The committee met to study antimicrobial resistance (AMR). The witnesses were Herman Barkema, professor at the University of Calgary; Isaac Bogoch, infectious diseases specialist at Toronto General Hospital; François M. Castonguay, assistant professor at Université de Montréal; John Conly, professor at the University of Calgary; Rita Dhami, adjunct clinical assistant professor at the University of Waterloo; Sameeh Salama, chair of the Canadian Antimicrobial Innovation Coalition; and Gregory Rose, infection control consultant with Infection Prevention and Control Canada.
Herman Barkema said AMR is a growing global crisis threatening health care, food security and economic stability, and that resistance genes move across human, animal and environmental settings. He identified four major gaps: lack of technology and monitoring to track AMR across reservoirs, insufficient documentation of health and economic impacts, no policy framework or overseeing organization for cross-sectoral containment, and undeveloped cross-sectoral infection prevention programs. He called for a unified, action-oriented approach and said existing surveillance programs are siloed and lack molecular resolution.
Isaac Bogoch said about 70% of global antibiotic consumption is in agricultural animals, and AMR causes more deaths per year than HIV, tuberculosis and malaria combined. He argued that Canada cannot solve AMR alone because resistant organisms spread through human mobility and trade, and that the issue is a health security concern, especially given conflicts where combat wound infections are often resistant. He recommended strengthening stewardship and infection prevention, enhancing surveillance, investing in research and innovation including phage therapy, launching public awareness campaigns, and leveraging security funding to support AMR initiatives.
François M. Castonguay said AMR creates a huge economic burden, with costs over $1.4 billion in 2018 potentially exceeding $7.6 billion by 2050, and that non-health care sectors will account for about two-thirds of costs by then. He said whole genome sequencing could save up to $70 million annually, and that combining a "one health" approach with economic tools would help identify priority interventions and improve intergovernmental cooperation. He argued that many measures are cost-saving rather than new investments.
John Conly described AMR as a slowly-moving tsunami and a silent pandemic, noting that drug-resistant organisms know no political boundaries and that COVID-19 has worsened the problem. He said Canada needs bold implementation of existing recommendations from the pan-Canadian action plan and the Council of Canadian Academies report, not new reports. He highlighted a Canadian digital supercluster stewardship app that has gone global and said directed funding for it would be a major contribution.
Rita Dhami said resistant organisms are now in communities, food supply and the environment, and that microplastics may facilitate the spread of resistance genes. She noted that Canada has demonstrated leadership in measuring antimicrobial use through programs like CNISP and the CLEAR registry, but that monitoring is limited to acute care hospitals, leaving gaps in community and long-term care. She called for a coordinated and adequately resourced national strategy anchored in research, surveillance, stewardship and innovation.
Sameeh Salama said Canada ranks last in the developed world in introducing new antibiotics, with only three of 18 new antibiotics available in the United States accessible to Canadian patients. He said the key weaknesses are limited access to capital and challenges in moving discoveries from preclinical development to commercial launch, and that current funding mechanisms do not bridge the gap between academic research and product development. He recommended adopting push-and-pull incentives, including reimbursement reforms, and said Canada's fair share of global AMR funding would be $11 million to $21 million annually.
Gregory Rose said antimicrobial stewardship and infection prevention and control are critical but that research in these fields is small and methodologically heterogeneous. He noted that best practices are often specific to time, place and patient population, and that subject matter experts in community hospitals and long-term care are disconnected from funding and methodological support. He proposed a carve-out of CIHR funding for small-cap grants of $100,000 or less for non-academic researchers, and creating networks linking subject matter experts with methodological experts.
During questions, Barkema agreed that economic considerations should be part of a "one health" framework and said Quebec's ban on class I antimicrobials in agriculture is working well. Bogoch said CIHR funding for AMR could be increased and that alternative sources, including security-related funding, should be tapped. Castonguay said efficient policies that save lives and money are needed. Conly highlighted the digital supercluster stewardship app as a Canadian success story needing more support. Dhami said reduced funding would lead to rising infections, mortality and loss of treatment options. Salama said the gap between academic research and clinical trials is unfunded, and that IRAP needs review. Rose said overcrowding in hospitals increases AMR risk. The committee agreed to proceed with the study.
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