphylococcus.
The World Health Organization warned three years ago that civilization is on the cusp of losing its “miracle cures” to the development and spread of drug-resistant diseases, while the World Organization for Animal Health identified antimicrobial resistance as its top priority in 2012 in a bid to spur action.
Hutchinson said statements like these have grabbed the public’s attention, but added that people need more information in order to make informed decisions.
“We’ve gotten to the place where people could say, ‘yeah, I’m worried about this,’ but they can’t say why,” he said, adding that kind of public education would take leadership on the part of government, along with access to information.
And as long as the current government is in power, Hutchinson doesn’t see that happening. Its policy is driven by political ideology, not reason, he said.
“Information gets in the way of their policy, you believe something because you believe it… but the information doesn’t support it.”