Thank you for the invitation to testify today.
My name is Joe Rubin. I'm a veterinarian, microbiologist and professor in the Department of Veterinary Microbiology at the University of Saskatchewan. I've been working on antimicrobial resistance, primarily in companion animals and food products, for nearly 20 years. My roles are as an educator of veterinary students in the areas of bacteriology and infectious diseases and as a researcher studying the problem of AMR from a number of perspectives.
Antimicrobial resistance is an underappreciated pandemic that urgently requires additional action. I'm very heartened to see this topic examined by multiple parliamentary committees. The committee has already heard foundational testimony from other witnesses, so I'll focus on areas in my field where I believe action is needed.
At present, we have an incomplete picture of the scope of the problem. The committee has heard about challenges with resistance surveillance in people. In animals, our knowledge is even more fragmented. Resistance is not a problem uniformly spread across all bacteria. Some organisms are more problematic than others in terms of how common resistance is, how frequently they cause infections and what animal species, including people, are impacted.
We have a very good understanding of antimicrobial resistance in Canadian-raised agricultural animals through the CIPARS program, which is within the Public Health Agency of Canada. There are, however, some very large and important gaps, including among imported foods, companion animals—dogs, cats and horses—and wildlife, although the impact of resistance in wildlife on human health may be more difficult to quantify. Resistance surveillance programs outside of CIPARS are limited to research projects initiated by individual scientists, which lack stable funding and broad integration with other researchers and other programs.
In previous testimony, the committee has heard how prescription audit and feedback programs are among the most effective stewardship interventions. This is something we don't do, and we probably can't do it at a meaningful scale in veterinary medicine.
Antimicrobial stewardship necessarily looks different in each context where it's applied. What works in a large human hospital may or may not be appropriate in the diverse environments or for the patient populations that veterinarians care for. An individually owned dog is quite different from a dairy cow, a barn full of broiler chickens or a hive of bees, and the stewardship approach in each of these contexts will look different.
In veterinary medicine, more data is needed to support stewardship in companion animal practice. The goal of stewardship is to change prescriber behaviours. For companion animal practitioners, we've relied largely on passive antimicrobial stewardship, which has consisted of providing knowledge and information through continuing education conferences and workshops. In human infectious diseases, we know that more active approaches have a bigger impact on prescriber behaviours. Furthermore, there are areas where we simply lack data on how antimicrobial use can be optimized. For instance, reducing the duration of therapy can greatly impact the total amount of antimicrobial that an individual animal is treated with, which, at a population level, can multiply to a big difference.
Finally, the committee also heard that AMR does not respect borders, and that the threat of resistance is global. Through international travel and trade, resistant bacteria and resistance genes can be easily transported intercontinentally. It is therefore in our best interest to assist low- and middle-income countries to build regulatory, diagnostic and stewardship capacity in the veterinary and human health sectors. Meeting the threat of resistance where it's most rapidly emerging will protect Canadians and reduce the burden of resistance on vulnerable individuals living in these regions, who may be both disproportionately impacted and least able to respond.
To conclude, antimicrobial stewardship is essential in our fight against AMR. In companion animals, more resources are needed to develop effective strategies to help veterinarians optimize antimicrobial prescribing and to ensure that best practices are implemented. We must also take a global perspective and work with our colleagues internationally to help combat AMR in regions where it's most rapidly emerging.
Again, thank you for the opportunity to share my perspective.