Miazga-Rodriguez, M

Progress on Antimicrobial Resistance and Utilization Surveillance Programs in Canada (2014-2019)
Miazga-Rodriguez, M., Lynora M. Saxinger, Simon J. G. Otto

Antimicrobial resistance (AMR) is a recognized global public health threat. Integrated, One Health based surveillance of AMR and antimicrobial use (AMU) must underpin efforts to protect human, animal, and crop health. In 2014, the National Collaborating Centre for Infectious Disease (NCCID) published a report assessing AMR/AMU surveillance in Canada along with recommendations to address gaps in Canada. The objective of this work is to assess the progress made towards these recommendations by:

1. Cataloguing surveillance programs in Canada.
2. Describing program scope
3. Evaluating progress made.

Federal, provincial, and territorial surveillance programs were identified by scanning grey literature, and semi-structured interviews were conducted with key-informant experts across Canada. Based on the collected evidence and a published framework for public health programs, the authors assessed the progress made on each recommendation using a rubric and set of criteria adapted from published components of sustainable public health programs.

Twenty provincial programs and one territorial program were identified. Six different national AMR/AMU surveillance programs were identified. For interviews, 33 invitations were sent, and responses were documented from 28 individuals. Of the provincial surveillance programs, all but two are focused on human health, with B.C. and Quebec collecting animal AMU data. No provinces are collecting animal AMR data. Nationally, no new surveillance programs have been created since 2014, but existing programs have been expanded. Representation of rural and northern Canada is limited. An annual national report, initiated in 2015, summarizes surveillance data from national AMR/AMU programs.

Progress has been made to improve AMU/AMR surveillance system in Canada. However, significant gaps remain in both animal and human surveillance that limit the comprehensiveness of collected data and the timeliness and actionability of reporting. More sustained resources are needed to support new and existing comprehensive surveillance initiatives at all levels of government.