Health Committee on Dec. 4th, 2025

[The Chair, Liberal, Hedy Fry]

Hello, everyone.

I call this meeting to order.

Welcome to meeting number 16 of the House of Commons Standing Committee on Health.

We acknowledge that we are meeting on the unceded territory of the Algonquin Anishinabe people.

Today's meeting is taking place in a hybrid format, pursuant to the Standing Orders.

I want to remind participants of the following points.

For those of you who are appearing virtually, please remember to turn off your mics when you are not speaking, and speak only when I call you by name. Everything goes through the chair, so if you have an issue or a problem, address it to the chair.

If you look on your computers, you will see a little globe icon. That's where you get your interpretation. You can pick whichever you want—English, French or floor— and move from one language to another.

For the people in the room, remember to put your earpiece on the decal so it doesn't bother the hearing of the people who are interpreting.

Madame Larouche, go ahead.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Chair, I just want to confirm that this meeting will work the same way as the last one.

[The Chair, Liberal, Hedy Fry]

Sorry; I am going deaf. I can't hear people without my earpiece.

[Andréanne Larouche, Bloc, Shefford, QC]

I just want to confirm that this meeting will work the same way as the last one and that I will have a second six-minute speaking turn during the second hour of this meeting.

[The Chair, Liberal, Hedy Fry]

Absolutely.

I want to inform everyone that there is one witness, Dr. Karl Weiss, who is not going to be able to be on because he didn't have—

[Maggie Chi, Liberal, Don Valley North, ON]

I have a point of order.

I absolutely agree with Madame Larouche getting the six minutes. For the future two hours, can we keep doing that for the Bloc so that she gets the six minutes as well?

[The Chair, Liberal, Hedy Fry]

She asked, and the chair has said yes.

[Maggie Chi, Liberal, Don Valley North, ON]

Not just for this meeting but going forward, can we make sure that Madame Larouche has the six minutes?

[The Chair, Liberal, Hedy Fry]

That's going to be the usual practice for her when we do the two-hour meetings.

We're going to do two one-hour meetings next time, because officials are coming and they cannot be on a panel with anybody else.

[Dan Mazier, Conservative, Riding Mountain, MB]

Are the officials coming on Tuesday?

[The Chair, Liberal, Hedy Fry]

Yes.

Dr. Weiss is not able to be on because for some reason his headset's not working. He's going to come back another time when we can get him ready to speak.

Today, pursuant to the motion adopted on Tuesday, September 23, 2025, the committee shall commence the study of antimicrobial resistance.

I want to welcome our witnesses.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Chair, just—

[The Chair, Liberal, Hedy Fry]

We have Dr. Judith Fafard, medical doctor.

From Fedora Pharmaceuticals Inc., we have Sameeh Salama.

[Andréanne Larouche, Bloc, Shefford, QC]

Before we begin the testimonies, I would like to take a moment to ask one last question.

I would like to verify why Mr. Weiss did not have the correct equipment.

Did the clerk or another member of the team provide information about what happened?

[The Chair, Liberal, Hedy Fry]

I'm not hearing the member in English or in French.

I'm going to suspend to get this fixed before we start the meeting.

[The Chair, Liberal, Hedy Fry]

I was in the process of reading the names of the witnesses.

We have Dr. Judith Fafard, who is a medical doctor.

From Fedora Pharmaceuticals Inc., we have Sameeh Salama.

Finally, we have Jennifer Buckley, senior director, Innovative Medicines Canada.

To the witnesses, you have five minutes each for opening remarks. I will give you a one-minute shout and a 30-second shout so you can wrap up. If you don't get to finish what you have to say, you will obviously get an opportunity during the question-and-answer period to elaborate on whatever you want to say.

I'll begin with Dr. Fafard for five minutes please.

[Judith Fafard, Medical Doctor, As an Individual]

Hello.

Thank you for inviting me to testify before the Standing Committee on Health.

My name is Judith Fafard. I am a microbiologist and infectious disease specialist. I have been working at the public health laboratory of the Institut national de santé publique du Québec, or INSPQ, for six years. I initially worked as a medical consultant and have been the medical director since 2021. My comments reflect my personal views and are based on my experience at the INSPQ, but do not represent the official position of the INSPQ.

The INSPQ supports provincial and regional public health authorities in their decision-making. It also informs the public about major public health issues, such as antimicrobial resistance. It manages several monitoring programs in health care settings that track infections caused by multidrug-resistant strains, such as vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus and carbapenemase-producing Gram-negative bacteria.

The Laboratoire de santé publique du Québec, LSPQ, produces monitoring reports on several resistant microorganisms, including Mycobacterium tuberculosis, the causative agent of tuberculosis, and those responsible for sexually transmitted or blood-borne infections, such as Neisseria gonorrhoeae. The LSPQ works with hospital laboratories to align practices and tests used to identify resistant microorganisms. It also works with other provincial laboratories and the National Microbiology Laboratory, or NML, to collect clinical and laboratory data on antimicrobial resistance through the Canadian Public Health Laboratory Network.

Antimicrobial resistance complicates and prolongs medical care, overloads health infrastructure and increases the risk of complications and death, particularly in vulnerable individuals.

Monitoring antimicrobial resistance enables us to adjust our interventions designed to address it. The Neisseria gonorrhoeae bacterium is a good example. While this bacterium had an azithromycin resistance rate of 1.7% in Quebec in 2013, this resistance rapidly increased, reaching a peak of 44.3% in 2022. Treatment guidelines for sexually transmitted and blood-borne infections, STBBIs, have been adjusted in Quebec, and azithromycin is no longer listed as the treatment of choice for chlamydia or gonorrhoea. Resistance levels subsequently declined to 16.3% in 2024, representing a 63% reduction in two and a half years.

Therefore, it is beneficial to pool data from such surveillance programs to observe trends in neighbouring provinces and territories and predict those in our own provinces and territories. As a result, we are able to implement measures where they will be most effective. The Public Health Agency of Canada recently updated the list of priority pathogens for antimicrobial resistance control, taking into account the disproportionate impact of antimicrobial resistance on certain populations. Most of these pathogens are already being monitored, but the picture of antimicrobial resistance remains fragmented across provinces and Canada.

Some pathogens are monitored through a number of different programs, each of which covers a certain segment of the population, while other pathogens, such as the bacterium Mycoplasma genitalium, are not currently monitored at all. It would be beneficial to continue to encourage alignment and sharing of surveillance protocols and data on antimicrobial resistance in humans.

One goal to pursue would be to target more representative coverage and encourage alignment and sharing of surveillance protocols and data on antimicrobial resistance in humans.

One of the interventions I would like to suggest is exploring the barriers that hinder better coverage of existing surveillance programs. Since most surveillance programs rely on voluntary enrolment by institutions or provinces and territories, we could raise awareness among decision-makers and the general public about the public health implications of the first two priority pathogen groups.

We could encourage research on the economic and health impacts of these resistant pathogens in Canada and improve the dissemination of data obtained through existing programs.

We could also encourage research on methods of monitoring resistance that are independent of human behaviour or access to health care, such as research on waste water metagenomics or the integration of animal and environmental monitoring systems to reach more vulnerable populations.

Thank you.

[The Chair, Liberal, Hedy Fry]

Thank you very much, Dr. Fafard.

I will now go to Fedora Pharmaceuticals and Sameeh Salama for five minutes, please.

[Dr. Sameeh Salama, Chair, Canadian Antimicrobial Innovation Coalition, Chief Scientific Officer, Fedora Pharmaceuticals Inc.]

Thank you, Madam Chair and members of the Standing Committee on Health.

My name is Dr. Sameeh Salama and I serve as the chief scientific officer at Fedora Pharmaceuticals, an Edmonton-based antibiotic drug discovery company.

I'm also the chairman of the board of directors of the Canadian Antimicrobial Innovation Coalition, CAIC, a national coalition of life sciences organizations working to address antimicrobial resistance, AMR.

Our company's scientific legacy includes the discovery of tazobactam, or Zosyn, a drug now used globally to treat serious infections, which saves millions of lives every year.

Our second flagship product, nacubactam, is currently in phase three clinical trials. This experience gives us direct insight into the scientific, regulatory and market barriers that must be addressed if Canada is to sustain antimicrobial innovation.

AMR is already having a profound effect on Canadian health systems. According to the Canadian Council of Academies, 26% of the infections in 2018 were resistant to first-line antibiotics, a number projected to rise to 40% by 2050. If nothing changes, AMR will result in nearly 400,000 Canadian deaths and hundreds of billions of dollars in health system and economic losses. More importantly, it threatens the foundation of modern medicine, cancer care, organ transplantation, neonatal care and even common surgeries.

Canada has taken an important step by releasing the “Pan-Canadian Action Plan on Antimicrobial Resistance”. I was part of the drafting of both the framework and the action plan. However, the plan has not yet been implemented or funded and therefore cannot drive change across jurisdictions or across health systems.

As we look ahead, it will be essential to develop action plan 2.0 and to build it on one central insight. Innovation is not one pillar of the AMR strategy; it is the backbone that enables all others. For example, surveillance depends on new diagnostics and data tools. Stewardship requires access to novel antimicrobials to prevent reliance on failing drugs. Infection prevention and control is strengthened by new vaccines, therapeutics and technologies. R and D depends on the stable ecosystem that supports development, manufacturing and commercialization.

For action plan 2.0 to succeed, innovation must be embedded across all pillars, not siloed. This cannot be done without structured ongoing consultation with industry. Companies, both large and small, understand financial, regulatory and operational barriers that prevent new antibiotics and diagnostics from reaching the Canadian market. Without this engagement, Canada risks designing policies that look good on paper but cannot be implemented.

Canada's scientific strengths are real. We have companies in traditional antibiotics, antifungal vaccines, phage therapy, diagnostics and information technologies, yet these trends are undermined by structural weaknesses that make it difficult to translate research into products that reach patients.

Most notably, Canada has no domestic manufacturing of antibiotics and active pharmaceutical ingredients, making AMR a national security issue as well as a public health issue.

To support innovation, Canada needs both push and pull incentives. On the push incentives, Canada should expand early R and D funding, including through IRAP and the health emergency readiness Canada program and other federal programs. Many international funding streams require companies to contribute cost-share funds. A domestic mechanism to help Canadian companies meet those obligations would increase our effectiveness and keep innovation here at home.

On the pull incentives, international experience is now very instructive. The United Kingdom subscription model, for example, provides predictable—

[The Chair, Liberal, Hedy Fry]

One minute.

[Dr. Sameeh Salama]

—de-linked pay system companies.

Sweden has a system that guarantees payment and the European Union is pushing towards transferable exclusivity.

In closing, Canada is well positioned to lead by leadership and action by implementing the current action plan, building strength to fully fund the action plan 2.0, and working in real partnership within industry to remove the barriers that stand between discovery and success. By doing so, Canada can protect the health system, support global competitive life sciences and be a major player in the international field.

Thank you very much, Madam Chair.

[The Chair, Liberal, Hedy Fry]

Thank you.

We'll go to the final witness, Jennifer Buckley, who is senior director of the regulatory affairs and clinical research transformation.

Go ahead please, Ms. Buckley.

[Jennifer Buckley, Senior Director, Regulatory Affairs and Clinical Research Transformation, Innovative Medicines Canada]

Thank you, Madam Chair.

Good morning, committee members.

My name is Jenny Buckley, and I'm the senior director of regulatory affairs and clinical research transformation at Innovative Medicines Canada, IMC. Thank you for the opportunity to speak with you today.

While I represent Canada's innovative pharmaceutical industry—the companies that are discovering, developing and delivering life-changing medicines, diagnostics and vaccines—I want to begin with a story from the hospital floor. It's a story we shared with the science and research committee, and I'd like to share it with you too.

A Canadian hospital pharmacist was called to consult on a patient with a severe infection caused by multidrug-resistant bacteria. None of the usual antibiotics worked. A newer medicine that might have helped was not on the hospital formulary. The care team scrambled as the infection spread. Every hour mattered. That pharmacist said something that stays with me: “This isn't rare anymore. This is becoming routine.”

Antimicrobial resistance is not a future threat. It's a present crisis. Globally, drug-resistant infections claim more than a million lives annually. By 2050, that number could reach 10 million, with global economic losses measured in the trillions.

AMR is a crisis of innovation and access. We are running out of effective antibiotics faster than we can replace them. Development is complex, economically challenging and, in Canada, often slowed by regulatory and reimbursement processes that delay timely access. Between 2010 and 2021, Canada secured access to only three of the 18 new antibiotics that were launched globally. This puts patients and providers at a serious disadvantage. Solving this requires urgency and action.

Canada has long supported global push mechanisms such as CARB-X to stimulate early-stage development, but push alone is not enough. We need a reliable pull system to bring innovative antibiotics to Canada and to the patients who need them.

IMC welcomes the federal pull incentive pilot that's currently under development. We urge the adoption of the refinements put forward by the Canadian Antimicrobial Innovation Coalition to build a learning, evidence-driven policy environment that strengthens access.

Other countries are already moving. The U.K. has a subscription-style pull incentive, and Italy launched one during its G7 presidency. France has made AMR a priority for its presidency next year. Canada's G7 presidency is ending, but we can still be a leader in preparedness and global health security.

However, incentives alone are not enough. Regulatory and reimbursement systems remain duplicative and slow. Health Canada's effort to allow reliance on trusted international reviews is an important step forward towards faster approvals, without compromising safety, efficacy or quality. Still, Canadians wait far too long. On average, it takes two and a half years from a Health Canada approval to public formulary listing. For antibiotics targeting multidrug-resistant infections, every day matters.

AMR is not just a health issue; it's an economic security and geopolitical issue. With the U.S. increasingly focused inward, Canada cannot assume external support in a future crisis. We must strengthen innovation at home, secure our antibiotic supply chain and partner with countries committed to science and global health security. If we act decisively, we won't just contain AMR; we will build a stronger, more resilient Canada.

Thank you, Madam Chair. I look forward to your questions.

[The Chair, Liberal, Hedy Fry]

Thank you very much. That was a very crisp presentation. You went one and a half minutes under time. That's great.

Now, we go to the question-and-answer segment. The first one is a six-minute segment. The six minutes include questions and answers, so if we could all be as crisp and focused as Ms. Buckley was, we will be able to get a lot of questions in.

I begin with the Conservatives.

Ms. Konanz, you have the floor for six minutes, please.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Dr. Salama, thank you so much.

In Canada, what kind of demographic or regional differences are we seeing in antimicrobial resistance? Are you seeing it worst among young versus old or rural versus urban?