We’re building plans for a unifying network to create collaboration amongst the diverse One Health stakeholders in our country. Funded by the Public Health Agency of Canada, we have one year to design, refine, and recommend models.
Due to the complexity of Antimicrobial Resistance (AMR), appropriately addressing the threat of AMR in Canada requires a strategic, coordinated, and highly collaborative approach that encompasses all aspects of the One Health continuum, all levels of society and government, and all regions of the country. This project is underway to develop options for a One Health pan-Canadian network that unites the diverse stakeholders in our country, so that they can work together to catalyze a national effort to mitigate the threat of AMR for all Canadians. Funded by the Public Health Agency of Canada, we plan to deliver a report in November 2020 that recommends governance model options and a five-year strategic plan.
Informed by the many voices of Canada’s diverse AMR stakeholders, we are an interdisciplinary leadership team working to design network governance model options for AMR in Canada. Drs. Gerry Wright and Andrew Morris are the project’s co-chairs, responsible for driving this project to success. They are supported by dynamic committees composed of representatives from across the One Health spectrum. This group’s role is to advise, to bring to the table a broader array of opinions and perspectives, and to help prepare the model options that we ultimately present for consideration to the broader stakeholder groups.
Our first step was identifying the vast array of AMR stakeholders across the Canadian One Health spectrum, a massive undertaking that formed the bedrock of our plans. With so many organizations in Canada that include AMR in their mandate, research, or broader social determinants, this list continues to grow every day. With our stakeholder identification process well underway, we began personally reaching out to each stakeholder to introduce them to the project and invite them to partake in a survey. To date, we have invited nearly 700 Canadian AMR stakeholders. Results from this survey have shaped higher-level discussions and informed different engagement strategies as we turned our focus toward developing network model options. The Steering Committee is doing some heavy lifting of combining their expertise with organizational design principles. We are now in the process of taking initial ideas out for broader consultation, with plans to create open forums to ensure all interested stakeholders have their voices heard. Feedback garnered from these sessions will help define the priority actions for the proposed network, which will be coalesced into recommendations and submitted to the Public Health Agency of Canada around November of 2020.
Our Guiding Principles
The following principles, adapted from the United Nations Development Program, have guided and continue to guide our network-building processes.
Project leadership and stakeholders are accountable to each other and to the Canadian public.
Where possible, project leadership mediates differing interests to reach a broad consensus.
We disclose information and progress so that stakeholders understand our processes and decisions.
We abide by processes that produce results while also making the best use of the resources at our disposal.
All of our stakeholders have an equal voice to ensure fair representation from all One Health dimensions.
A Brief History of Federal AMR
Coordination in Canada
In 1997, Health Canada hosted a national conference in Montreal, QC that heightened awareness and urgency surrounding AMR in the country. This conference ultimately led to the creation of the Canadian Committee on Antibiotic Resistance (CCAR), which, for more than a decade, laid the groundwork for much of the AMR infrastructure that exists today. The CCAR existed at a unique intersection between the human health and agrifood sectors, and worked closely with various levels of government to develop policy and solutions for managing AMR. However, in 2008, the CCAR and the Public Health Agency of Canada (PHAC) agreed that it was time to develop a more comprehensive approach to addressing AMR issues in Canada, and so the CCAR was dissolved. In the years that followed, the federal government strengthened its focus on AMR by embracing a One Health approach. In 2009, it hosted “One World, One Health” in Winnipeg, MB, a watershed event that gathered 120 experts from 23 different countries. Since then, Canada has established the Canadian Antimicrobial Resistance Surveillance System (CARSS), and, in 2017, issued “Tackling Antimicrobial Resistance and Antimicrobial Use: A Pan-Canadian Framework for Action,” which provides the foundation for a national One Health approach to AMR coordination. Work on the Pan-Canadian Action Plan for AMR and AMU began in 2018 and is now nearing completion. In the same span, several groups in the animal and environment sectors have also increased their priorities around AMR. For this reason,
PHAC funded this project to explore models and options for coordinating these different efforts.
Why does Canada Need a National
One Health AMR Network?
Although AMR has long been a threat, much of the country’s work toward mitigation has been largely siloed from a One
Health perspective. Because AMR is so deeply rooted in so many different areas, industries, and regions, governance over the issue has remained far beyond the reach of any existing organization or government agency. But there is global consensus that this must change. Many countries around the world have begun addressing AMR using a coordinated One Health approach, and Canada wants to follow suit. Now more than ever, there is an obvious appetite to do so. In fact, in December 2019, AMR was listed as a priority issue for Canada’s Minister of Health in her mandate letter — and it’s no wonder. AMR is costing the country thousands of lives and millions of dollars each year, and, if left unchecked, forecasts show it will worsen considerably.
Coordinating a One Health Network won't be easy, though. The figure below illustrates just how complex the
interconnections of One Health can be.