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4 The Manitoba Co-operator | July 12, 2012 OPINION/EDITORIAL Accountability, public health and trade Reading between the lines of the article by Canada’s top veterinarian in the July issue of the Canadian Veterinary Journal, this country suffers from a jurisdictional void that constrains its ability to address a high-priority public health issue. The World Health Organization and the World Organization for Animal Health have both been sounding the alarm over Laura Rance the growing problem of pathogens that Editor are becoming resistant to the antimicrobials used in both human and animal health. The WHO went so far last year as to warn that the world is on the brink of losing these “miracle cures” a mere 60 years after their introduction. There is little argument that the are being abused. In human health, doctors routinely describe antibiotics as a precaution and patients often stop taking their pills as soon as they start to feel better. In livestock production, they are frequently used as growth promoters rather than to treat sickness. Dr. Brian Evans, whose job these days is to serve not only as the country’s chief veterinarian but its chief food-safety officer, treads carefully in his article, calling the misuse of antimicrobials in human and animals a “complex, multifactorial problem.” The way he describes it, three federal agencies — the Public Health Agency of Canada, Health Canada and the Canadian Food Inspection Agency (CFIA) — monitor for resistant microbes in the food-animal sector. That surveillance shows that antimicrobial resistance is rising. The CFIA also watches for drug residues in food and makes sure livestock feeds meet federal standards. Health Canada encourages prudent use of antimicrobial drugs and has gone so far as to categorize these drugs according to their importance to human medicine. It has a policy on extra-label use of veterinary drugs and recommends against using the critically important ones in mass-medication situations. But the key words here are “encourage,” “policy” and “recommends.” Extra-label use and prescribing medication for livestock is done by veterinarians, who are regulated by provincial governments. But use of these medications, short of ensuring they meet efficacy and safety standards, is barely regulated at all. So, we know — or at least the federal government knows — the problem of antimicrobial resistance is getting worse. But it can’t do anything about it. And because many of these drugs do not require a prescription from a vet to obtain, there is no way of monitoring how much or how often they are used. “In Canada, we do not know the quantities of various antimicrobials used in animals, and we do not collect use data in a manner that helps to further our understanding of resistance and its impact on human health,” says the report Uses of Antimicrobials in Food Animals in Canada: Impact on Resistance and Human Health. The committee behind this report recommended that be changed, although it acknowledged that forcing producers to obtain a prescription would increase costs and would meet with resistance. “It is important that this information be available in the future. These data are needed to interpret changes in resistance over time, to assess the impact of resistance on human health, and for development and evaluation of programs designed to contain antimicrobial resistance,” the committee said. Judging from the Evans article, there has been little progress on this front over the past decade. The U.S., as well as many other countries, also lacks data, the report noted. The available estimates for the U.S. vary widely between 50 per cent and 87 per cent of the antibiotics sold annually in the U.S. are for growth promotion and prophylaxis in swine, cattle and poultry. But the U.S. Food and Drug Administration was recently raked over the coals by a U.S. magistrate for its reluctance to stare down the powerful meat-industry lobby on this issue. “For over 30 years, the agency has been confronted with evidence of the human health risks associated with the widespread subtherapeutic use of antibiotics in foodproducing animals, and, despite a statutory mandate to ensure the safety of animal drugs, the agency has done shockingly little to address these risks,” Judge Theodore Katz said in a recent ruling, It ordered the FDA to reverse its decision to ignore consumer petitions calling for more stringent controls. If the U.S. moves forward on this front, Canada will be forced to follow. Simply encouraging prudence and judicious use won’t be enough to convince trading partners that our use of antimicrobials is under adequate control. laura@fbcpublishing.com U.S. farmers don’t deserve more subsidy: think-tank An excerpt from “Field of Schemes, The Taxpayer and Economic Welfare Costs of Shallow-Loss Farming Programs,” a paper published by the American Enterprise Institute under its “American Boondoggle: Fixing the 2012 Farm Bill” Series. The AEI says U.S. farm policy consists of “an array of subsidies, regulations, spending programs, and land-use restrictions that are widely blamed for the increased cost of food, environmental degradation, fiscal burdens, and the failure of global trade negotiations.” Since 2007, American farmers have consistently enjoyed record crop prices, increasing yields, and record farm incomes. Nevertheless, they still want as many farm subsidies as they can get, ideally through programs that lock them into their current record income levels. Most — though not all — farm lobbies have recognized that the Direct Payments Program, a $5 billion-a- year welfare program in which payments mainly go to larger and wealthier farms, is no longer politically viable. Consequently, over the past two years, many farm groups have rushed to embrace the concept of shallow-loss programs. Shallow-loss programs would provide farm- OUR HISTORY: July 13, 1961 ers who produce crops like corn, soybeans, and wheat with subsidies when current-year revenues for that crop fall below about 90 per cent of their average levels over the previous five years. The farm lobby typically claims that farmers deserve an extensive shallow-loss income “safety net” because, without it, so many of them would go broke that the American food supply chain would fail to deliver enough food for the rest of the population. The reality is very different. The current average debt-to-asset ratio in the farm sector is less than nine per cent and has been declining steadily over the past decade. Moreover, farms fail at a rate of less than one in two hundred a year, and, from a financial perspective, farms are better placed than almost any sector of the economy to handle year-to-year variations in revenues and costs by themselves. Yet, effectively, farmers want a taxpayer-funded guarantee that their revenues will never fall below about 90 per cent of their recent levels. Imagine how much homeowners in California, Nevada, and Florida would have enjoyed if, in 2008, the government had guaranteed that no matter when they sold their homes, homeowners would receive no less than the price for which they could have sold their properties at the peak of the housing bubble. And just think how unreasonable and outrageously costly for the taxpayer such a program would be. Yet this is essentially what farmers are seeking, and what the congressional agricultural committees are considering providing. The Co-operator’s July 13, 1961 issue featured several stories related to the drought that year, which turned out to be the driest on record in Western Canada. Rain the previous week was thought to be too late to save the “doomed” crop. The province had set up a plan to pay farmers a bonus of $5 per ton if they would allow their standing crops to be cut for forage. The wheat board had withdrawn from the durum market, and there were egg shortages resulting from the hot weather. In the following issue it was reported that Premier Duff Roblin had announced a plan to help farmers buy hay from the U.S. at “reasonable prices.” In our classified section, a half section two miles west of the Cordova elevator, 240 acres broken with “fair” buildings, was offered at $45 per acre, “crop and all.” Address accuracy, let alone postal codes, was apparently not a concern in 1961. Another ad read, in full: “Used welders, write us today, stating requirements. Smith Roles, Saskatoon.”
The Manitoba Co-operator | July 12, 2012 5 By Ron Bonnett CFIA advises caution on agricultural use of antimicrobials Canada’s chief vet says antimicrobial resistance is rising in the food-animal sector By Dr. Brian Evans Chief Veterinary OffiCer fOr Canada Canadian fOOd inspeCtiOn agenCy Since their introduction some 60 years ago, antimicrobials have revolutionized both veterinary practice and human medicine. When used appropriately, antimicrobials — including antibacterials, antifungals and antivirals — continue to play an important role in animal and human health. They reduce suffering and help farmers raise healthy animals, which in turn provide safe meat, milk and eggs for human consumption. They are also critical tools in human medicine. However, the misuse of antimicrobials in both human and animal health contributes to the development of resistant bacteria, thereby posing a risk to people and animals. It’s a complex, multifactorial problem that requires veterinarians to work closely with professionals in public health and animal owners to find solutions from both animal and human health perspectives. Earlier this year, the World Organization for Animal Health (OIE) identified the fight against antimicrobial resistance as one of its priorities for 2012. The OIE also advocated for good veterinary control of the registration, import, distribution and on-farm use of antimicrobials. The OIE’s call for better control of antimicrobials echoes last year’s statement from the World Health Organization (WHO), which warned that the world is on the brink of losing these “miracle cures” due to the emergence There has been a flurry of negative press recently against supply management with many making claims the Canadian dairy and poultry industries overcharge consumers and interfere with international trade negotiations. Representing 200,000 farmers across Canada, many of whom are a part of supplymanaged industries, the CFA feels it is important to offer up the farmers’ position on the issue. Myth: Canadians pay higher prices because of supply management FACt: This is simply not true. There are about four retail chains dominating 85 per cent of the Canadian marketplace. Retail prices are set by retailers, not by farmers. Farmers are the first step in a long series of transactions that are and spread of drug-resistant pathogens. As the WHO noted, the development of resistance is a natural process that eventually happens with every drug. However, a number of factors in both human medicine and veterinary practice have accelerated this process. According to the WHO, in human medicine, drugs are sometimes dispensed too readily, “just to be on the safe side” — often in response to patient demand. In other cases, patients do not complete the full course of treatment. In some countries, substandard products are sold and individual pills are available over the counter. On the animal side, antimicrobials are routinely used in livestock feed for growth promotion and to prevent infections in food-producing animals. Some drugs can be purchased without a veterinary prescription, or used outside the approved levels with a veterinary prescription. Some of the drugs commonly used in livestock production are medically important for human health. For example, macrolides and tetracyclines are often incorporated into feed for growth promotion or disease required to get a product from the farm gate, to processors, to further processors, to distributors and finally to a point and place where Canadian consumers can buy it. Countless studies have shown that the farmers’ share represents a small fraction of the final price Canadians pay for their food. With supply management, farmers are able to get a return equivalent to their cost of production. Furthermore, Canadians pay about 10 per cent of their disposable income on food, which is among the cheapest level worldwide. Myth: Free trade will benefit these farmers and unleash their potential FACt: Never mentioned by the critics, all these farm sectors operated under free markets before supply management and were much worse off. The supply management system matches production with Canadian demand, avoid- prevention, and fluoroquinolones and cephalosporins are frequently used to treat and prevent infections. Pathogens and commensal organisms resistant to these drugs in animals can be transmitted to humans, and the management of animal health then becomes a human health issue. The reverse can also be true. Further exacerbating the situation is the fact that new drugs are not being developed quickly enough to replace existing drugs that are failing in the face of emerging drug-resistant pathogens. At the provincial and territorial level, both veterinary and medical regulatory bodies need to encourage their members to be vigilant… ing surplus and shortages, which are very inefficient for any industry. Stability allows efficient farms to remain in business. Considering the current global food supply challenge, this is an extremely important consideration. With supply management, farmers can earn a fair return for their product from the marketplace and are in a better position to adapt quickly to changes in the marketplace and invest in the latest technologies. Myth: Supply management is an archaic, out-of-date system meant to keep production low FACt: In a free-market environment, producers respond to market signals. When prices are high, producers will tend to plant or produce more of a commodity to take advantage of price. Inevitably, prices start to decrease as production outstrips demand, causing what every farmer knows is the boom-and-bust cycle of com- COMMENT/FEEDBACK Animal resistance is rising Internationally, the OIE and WHO are raising awareness of the issue. In Canada, federal, provincial and territorial government departments continue to work together on surveillance, prevention and education. Federally, the Public Health Agency of Canada works with Health Canada and the Canadian Food Inspection Agency (CFIA) to conduct surveillance to monitor antimicrobial resistance through the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS), which shows that antimicrobial resistance is rising in the food-animal sector. The CFIA also monitors modity pricing. Supply management has evened out this cycle by making sure that production levels meet consumer demand and are not propelled by price. Production levels that meet demand promote stability, not only for farmers and Canadian consumers, but the entire market chain. Myth: Canada is losing out in trade negotiations FACt: Canada has successfully concluded a myriad of free trade agreements while maintaining supply management. All countries have their own offensive and defensive interests, and successful trade deals are those which recognize and respect all of these interests. Over the years, Canada’s supply management model has provided a stable environment within which the dairy and poultry industries have been able to meet the challenges of changing domestic drug residues in food and verifies that medicated livestock feeds meet federal standards. Health Canada encourages the prudent use of antimicrobial drugs by health-care professionals and patients, as well as by veterinarians, farmers and other food producers. As part of its efforts to address concerns about antimicrobial resistance, Health Canada has categorized antimicrobials based on their importance in human medicine and is currently addressing the growth-promotion claims of medically important antimicrobials. It has also developed a policy on the extra-label use of veterinary drugs and recommends against the extra-label use of critically important antimicrobial drugs (e.g., ceftiofur and fluoroquinolones) in mass-medication situations. However, extra-label drug use and prescribing medication is a practice of veterinary medicine and is regulated by the provinces. At the provincial and territorial level, both veterinary and medical regulatory bodies need to encourage their members to be vigilant in their oversight and to prescribe antimicrobials judiciously. By recognizing that there are risks as well as benefits associated with antimicrobials and engaging in an informative and frank dialogue with all concerned, we can ensure that these valuable tools for health professionals are used prudently in order to preserve their efficacy for treating both animals and people. Society expects no less. This article was published in the July 2012 issue of the Canadian Veterinary Journal Supply management: Canada’s success story CFA president disputes need to give it up to join trade deal markets and international trade rules, allowing the industry to be a consistent job provider and contributor to the economy. The dairy and poultry industries sustain 300,000 jobs, contribute $24.5 billion to Canada’s GDP and pay $4.8 billion in taxes. It is paradoxical that anyone would criticize a successful agricultural system that offers farmers a fair return for their product, processors a reliable supply of product, and Canadians with a consistent wide choice of high-quality and safe foods at reasonable prices, especially at a time when society is looking to agriculture to ensure food security — in Canada and abroad. Supply management is a smart business move for our country. It’s a risk management measure that is most needed now in the midst of high global market volatility. Ron Bonnett is president of the Canadian Federation of Agriculture
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