OTTAWA - The auditor general is urging the federal government and Canada's public health authorities to get serious about the expanding threat of drug-resistant infections.In his spring report, auditor Michael Ferguson said the Public Health Agency of Canada has failed to mobilize its provincial and territorial counterparts in developing a national strategy to deal with the growth of antimicrobial resistance, a problem which places decades of medical advances at risk."The Public Health Agency has identified that there has to be stronger national leadership. Well, a lot of that stronger national leadership has to come from the Public Health Agency itself. They have to get those provinces on board," Ferguson said at a news conference."But right now given that most of the work is happening within the federal family, it's hard to see how we'll ever have a comprehensive, pan-Canadian strategy for many years to come."Ferguson's audit found that incomplete surveillance has left the agency without a comprehensive national picture of the resistance problem. It has limited information on drug-resistant infections at clinics and long-term care facilities, and lacks details about the extent of the problem in remote areas and among vulnerable members of the population.The limited information at its disposal means that the Public Health Agency can't estimate how much antibiotic resistant infections drive up the cost of health care in Canada, the report said.The audit also recommended that Health Canada take additional steps to promote the proper use of the drugs in food animal production, which can contribute to antimicrobial resistance.Dr. Scott Weese, an expert in antibiotic resistant bacteria in animals, said there are several low-hanging fruit that could be easily plucked to help address the problems of inappropriate antibiotic use in this sector.For instance, the report notes that Health Canada has not yet plugged a loophole that allows farmers to import antibiotics for unlicensed and unprescribed use in animals, as long as the farmer is buying the drugs for his or her own operation."The fact that I can go into a feed supply store down the road and buy a case of penicillin makes no sense," said Weese, who teaches at the Ontario Veterinary College in Guelph, Ont.A federal government action plan on antimicrobial resistance and use that was released late last month said Health Canada will "address" the so-called own-use importation of veterinary antibiotics, though it does not state what action will be taken. The report gives 2017 as a target for completion of this work.The auditor general's report said Health Canada should review antimicrobials regularly to determine whether agricultural use increases the risk of the drugs becoming ineffective in humans.Antimicrobial drugs are used to treat bacterial infections, such as pneumonia, and reduce the risk of serious complications and death. Without them, many life-saving surgeries — joint replacements, organ transplants, even appendectomies — could not be performed safely, because of the infection risk. Antibiotic resistance can develop naturally. But misuse and overuse of antibiotics creates situations in which infections that could easily be treated a couple of decades ago can now only be cured with longer and costlier courses of antibiotics, some of which carry the risk of serious side-effects.
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