A Pan-Canadian Framewrk n Antimicrbial Resistance Presentatin t the Natinal Farmed Animal Health and Welfare Cuncil Nvember 30, 2016
PURPOSE Purpse T prvide an update n the develpment f a Pan-Canadian framewrk n Antimicrbial Resistance (AMR) 2
Since the last time we were here Internatinal: Increased recgnitin that AMR requires glbal actin at all levels G7 and G20 have identified AMR as a pririty at the Leaders level, and by Ministers f Health, Agriculture and Science Demnstrating the significant level f cncern acrss the internatinal cmmunity, in September 2016 the United Natins General Assembly (UNGA) cnvened a High Level Meeting n AMR Cnsensus that an effective respnse requires a crdinated apprach t acrss multiple sectrs The WHO Glbal Actin Plan n AMR was recgnized as the blueprint fr actin Cuntries called n t: Develp and fund sustainable crss-sectral natinal actin plans Fcus n cncrete indicatrs t measure the effectiveness f interventins Harmnize regulatry framewrks as a mechanism t supprt R&D 3
Since the last time we were here cnt d Dmestic Implementatin f Federal Actin Plan Cmmitments: Wrkshp held in Octber 2016 t begin discussin n AMR and antimicrbial use (AMU) surveillance in animal agriculture Advancing regulatry and plicy changes fr medically imprtant veterinary antimicrbials Supprting research and innvatin, including the launch f a pint f care diagnstics initiative, a funding pprtunity n transmissin dynamics, and funding thrugh investigatr-initiated cmpetitins Discussins are underway between the CFIA and CVMA t cnduct a multiyear prject n AMU data cllectin with practising veterinarians F/P/T gvernments are develping a Pan-Canadian framewrk n AMR, and actin plan 4
Develpment f a Pan-Canadian Framewrk n AMR Acrss Canada, respnsibility fr AMR is shared acrss multiple sectrs, all levels f gvernment, and with stakehlders Numerus actins t address AMR are being taken by actins in public health, healthcare, and agriculture and agri-fd sectrs --- but are ften undertaken independently An effective Pan-Canadian apprach must reflect the multi-sectral nature f AMR and uses a One Health lens that wuld: Invlve all levels f gvernment Be crdinated acrss human health, agriculture/agri-fd sectrs and include engagement with external stakehlders Clearly define rles and respnsibilities f each sectr t ensure accuntability PHAC is leading effrts t develp a pan-canadian framewrk by bringing tgether federal, prvincial and territrial gvernments as well as key stakehlders frm the veterinary and medical cmmunities, industry and academia With a Pan-Canadian framewrk we are trying t: Crdinate and leverage individual actins being taken acrss sectrs; Share infrmatin and best practices; Create pprtunities fr cllabratin; Establish a cherent apprach that will guide ur cllective effrts and ensure we are mving tgether in the same directin 5
Pan-Canadian Framewrk and Actin Plan n AMR The Pan-Canadian framewrk will be a high level plicy dcument utlining strategic bjectives, utcmes and ptential actin areas under each f the pillars The framewrk will serve t guide, align cllective actins acrss sectrs and is being develped n a faster track --- targeting its cmpletin in May 2017 Once the framewrk is cmplete, will then fcus n the develpment f an actin plan t supprt implementatin f the Framewrk bjectives The actin plan will lay ut details f cncrete deliverables, measurable utcmes and timeframes On a lnger track t prvide the pprtunity fr further discussin abut what everyne can cntribute within their sphere f influence Existing gd wrk undertaken in the agriculture and agri-fd sectr are f value t infrming the framewrk and actin plan, fr example: NFAHWC s Reprt n Antimicrbial Stewardship in Fd Animals in Canada CVMA s Pan-Canadian Framewrk fr Prfessinal Standards fr Veterinarians Chicken Farmers f Canada s 5-year Strategic Plan Research by Beef Cattle Research Cuncil and ther industry rganizatins 6
Pan-Canadian Framewrk n AMR Draft Surveillance Stewardship Infectin Preventin & Cntrl Research and Innvatin Desired Outcmes Enhanced understanding f hw AMR spreads in human and animal settings Cmprehensive picture f AMR and AMU in Canada Effectiveness f current antimicrbial drugs f imprtance t humans maintained Health prfessinals and the public adpt apprpriate antimicrbial use practices Reduced infectins in health care and the cmmunity Better tls and appraches t detect and treat drug resistant infectins in humans and animals Ptential Actins Supprt the develpment f a centralized, harmnized database platfrm t integrate human and animal health data Identify pririty rganisms that cntribute t AMR in animals and humans Enhance human AMR/AMU data cllectin in cmmunitybased settings Strengthen the prmtin f apprpriate AMU in human and animal medicine Develp awareness, educatin and training t imprve prescribing practices in human and veterinary settings Strengthen regulatry versight and framewrk n veterinary medicines and medicated feeds Increase awareness and understanding f AMR, and the rle that infectin preventin and cntrl play in limiting the spread f infectius agents Imprve management practices t reduce the need fr antimicrbials Increase awareness and understanding f the imprtance f bisecurity measures t limit the spread f infectius agents and the need fr antimicrbial use Supprt the develpment f rapid diagnstics that guide the chice f treatment and therapeutic use Supprt clinical trials fr drugs that are already n the market, and/r dn t have ther supprt Explre alternative and adjuvants t antibitics as a made in Canada apprach that addresses bth veterinary and human medicine 7
Gvernance Structure fr Pan-Canadian Framewrk AMR is a cmplex issue invlving multiple players and actrs acrss sectrs An F/P/T dedicated AMR Gvernance Structure is bringing tgether human health, animal health, and agriculture t develp the framewrk and actin plan The structure prvides a systematic, crdinated apprach in wrking tgether and mving in the same directin t mitigate risks f AMR 8
F/P/T Gvernance Mdel n AMR 9
F/P/T AMR Task Grups Task grups established fr each cmpnent f the framewrk Task Grups are cmpsed f subject matter experts frm industry, academia, and nn-gvernmental rganizatins frm bth human and animal health sectrs, and were nminated by F/P/T gvernments Fd prducer rganizatins are represented n each f the grups Task Grup members act as AMR champins in reaching acrss t clleagues t engage them in the wrk f their grup Task Grups will be respnsible fr: Identifying existing best practices, expertise, tls, resurces, while als identifying gaps and pprtunities Prviding the F/P/T AMR Steering Cmmittee with advice and recmmendatins fr health care (hspital and cmmunity settings) and animal health in the veterinary and n-farm/agri-fd settings 10
Opprtunities t engage n the Pan-Canadian Framewrk T functin effectively, membership f Task Grups is limited Task Grup members will act as AMR champins in reaching acrss t clleagues t engage them in the wrk f their grup Fr example, the Stewardship Task Grup reached ut t the NFAHWC t present its Antimicrbial Stewardship in Fd Animals in Canada Reprt The Research and Innvatin Task Grup cnnected with varius livestck stakehlders (beef, prk, chicken, dairy etc) and reviewed research dcuments t infrm their wrk Cnducted an nline survey, and are undertaking cnsultative interviews with human and animal health stakehlders t seek infrmatin n framewrk cmpnents The General Manager f the Cattlemen s Assciatin and the C-Chair f the NFAHWC was a participant t these engagement initiatives In additin t this NFAHWC Meeting, the Public Health Agency f Canada senir fficials engage stakehlders at key events: Canadian Meat Cuncil Meeting (September 2016) Canadian Veterinary Medical Assciatin Cuncil Meeting (Nvember 2016) Multi-sectral Antimicrbial Stewardship Expert Frum (Nvember 2016) (hsted by CIHR) Alberta One Health Antimicrbial Wrkshp (Nvember 2016) 11
Things fr NFAHWC t Cnsider Frm yur perspective what are the key pints fr inclusin in the framewrk and actin plan? What culd yu cntribute as actinable deliverables under each f the framewrk cmpnents fr the actin plan? What actins are the Cuncil expect t see as utcmes f the Pan-Canadian framewrk and actin plan? Hw can the Cuncil supprt wrk n AMR within their wn sectr fr sustainable results when the framewrk and actin plan are cmpleted? Hw can the Cuncil interface with the ther sectrs n the framewrk and actin plan fr sustainable results? 12
Rle f Key Federal Departments Engaged in Pan- Canadian Framewrk n AMR Health Prtfli Appendix A Public Health Agency f Canada is prviding natinal leadership and wrks with partners n the public health aspects f antimicrbial resistance, e.g. surveillance, labratry analysis, infectius disease utbreaks, awareness and public health guidance develpment Health Canada regulates the apprval f antimicrbial drugs fr humans and animals, and sets plicies and standards related t the safety and nutritin f the fd supply Canadian Institutes f Health Research supprts antimicrbial research and cllabrates internatinally n AMR research prjects Canadian Fd Inspectin Agency enfrces regulatry requirements fr the health and safety f animals and the fd supply, and the develpment f natinal bisecurity standards Agriculture and Agri-Fd Agriculture and Agri-Fd Canada supprts the develpment and adptin f industry-led assurance systems, and mnitrs trade and market access activities 13