Thank you for the question. I'll try to be as brief as possible.
On the CARSS, Canadian Antimicrobial Resistance Surveillance System, report, I apologize to the people who have done very hard work on it, but it relies on data of very poor quality, and I don't trust it for the paper that it's printed on. We have no current understanding of antimicrobial use in Canada and in most provinces. It's the same problem that we've had with opioids. If you can't properly, reliably, and validly identify the problem, it's very difficult to act on it. A basis has to reside with good data.
Yoshi and I are colleagues, and we've learned over time that leadership is absolutely important in this. I'm going to say that the national leadership around antimicrobial resistance has been largely deafening in its silence. We don't really have a national voice on antimicrobial resistance and stewardship. AMMI Canada likes to see itself as a partner with some of these other organizations here in taking a leadership role, but we need a more centralized role. It hasn't come from the federal organizations. For most provincial organizations as well, we haven't seen that.
Almost certainly what needs to be coupled with leadership and sound data is money that supports an infrastructure to share information across the country, to act on a plan that has been very carefully thought out, and to then be able to provide on a broad level and then at a very granular level the issues around antimicrobial use and antimicrobial resistance. They are intertwined; they are not separate. They are very closely related, and they include both humans and animals and other aspects of our “one health” ecosystem.
When we don't have significant money being put into the pot, we don't have leadership, we don't have reliable data, and we aren't going to go anywhere without those foundations.