June 2026 Board of Health Meeting - Antimicrobial Resistance Mitigation Strategies Resolution

BACKGROUND

The World Health Organization (WHO), Public Health Agency of Canada (PHAC), and Public Health Ontario (PHO), along with other public health agencies, have recognized antimicrobial resistance (AMR) as a serious and growing threat to public health globally.^1,2 AMR occurs when microbes, such as bacteria, evolve, making them more difficult to treat and contributing to longer hospital stays and poorer patient outcomes.^1,4 AMR infections are projected to continue rising, and by 2050 are expected to cost the Canadian healthcare system $120 billion, with additional impacts on the broader economy.^3. Inappropriate antimicrobial use is a leading cause of AMR. In Ontario, AMR is associated with an estimated 6 lives lost daily and is a leading cause of death globally.^2,4,5 

AMR rates in Ontario are impacted by the “misuse and overuse” of antimicrobials, with approximately 1 in 4 antimicrobial prescriptions in Ontario considered unnecessary.^1,2,3 Locally, Windsor-Essex County (WEC) has been identified as having the highest antibiotic use in Ontario with “787 antibiotic prescriptions per 1000 population per year”.⁴ 

AMR has direct consequences across human, animal, agricultural and environmental sectors.⁷ For example, the use of antimicrobials in farming can lead to contamination in livestock, water, and the soil, which has a ripple effect on human health.⁸ Addressing AMR requires a comprehensive One Health approach that integrates human health, animal health, agriculture, and environmental sectors, and includes coordinated action at the national, provincial, and local levels. AMS is a critical AMR mitigation strategy that aims to improve appropriate antimicrobial use, reduce resistance, and promote health across all sectors. ^1,7 

There is clear evidence that AMR disproportionately affects populations experiencing social and economic deprivation, where barriers such as limited access to healthcare, overcrowded housing, and reduced access to preventive measures increase infection rates and antimicrobial use. Improving the social determinants of health (SDOH) is therefore a critical component of AMR mitigation.⁶ Preventing infections through vaccination, infection prevention and control measures, and public health interventions is essential to reducing reliance on antimicrobials and slowing the development of resistance.

In the health system, hospitals operate under defined pharmacy mandates and accreditation requirements that support AMR mitigation; comparable structures are largely absent in community-based settings. In Ontario, AMR is addressed indirectly through the Ontario Public Health Standards, resulting in limited accountability and implementation of coordinated AMS practices outside of hospital environments.

Finally, comprehensive AMR and AMS surveillance is needed to support an understanding of the presence of resistant organisms and clinical microbial prescribing practices. Healthcare providers play a key role by using evidence-based antimicrobial prescribing tools, implementing robust infection prevention and control measures, and being aware of the impact of AMR⁹ and public can also support AMS as an essential partner. 

PROPOSED MOTION

Whereas, antimicrobial resistance is a growing global and local public health threat that undermines the effective prevention and treatment of infections^1,2 across human, animal, agricultural and environmental systems; and 

Whereas, misuse and overuse of antimicrobials contribute significantly to resistance, with approximately 1 in 4 antimicrobial prescriptions in Ontario considered unnecessary^1,2; and

Whereas, antimicrobial-resistant infections increase morbidity, mortality, and healthcare system burden, contributing to six deaths daily in Ontario and projected national costs exceeding $120 billion by 2050; and

Whereas, Windsor-Essex County has the highest antibiotic prescribing rates in Ontario⁴; and

Whereas, effectively addressing AMR requires a One Health approach with coordinated action at national, provincial, and local levels across sectors; and

Whereas, antimicrobial resistance disproportionately affects populations experiencing social and economic inequities, necessitating action on the social determinants of health; and

Whereas, vaccination and infection prevention strategies are key mechanisms for reducing antimicrobial use and preventing resistance;

Now therefore be it resolved,the Windsor-Essex County Board of Health supports antimicrobial stewardship and AMR mitigation efforts, including antimicrobial stewardship, in alignment with the Pan-Canadian Action Plan on Antimicrobial Resistance;

FURTHER THAT, the Board of Health advocates for integrated AMR and antimicrobial use surveillance and AMS strategies at national and provincial levels, aligned with local implementation;

FURTHER THAT, the Board of Health advocates for policies and investments that address social determinants of health, recognizing their role in reducing infection burden and inappropriate antimicrobial use;

FURTHER THAT, the Board of Health advocates for increased investment in vaccination programs and preventive public health strategies to reduce unnecessary antimicrobial use;

FURTHER THAT, the Board of Health advocates for sustained AMR mitigation efforts to be prioritized in public health mandates, with sustainable funding to support implementation;

AND FURTHER THAT, the Board of Health requests federal and provincial governments to invest in comprehensive AMR and AMS surveillance systems, including innovative approaches such as wastewater surveillance.

References:

1. Public Health Ontario (PHO). (2023). At a Glance: Opportunities in Public Health to Improve Antibiotic Use in Ontario.publichealthontario.ca
2. World Health Organization (WHO). (2015). Global Action Plan on Antimicrobial Resistance. who.int
3. Public Health Agency of Canada (PHAC) (2026). Antimicrobial Resistance: What Canada’s doing. canada.ca
4. Schwartz, K. L., Achonu, C., Brown, K. A., Langford, B., Daneman, N., Johnstone, J., & Garber, G. (2018). Regional variability in outpatient antibiotic use in Ontario, Canada: a retrospective cross-sectional study. Canadian Medical Association Open Access Journal. cmajopen.ca
5. Public Health Agency of Canada (PHAC). (2025). Canadian Antimicrobial Resistance Surveillance System (CARSS): 2025 Key Findings. canada.ca
6. Blackmon S, Avendano E, Nirmala N et al. Socioeconomic status and the risk for colonisation or infection with priority bacterial pathogens: a global evidence map The Lancet Microbe, 2024; 6
7. Public Health Agency of Canada (PHAC). (2026). Pan-Canadian Action Plan on Antimicrobial Resistance: Year 2 Progress Report (June 2024 to May 2025). canada.ca
8. Al-Khalaifah, H., Rahman, M. H., Al-Surrayai, T., Al-Dhumair, A., & Al-Hasan, M. A. (2025). One-Health Perspective of Antimicrobial Resistance (AMR): Human, Animals and Environmental Health. Life (Basel). pmc.ncbi.nlm.nih.gov
9. Leung, V., Ashiru-Oredope, D., Hicks, L., Kabbani, S., Aloosh, M., Armstrong, I. E., Brown, K. A., Daneman, N., Lam, K., Meghani, H., Nur, M., Schwartz, K. L., & Langford, B. J. (2024). Leveraging local public health to advance antimicrobial stewardship (AMS) implementation and mitigate antimicrobial resistance (AMR): a scoping review. JAC Antimicrob Resist. pmc.ncbi.nlm.nih.gov