Growing Forward 2 - Final Report - Page 6

INTRODUCTION The Council of the CVO has as its mission “To guide, govern and inspire excellence in the profession through partnerships with veterinarians and the public in the service of society”. Accordingly, its 2017 Strategic Framework identified four key objectives, including to “Advance One Health stewardship enabling public health initiatives within veterinary medicine”. This objective highlights the importance of the intersection of public health, animal health and, in this case, veterinary medicine. The government and public discourse on antibiotic resistance in human health is ever present and mounting, particularly at a national level with the release of the Report of the Auditor General of Canada on Antimicrobial Resistance1. A logical question is what is the veterinary contribution to a solution that would reduce identified risks? While not a complete conversation on the topic on antibiotic prescribing patterns and animal care, the CVO initiative provided a focused “kick-start” to a larger conversation within the veterinary profession in Ontario. Advance One Health stewardship enabling public health initiatives within veterinary medicine. Strategy 2017 College of Veterinarians of Ontario The College, recognizing its unique public interest contribution, saw an opportunity to create a dialogue with food-producing animal veterinarians to consider what actions might advance progress on the antibiotic prescribing practises of veterinarians. This project is viewed as an important step for collaborative thinking within the profession, including leading to specific suggested actions which could influence and advance solutions to this challenge of antibiotic resistance. While the majority of the ideas generated and discussed may not be resolved within the College’s jurisdiction, leadership on public interest matters is paramount. Antimicrobial pharmaceutical products form an essential component of modern veterinary and human health care. As such, all veterinarians share the responsibility with human health practitioners in addressing the problem of the potential impact on human and animal health as antibiotic resistance develops in common bacterial pathogens and antibiotics become less effective. Every use of an antibiotic increases the possibility for the development of resistance and further promotes the dissemination of resistant bacteria and resistance genes. If the development of antimicrobial resistance (AMR) continues unchecked, antimicrobial compounds will lose their effectiveness, and currently treatable ailments might again become intractable. The continued emergence of resistant bacteria, along with a lack of new antimicrobials on the market, poses a worldwide human health threat. Resistant bacteria carried by food-producing animals can spread to people through the consumption of inadequately cooked food, handling of raw food or by crosscontamination with other foods, through the environment (e.g. contaminated water) and through direct animal contact. Antimicrobial residues and resistance genes can enter the environment through the application of manure to fields. This environmental dissemination can impact the surrounding ecosystem, sympatric wildlife and neighboring human communities. Antimicrobials in feed are often water-soluble, with up to 90% of the dose administered excreted in urine, and up to 75% excreted in feces. It has been demonstrated that medication protocols on beef feedlots can impact wastewater levels of tetracycline resistance genes. Also, antibiotic resistant Escherichia coli (E. coli) has been detected in small mammals trapped near swine farms. The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS), operated through the Public Health Agency of Canada (PHAC), monitors trends in antimicrobial use and antimicrobial resistance in selected bacterial organisms from human, animal and food sources across Canada. The program is based on several representative and methodologically unified surveillance components that can be linked to examine the relationship between antimicrobials used in food-animals and humans and the associated health impacts. This information supports: (i) the creation of evidencebased policies to control antimicrobial use in hospital, community, and agricultural settings and thus prolong the effectiveness of these drugs, and (ii) the identification of appropriate measures to contain the emergence and spread of resistant bacteria between animals, food, and people in Canada2. 1 2 College of Veterinarians of Ontario  http://www.oag-bvg.gc.ca/internet/English/parl_oag_201504_01_e_40347.html http://www.phac-aspc.gc.ca/cipars-picra/index-eng.php 6