Thank you. It's an honour and a privilege to have the opportunity to present to the House of Commons Standing Committee on Finance.
I come to you as vice-president of research for Vancouver Coastal Health, which is the area that we're in now. Also, I am executive associate dean of research at the faculty of medicine of the University of British Columbia. That's my day job. I'm also a board member of HealthCareCAN, which is the national voice for Canada's research and teaching hospitals and health care organizations. HealthCareCAN is centred in Ottawa.
I mention this to you because what I'm talking about does not directly concern Vancouver. It concerns the whole country and really driving innovation in the health care system.
I will touch on three related subjects today. One is health care research and innovation, the second is health infrastructure, and the third is antimicrobial resistance and stewardship. They're all very much related, both in the research area and also in the health care area.
With regard to health care research and innovation, the importance of research and innovation has not been lost on this government. We're really grateful for the initiatives in innovation, and we feel that this really affects and gives a great opportunity for health research to participate.
Canada's life sciences, which include both biotechnology and research should be a dominant force in Canada's economy, yet as the report of Canada's Fundamental Science Review finds, Canada's position in science and innovation has fallen out of step with the G20. Our global position in science is declining across a range of measures relative to our peers. Nowhere is this more important than in the health care sector, which accounts for over 10% of Canada's GDP, contributing to longer lifespans, improved quality of work, and higher productivity for the entire economy.
As a nation, we are failing to provide a thriving environment where our scientists and innovators can drive productivity. Simply put, the decline in funding is untenable for our nation. Particularly affected are early career investigators who are finding it more and more difficult to establish their careers due to the limited funding available for their research. These investigators are our future for driving the innovation of the 21st century.
Our health sector and research institutes are major employers that help local economies thrive. Canada plays host to 777 general hospitals, 304 specialty hospitals, and 115 psychiatric hospitals in addition to 19 pediatric hospitals. These hospitals operate at the leading edge of health research. Every dollar invested in fundamental research is estimated to result in a two-fold to five-fold increase in returns to Canada. This also contributes 20% to 60% to pay for itself, saving the health care dollars within five years. Thus this is an important aspect of research that leads to sustainability and better outcomes for our patients.
With this in mind, HealthCareCAN fully supports the recommendations in the final report of Canada's Fundamental Science Review, which was released last year. As recommended in the report, we recommend that the federal government invest $485 million over four years for investigator-led research. Such an investment will help restore Canada's international competitiveness.
A related topic is health infrastructure. Health care organizations maintain, operate, and use key elements of the country's critical infrastructure. National and international accidents and hazards affect the sector's response to result in a crisis. An example of that would be the SARS infection several years ago where Canada was a lead in actually containing that across the country.
Aging physical and technology infrastructure has been identified as a key risk to Canada's overall resilience in health care. Canada's hospitals face an accumulated deferred maintenance cost of approximately $28 billion. A recent study found that health care facilities are among the oldest infrastructures in use today, with 40% of the inventory being older than 50 years. As you would hope, you would expect up-to-date, state-of-the-art facilities if you happened to be in a health care facility.
With regard to research, for the past 10 years, research hospitals, where the bulk of the research is conducted, have been excluded from directly applying to federally funded infrastructure funds. In a welcome change, the 2016 post-secondary institutions strategic investment fund reversed this trend. We really appreciate this opportunity coming from the current government.
This is not to say that the government does not support research through hospital infrastructure. We are most grateful for the federal support of the Canada Foundation for Innovation, or CFI, which has been a strong supporter of research of hospitals in partnerships with universities. However, it still requires university-affiliated hospitals to obtain proposals to be submitted through the corresponding affiliated university.
I think this model reflects the misunderstanding of the nature of where the research is conducted. Within Vancouver Coastal Health, which would be greater Vancouver, we have over $300 million of health research, much of that federal research, conducted within the hospital system in infrastructure owned by the hospital, not by the universities. If you just go up the street in Richmond, you see that we have a small community hospital. We have research activity there, for example. This is typical across Canada. The major institutes of health research are research hospitals affiliated with a university.
What we are asking is that the government recognize that research hospitals should have the ability to directly compete for infrastructure funding from the government on equal footing. We are not asking for special privileges. We are just asking that the research hospitals be able to apply directly to whatever corresponding program the government has on at the moment. Typically, it would be the Canada Foundation for Innovation, and some of the innovation and infrastructure programs in existence.
We are also asking for $250 million for a second intake of the post-secondary institutions strategic investment fund, to help address the shortfall facing Canada's hospitals.
A third topic, somewhat unrelated to infrastructure but definitely related to innovation, concerns antimicrobial resistance and stewardship. Antimicrobial resistance refers to bacteria, viruses, and other pathogens that acquire resistance to the current drugs. This is a huge emerging worldwide problem that I would like to bring to the committee's attention.
At a basic level, infections are becoming more and more resistant to treatment. At the current rate, no part of modern medicine will be untouched, as many areas involve infection and inflammation. We will enter an era similar to the pre-1940s, prior to the discovery of antibiotics, meaning that many common diseases will not be able to be treated.
The U.K.'s review on antimicrobial resistance found that 10 million people around the world will die annually from infections by 2050, as we have lost the capacity to treat them with the current use of antibiotics. This estimate surpasses cancer mortality on the whole. The cost of ignoring antimicrobial resistance today will be paid many times in lost lives tomorrow.
I should say that Canada is a leader in antimicrobial resistance research. We should be proud of that.
Each year, over 23 million antimicrobial prescriptions are written in Canada. Half of these are estimated to be unnecessary. This leads to the generation of the pathogens' resistance. A better stewardship of antibiotics would benefit our economy, as well as our health. For example, in British Columbia, a 15% reduction in prescribing antimicrobials resulted in $50 million a year of cost savings for society, and $25 million for government.
The antimicrobial stewardship program is currently undersupported. HealthCareCAN has played a key advocacy role on this file and has convened a number of national networks of players, in collaboration with the Public Health Agency of Canada.
With this in mind, we recommend that the federal government allocate $25 million over five years to the Public Health Agency of Canada to fund projects on antimicrobial resistance and antimicrobial stewardship in collaboration with the Canadian antimicrobial stewardship network.
This concludes my remarks, and I'd like to thank you for giving me the opportunity to address you today.