Their misuse has the power to render the most powerful tools in modern medicine impotent, yet in Manitoba there is more regulation around the sale of pesticides than antimicrobials used in livestock production.
Mounting evidence points to an increase in antimicrobial-resistant diseases worldwide, and a research paper published recently in The Lancet calls for greater political oversight, as well as more judicious use of antibiotics in human medicine and animal agriculture.
But government action has been slow or non-existent.
“We’ve been actively lobbying the provincial government to get some controls over antibiotics, how they’re distributed, making sure that when they’re dispensed, that they’re dispensed with some appropriate advice to the producer,” said Wayne Tomlinson, president of the Manitoba Veterinary Medical Association. “This is such a multi-layered issue, you’ve got the federal jurisdiction, you’ve got provincial jurisdiction, you’ve got the international community dealing with this, it’s a huge issue.”
Call for improvement
Nearly two years ago, the Canadian Food Inspection Agency’s then chief veterinary officer Brian Evans, made an impassioned call to improve usage of antimicrobials to avoid the development of resistant organisms and keep antibiotics in the disease-fighting tool box.
In 2011, the World Health Organization warned 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.
But governments, including Manitoba’s, have not moved forward with new regulations.
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 federal government does monitor antimicrobial resistance, but it does not control production, distribution or use of veterinary drugs in Canada; that role belongs to the provinces.
Tomlinson said he would like to see regulation in Manitoba around veterinary antibiotics that is similar to the pesticide licence. “Where we can make sure that the people who are dispensing pharmaceuticals have some training, so that they can help guide the people who are using them,” said the veterinarian.
But he doesn’t believe a nationwide regulatory system is the way to go, preferring to focus on awareness and education for producers.
“We’ve been promoting evidence-based usage of antibiotics,” he said. “So let’s use the right antibiotic at the right dose, at the right time.”
Glenn Duizer, an animal health veterinarian with Manitoba Agriculture, Food and Rural Development (MAFRD) agrees that education is key for producers and veterinarians when it comes to stymieing antimicrobial resistance.
“We haven’t changed anything from the regulatory side, but we are certainly continuing on with the education and awareness program,” he said, adding producers also have on-farm food safety programs, and veterinary advice to guide them in the responsible use of antibiotics and other antimicrobials.
But the 26 researchers who authored the recent The Lancet article — titled “Antibiotic Resistance: the need for global solutions” — go further, calling for the banning of non-prescription antibiotic sales, and the curbing of non-therapeutic antibiotic use in animal agriculture.
Tomlinson said that the amount of antibiotics used at sub-therapeutic levels has decreased greatly in recent years adding that human medicine is still responsible for the bulk of antibiotic-resistant organisms.
“I think our livestock producers are getting a bit of a bad rap here,” he said. “That doesn’t mean that we can’t improve and certainly, we are trying to make headway in making improvements in our management systems so we reduce our reliance on antibiotics, through proper nutrition, through proper ventilation and through proper housing. We’re making tweaks to reduce our need for antibiotics.”
Lead author of The Lancet piece, Professor Otto Cars, of Uppsala University in Sweden and ReAct Action on Antibiotic Resistance, notes that finger pointing has been an issue when it comes to finding solutions.
“We need to move on from ‘blaming and shaming’ among the many stakeholders who have all contributed to the problem, towards concrete political action and commitment to address this threat,” he said in an excerpt from the article.
But even if calls to action haven’t resulted in sweeping reforms, they have resulted in a greater awareness among producers about the issues surrounding antimicrobial resistance and responsible antibiotic use.
“I think it’s slow, but we’re seeing producers who are more and more concerned about it, I think that producers are realizing that it’s no longer just about residue… that it’s moved beyond just a food safety concern, that resistance is applicable to all of us, from animals to people, to the environment,” Duizer said.