Good afternoon, Madam Chair.
I'd like to thank the committee for the opportunity to testify and share my perspective. My name is Joe Rubin. I'm a veterinarian and microbiologist and a 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 current roles are as an educator of veterinary students in the areas of bacteriology and infectious diseases and as a researcher, where I study the problem of AMR from a number of perspectives.
There are three areas I would like to highlight today where I can see a need for additional support: first, research into evidence-based antimicrobial stewardship for companion animals; second, support for global collaborations to tackle resistance in low- and middle-income countries; and third, support to harmonize diagnostic testing in veterinary labs, with the goal of improving both passive surveillance and antimicrobial stewardship.
With respect to the first topic, the committee has heard testimony about the importance of stewardship to improve how and when antimicrobials are used, so that we can preserve their efficacy. Antimicrobial stewardship necessarily looks different in each context where it's applied. What might work 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 barnful of broiler chickens or a hive of bees. The stewardship approach to each of those situations is necessarily different. In veterinary medicine, more data is needed to support stewardship in companion animal practice.
The goal of stewardship is to change prescriber behaviours. This is quite a difficult thing to do. For companion animal practitioners, we've largely relied on passive antimicrobial stewardship, which essentially consists of providing knowledge and information through continuing education conferences and workshops. In the context of human infectious diseases, we know that more active approaches have a bigger impact on prescriber behaviours. Furthermore, there are areas in which we lack data to inform how antimicrobial use can be optimized. For instance, reducing the duration of therapy can greatly impact the amount of antimicrobial that an individual animal is treated with. At a population level, this can multiply to make a big difference.
With respect to the second topic, the committee has 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's 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 not only protect Canadians but also reduce the burden of resistance on vulnerable individuals, such as small-scale sustenance farmers, who may be disproportionately impacted.
Finally, in Canada there are improvements that should be made in veterinary diagnostic microbiology. While our domestic diagnostic labs are doing a good job in providing services to veterinarians, changes could be made that would have both surveillance and stewardship benefits. First, national harmonization of the antimicrobial susceptibility test methods used will ensure that all the data these labs generate as part of their routine work can be directly compared across the country, facilitating passive resistance surveillance. Second, developing a harmonized strategy for how lab results are reported would advance stewardship goals. For instance, including relevant data from current treatment guidelines, such as the veterinary Firstline application that was mentioned previously, along with lab reports that go to prescribers would provide additional context to help veterinarians optimize their therapy.
In conclusion, as other witnesses have testified, antimicrobial stewardship is essential in our fight against AMR. In companion animals, more resources, including grants, are needed to support the development of effective strategies to help veterinarians optimize their use of antimicrobials and ensure that current best practices are implemented. Second, we must take a global perspective and work with our colleagues internationally to combat the emergence of resistance in low- and middle-income countries. Finally, I suggest providing support to develop harmonized susceptibility testing and reporting protocols amongst Canada's veterinary diagnostic labs.
Thank you very much for this opportunity.