Canadian families living with food allergy were understandably feeling uneasy with the recent news that the EpiPen auto-injector is again under a supply constraint. This issue dates back to January 2018. For the more than 2.6 million Canadians with this condition, the ongoing uncertainty is untenable.
Health Canada is monitoring the situation to ensure those who need a device continue to have access. Having epinephrine auto-injectors consistently available, accessible and affordable (which for many families without a drug plan remains an issue) is critical. If the drug is not available, you can die.
Still, this is just one aspect needed to effectively manage food allergy and stay safe.
It is time Canadian policy-makers look beyond emergency treatment options to what can be done to effectively prevent and manage food allergy. Only a comprehensive approach can reduce reactions and save lives, improve quality of life and lower public health costs.
Canadians living with food allergy are taught from a young age the importance of individual responsibility when managing their condition. Yet these Canadians must also live with its unpredictability, life-threatening potential and the absence of a cure. Every day, they must navigate gaps in ingredient listings and how this condition is understood by the public. For some children, this can manifest in bullying. Our goal must be to help families live well and confidently with food allergy.
Effective self-management starts with proper diagnosis by an allergist, as well as allergy education and support. Unfortunately, many Canadians cannot access an allergist and the problem is particularly acute for those in rural, northern and remote communities.
Food allergy is increasingly touching our lives whether we are living with the condition or not. Consider the impact of more than 500,000 children at risk of an allergic reaction. Every parent, sibling, grandparent, teacher, childcare worker, camp counsellor, family doctor and friend of one of those children is affected in some way as part of the shared community responsibility to keep kids safe. We should ensure our communities have better information so they know how to do just that — keep kids safe by preventing reactions in the first place.
Finally, a new body of research around early introduction of allergenic foods to high-risk infants and encouraging new therapies for increasing tolerance of such foods in children are dramatically reshaping our view of how we can prevent and treat food allergy. It is vital that these opportunities, and other research possibilities, are explored vigorously.
Food Allergy Canada and the Canadian Society of Allergy and Clinical Immunology recently launched the National Food Allergy Action Plan: Charting the path forward, which provides a specific framework for integrating prevention, diagnosis, treatment, self-management and community and food system support.
Our plan is informed by a similar action plan created in Australia and by specific best practices and research efforts in the U.K., U.S. and elsewhere. We know it can be done in Canada.
Among our specific proposals are a national awareness campaign to enhance understanding of food allergy; better access to accurate ingredient information and a safe eating strategy; supporting guidance for early introduction of allergenic foods; new investments in research; and greater access to epinephrine auto-injectors.
Putting off a comprehensive plan to address food allergy would be a missed opportunity for Canadian families and our broader public policy goals. The incidence of food allergy has a corresponding impact on public health. The Canadian Institute for Health Information reports a 95-per-cent increase in emergency room visits per 100,000 people due to anaphylaxis between 2006-2007 and 2013–2014. These are services and funds that could be redirected elsewhere if we can better prevent food allergy reactions.
The recent news and the periodic reports of tragic food allergy fatalities signifies both the urgency of food allergy and the complexity of this medical condition. Increasingly, we have more tools, evidence-based research and best-practice examples available to make progress on the treatment, management and prevention of food allergy.
Now we need the political will to make it happen.
Jennifer Gerdts is executive director of Food Allergy Canada. Dr. Harold Kim is president of the Canadian Society of Allergy and Clinical Immunology
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