Thank you, Madam Chair.
I'm an infectious disease veterinarian, and I direct our university's Centre for Public Health and Zoonoses. I deal with antimicrobial use and resistance at the animal level, but also at the human-animal interface, ranging from local to global activities.
This may be fairly high-level, but I want to emphasize the complexity of the issue, the oversimplification of the problem, the lack of action-based approaches and the need to consider animal and human health as separate but linked entities.
There's increasing recognition of AMR as a “one health” problem, because it is. However, it's not human health and one health; it's human health, animal health and environmental health under the one health umbrella, and we have to remember the animal health component of that.
The other thing with one health is that it tends to be more talk than action. It's very difficult to define. It's difficult to act upon. We need to think about one health, but we can't wait for a one health approach. We can't let one health be the anchor that slows us down.
We need individual actions in human and animal sectors. We need to keep one health in mind, but action is largely going to be done at the species and sector levels.
If we look at the World Organisation for Animal Health, they have estimated that by 2050, if AMR is unchecked, food production losses will be the equivalent of the food needs of 750 million to two billion people. That's a staggering number.
A small percentage of them will be in Canada, but a small percentage of a staggering problem is still relevant, and it's growing. That doesn't even show the whole scope of the problem. As Dr. Rubin mentioned, we have other species and have companion animals and their emotionally attached owners, and there are significant health impacts there.
One of the reasons we're here is to think about the role of animals in human health. We really don't understand the role of antibiotic use in animals and in resistance in humans. It's probably a very small proportion. Most of the resistance in humans comes from antimicrobial use in humans and most of the resistance in animals comes from use in animals, but there is some crossover in both directions. Again, a small proportion of a very large problem is something we'll still need to address.
We need to address AMR in humans and animals, but human and animal health needs are different. We have to recognize that. We can't ignore the animal health and welfare components.
The other thing is that we can't fix the problem of AMR by just addressing AMR. AMR is the end result; it's not the problem per se. Our problem is antimicrobial use. Why do we use antimicrobials? It's because of health, or a lack thereof. If we focus only on new drugs and new tests, we avoid addressing the true problem and we're perpetually trying to keep up with a problem that's more agile than we are. If we just focus on surveillance, we have a great view of a problem, but we're not actually doing anything to fix it, so we need to optimize health and welfare if we're going to have an impact.
For animal health, we need innovation, but we need it in things that improve health: better animal management, better access to vaccines and other preventive measures, nutrition, access to veterinary care, treatment guidelines, willingness to change and social science interventions to help us effect changes that we all know we need to make. These are often outside what's considered innovation and can be challenges to getting support for funding in particular.
Additionally, while we know we have a problem with AMR, we can't define it well, as mentioned before. If we can't understand a problem, we can't efficiently address it. That can lead to inaction, inefficient action or, sometimes, harmful action. We need to think about action-oriented, broad, and integrated, or at least integrable, surveillance, with an ability to understand where, why and how antimicrobials are used in my area on animals, but also more broadly anywhere.
With better surveillance, we can focus on appropriateness of use and actionable data, not crude numbers that are better for sound bites than action. For that, we need industry buy-in and commitment, political buy-in and commitment, sustained funding and sustained will.
We have to accept that there is a role for the use of antimicrobials in animals but not accept the status quo. My mantra when it comes to antimicrobials is “use as little as possible, but use enough”, and we have to maintain what we have.
We can't rest on our laurels. Canada has done well in the AMR field. We've been well regarded, but we have slipped internationally.
We have to continue to act, continue to innovate and truly commit to addressing this problem. We have well-respected groups and individuals and the foundation to re-emerge as a world leader if there is will and support, part of which has to come from the political level to ensure action.
My final point is that it's complicated. It's a complex problem. It's going to require complex, multisectoral solutions and support for sustained and aspirational action. AMR is a problem that spans decades and generations. It's bigger than election cycles, it's bigger than administrations and it's bigger than granting cycles, and that's a problem for motivation. We need short-term wins, but we need a long-term strategic plan, commitment and support if we want to address this problem.
I thank you for addressing this important issue, and I would encourage you to consider animal health when you're thinking about the AMR crisis.